Alternative Response Models for Behavioral Health
Written by Sophia Cassim, Public Health Intern
March 17, 2025 – Behavioral health challenges touch many parts of our communities, including schools, neighborhoods, workplaces, and homes. Responses to these challenges have come from many sectors and one of the most prominent is from those in public safety. To address these challenges, public safety professionals has developed models to embrace greater community collaboration and promote connections to local resources.
Types of Alternative Response Models
Many response models have arisen to provide individually tailored and comprehensive responses for individuals experiencing behavioral health challenges. This blog post explores three common models, each with its own structure, implementation, and impacts. These models are Crisis Intervention Team (CIT) Training, Co-Response Team (CRT), and Mobile Crisis Team (MCT).
| Crisis Intervention Team (CIT) Training | Co-Response Team (CRT) | Mobile Crisis Team (MCT) |
| Description:
Police officers are trained in de-escalation, communication strategies, & trauma-informed skills |
Description:
Trained police officer & mental health personnel respond together to behavioral health call |
Description:
Team of behavioral health clinicians, crisis workers, emergency medical technicians or paramedics respond together to behavioral health call |
| Structure:
40 hour training including lectures from mental health professionals, scenario based training, Q&A |
Structure:
housed in police department or separate (health department, community mental health center) |
Structure:
mainly operates independently, designed to reach people in their home or community-based location |
| Public Health Outcomes:
forms positive community relationships, reduces stigmatizing attitudes, increases connection to resources |
Public Health Outcomes:
reduces ED transports & use of force on scene, promotes service use following initial contact |
Public Health Outcomes:
enhances connection to community-based care, promotes shared understanding with individual’s situation |
Guidance for Massachusetts’ Municipalities to Adapt Public Safety Responses to Behavioral Health
While these models may look different, they have the common goal of redesigning public safety. Communities may consider the following steps when entering this work.
Understand the outcomes of the current system and identify who is being underserved
To begin engaging with alternative response models, municipalities should explore the discrepancies of the current systems. Who’s not getting the help they need? What are the goals of their new response model? Municipalities should compare the public health outcomes of each model to evaluate the best fit. It’s important to involve the community in the design and implementation of programs through community-based participatory research, community assessments, advisory boards, and surveying front line workers.
Gather information on existing community structures, relationships, funding, perceptions, etc.
Before establishing details of the program, collecting feedback on the community’s existing dynamics can identify strengths and areas for improvement. For example, the City of Lynn formed a committee of activists, mental health and public personnel to determine which models work best for them. One health director suggested mapping out available services and talking with a diverse range of community members to gauge facilitators and barriers of utilizing services.
Hold regular meetings to establish roles, safety protocols, data processes, and evaluation
Regular meetings with program stakeholders can help determine key program details, such as streamlining data to coordinate resources and establishing safety protocols. Developing a strong data collection process helps provide a snapshot of the program’s impact and can attract external support. There should be continuous evaluation of these metrics to ensure emerging gaps of care are addressed and to incorporate the community’s input to shape the program’s future.
Acknowledge resistance, maintain commitment to work, and be open to learning & pivoting based on feedback
A core component of a program’s success is the culture of the response team and the collaboration of program leaders. Training, such as CIT Training, can build a foundation of trust and skills. Framing the program’s goals within the scope of each profession can ease concerns of stepping over boundaries and help establish clear roles. Programs should embrace adapting their goals based on community feedback.
Recommended Implementation Steps
The process below serves as a follow-up to the guidance offered in the previous section. It proposes a path towards adopting a model and, through experience with implementation, opportunities to evolve.
Overall, these steps are very dependent on the dynamics and relationships of a municipality. Implementation of these models may look different for each community. A community with strong mental health resources may be able to start with a mobile crisis team right away. Or, if a community faces resistance, engaging in smaller steps to develop an alternative response may be more attainable.
The key idea behind alternative response models is that “it’s not about crime reduction – it’s about service provision,” as one health expert stated. Crafting safety interventions based on emerging community-oriented needs ensure that individuals will get the support they need. With these frameworks, MAPC can be a resource to municipalities who are considering implementing alternative response models or revising their existing structures to promote more equitable access to mental health services.
Additional resources:
Winthrop Community and Law Enforcement Assisted Recovery (CLEAR)
Boston Emergency Services Team of the Boston Medical Center
Cambridge Community Safety Department Community Assistance Response and Engagement (CARE) Team