Bakko Matthew, Swanson Leonard, Zettner Catherine, Kok Kaitlyn, Fukuzawa Hosanna, Kubiak Sheryl
School of Social Work, Wayne State University, Detroit, MI, USA.
Center for Behavioral Health and Justice, Wayne State University, Detroit, MI, USA.
Community Ment Health J. 2025 Aug;61(6):1072-1082. doi: 10.1007/s10597-024-01447-4. Epub 2025 Jan 3.
Various behavioral health crisis models have been developed to advance the shared goals of improving behavioral health outcomes and increasing diversion from criminal legal systems. The effectiveness of these models is promising, yet research is needed to understand their comparative advantages. This study compares the effectiveness of three community mental health response models-co-response, mobile response, and office-based response-and law enforcement-only response in addressing key behavioral health and diversion goals. These goals include improvements to follow-ups, service linkages to community resources, crisis de-escalation, and dispositions (i.e., decreasing hospitalizations and arrests). Five partner sites in Michigan provided administrative data on crisis cases and outcomes. The sample included crisis cases from one office-based model (n = 91), two mobile response models (n = 306), and two co-response models (n = 322), along with data from the partnering law enforcement agencies at each site (n = 669). Results show that model type is associated with all key outcomes. Mobile response effectively met all examined crisis response goals, including by resolving crises informally or without hospitalization, providing links to community services, and conducting follow-ups. Co-response showed some success in meeting goals, while the law enforcement-only model showed more limited results. Additionally, law enforcement presence during a mobile crisis response produced worse disposition outcomes, while contacting a CMH during law enforcement response produced better disposition outcomes. Overall, this study contributes to SAMHSA's (2020) crisis response vision to effectively meet the behavioral health needs of those in need of service by providing "someone to respond."
为了推进改善行为健康结果和增加从刑事法律系统分流的共同目标，已经开发了各种行为健康危机模型。这些模型的有效性很有前景，但仍需要进行研究以了解它们的相对优势。本研究比较了三种社区心理健康应对模型——联合应对、移动应对和基于办公室的应对——以及仅由执法部门应对在实现关键行为健康和分流目标方面的有效性。这些目标包括改进后续跟进、与社区资源的服务联系、危机降级以及处置方式（即减少住院和逮捕）。密歇根州的五个合作站点提供了危机案例和结果的行政数据。样本包括来自一种基于办公室的模型的危机案例（n = 91）、两种移动应对模型的危机案例（n = 306）和两种联合应对模型的危机案例（n = 322），以及每个站点合作执法机构的数据（n = 669）。结果表明，模型类型与所有关键结果相关。移动应对有效地实现了所有考察的危机应对目标，包括通过非正式方式或不住院解决危机、提供与社区服务的联系以及进行后续跟进。联合应对在实现目标方面取得了一些成功，而仅由执法部门参与的模型效果较为有限。此外，在移动危机应对期间执法人员在场会产生更差的处置结果，而在执法应对期间联系社区心理健康机构会产生更好的处置结果。总体而言，本研究通过提供“有人来应对”，为美国药物滥用和精神健康服务管理局（2020）的危机应对愿景做出了贡献，以有效满足有服务需求者的行为健康需求。
