What are Crisis Services?
Like a health crisis, a mental health, alcohol, or drug crisis can be hard for the person experiencing it. It is also hard on their loved ones and their community. In the moment, the person may feel overwhelmed or unable to cope with what is happening. Some crises include safety concerns for the person or those around them.
Crisis Services are for anyone, anywhere and anytime. They are the first line of care in helping people and preventing tragedies. DMH strives to use the best tools and practices to meet the needs of people in crisis. The goal is to help each person work through the crisis so they can get back to how they were doing before it happened. This can be done in different types of settings. Missouri follows national best practices to provide crisis services in three ways:
- Someone to talk to: 988 crisis line workers accept all calls, texts, and chats. They help with the immediate need and can connect people to resources for ongoing help;
- Someone to respond: If help from the crisis line is not enough, a mobile team can respond to meet the person where they are in the community and provide in-person help;
- Somewhere to go: If a person needs more help than a mobile team can provide, they can go to a crisis center. Crisis centers provide more intense help for up to 23 hours and can usually help the person not need to be hospitalized.
Someone to Talk To:
988 - The three digit number for anyone going through a mental health, drug or alcohol crisis. The goal of 988 is to connect people to a Crisis Specialist 24/7 through call, chat or text. DMH is working with seven National Suicide Prevention Lifeline centers located in Missouri to handle all 988 contacts that come from Missouri. Together, the seven centers cover each county in Missouri, including the City of St. Louis. Click here for a 988 infographic.
How Does It Work?
When someone in crisis calls, texts, or chats, 988, they will be connected to a crisis specialist who is trained and prepared to deliver crisis support in the moment. Because a crisis is defined by the individual or family experiencing it, the crisis specialist will work with the person to understand and address their needs and concerns. The crisis specialist will also work with them to connect to ongoing resources and supports if needed.
When Should You Call 988?
If you are thinking about suicide, are experiencing a mental health or substance use crisis, or are worried about a friend or loved one, reach out to the 988 Suicide & Crisis Lifeline for support by calling or texting 988, or chatting at 988 Lifeline Chat and Text : Lifeline
Someone to Respond:
Mobile Crisis Response - If help from the crisis line is not enough, a mobile team can respond to meet the person where they are in the community to help them through their crisis.
How Does it Work?
Mobile Crisis Response services offer onsite response to help the person in crisis. Peer Specialists (who have lived through what the person in crisis may be going through) and Mental Health Professionals will respond to where the person is. When the crisis is resolved, the person is connected to the medical and mental health services they need to help prevent future crisis situations. Now that mobile crisis response is available to more people in the state, help will be available 24 hours a day, seven days a week.
Somewhere to Go:
Behavioral Health Crisis Centers - provide a place for people to go who are in crisis for short periods of time. Behavioral Health Crisis Centers (BHCCs) are used if the person’s crisis is not resolved over the phone or in person with a mobile crisis response. This may prevent the person from needing to go to an emergency or room jail. A goal of BHCCs is to provide a safe space for the person to receive mental health and drug services for their crisis. BHCCs have an open door policy. No one needing help will be turned away because they cannot pay or do not have insurance. Click here for a BHCC infographic.
How Does it Work?
Behavioral Health Crisis Centers (BHCCs) provide care that brings the person back to their normal functioning before the crisis started. They connect the person to community resources to make sure the person stays safe and has a plan to help prevent future crises. BHCC’s provide walk-in services. They also give law enforcement options other than taking the person to the emergency room or jail. More information on BHCCs, including contact information can be found at: Behavioral Health Crisis Centers.
- Missouri Crisis Service Newsletters
- Additional Crisis Related Resources
Access Crisis Intervention (ACI)
- Access Crisis Intervention (ACI) are crisis intervention/referral services that are provided 24/7/365 by telephone hotline and available statewide. Click here for the ACI statewide map.
Crisis Residential Programs
- Crisis Residential Programs serve people who may not be able to recover at a BHCC within 23 hours. They provide help in a home-like setting. A person can access peer support, one-on-one counseling, and group counseling services. Medication services are also offered. These short-term services can help people avoid needing to be hospitalized. Before discharge, the programs connect people to services in their community to provide ongoing help.
- Sobering Centers provide supervised care for people to safely recover from the effects of alcohol and drugs. They operate 24 hours per day, 7 days per week. Care can be provided for up to 23 hours. To receive services, a person must be nonviolent. A Sobering Center may not accept all walk-ins.
Emergency Room Enhancement (ERE)
- Emergency Room Enhancement programs were designed to reduce barriers that prevent individuals from seeking care in the most appropriate setting. ERE programs aim to reduce the use of emergency departments and hospitalizations as well as decrease rates of homelessness, unemployment, and arrests/law enforcement involvement by engaging individuals into treatment and utilizing community supports. Click here for more information on ERE.
Crisis Intervention Team (CIT)
- The Missouri CIT program is a partnership that includes law enforcement, behavioral health providers, hospitals, the court system, individuals with lived experience and community partners who are dedicated to implementing the Missouri Model of CIT. The goals of CIT are to promote more effective interactions between law enforcement and individuals in crisis through a 40 hour training centered on behavioral health education and de-escalation skills; Help individuals in crisis by connecting them with appropriate community resources in an effort to divert involvement with the criminal justice system, Improve the safety of the officer and individuals in crisis; Reduce stigma; and Expand CIT across the state. Click here for more information on CIT Missouri CIT Council.
Community Outreach - Missouri Liaisons
- For more information about Community Behavioral Health Liaisons (CBHLs), and Youth Behavioral Health Liaisons (YBHLs) click here.
- Missouri 988 Website - https://missouri988.org/
- Suicide Prevention & 988 Guide for Missouri Schools - 988_Guide for Schools by John Ginwright - Flipsnack
- Missouri Suicide Prevention Network – https://www.mospn.org/
- Statewide Suicide Prevention – https://dmh.mo.gov/behavioral-health/suicide-prevention
- National Guidelines for Behavioral Health Crisis Care -national-guidelines-for-behavioral-health-crisis-care-02242020.pdf (samhsa.gov)
- National Guidelines for Child & Youth Behavioral Health Crisis Care - https://store.samhsa.gov/product/national-guidelines-child-and-youth-behavioral-health-crisis-care/pep22-01-02-001
- National 988 Information - https://www.samhsa.gov/find-help/988
- 988 & the Answering the Call Collaborative - https://988answeringthecall.org/
- Other Crisis Assistance - https://dmh.mo.gov/crisis-assistance
- Tradeoffs Podcast Episode: Answering the Call Podcast Series - https://tradeoffs.org/answeringthecall/