SAMHSA2025-03-172025-03-172025-01-15Substance Abuse and Mental Health Services Administration: Model Definitions for Behavioral Health Emergency, Crisis, and Crisis-Related Services. HHS Publication No. SMA XX–xxxx [or PEPXX-XX-XX- XXX]: Substance Abuse and Mental Health Serviceshttps://archive.hshsl.umaryland.edu/handle/10713/23228ReportCrisis services have been undergoing a rapid expansion of growth that has been catalyzed since the release of the 2020 National Guidelines for Behavioral Health Crisis Care Best Practice Toolkit and the transition of the National Suicide Prevention Lifeline to the 988 Suicide & Crisis Lifeline (988 Lifeline). In light of this expansion, communities have been designing crisis systems to meet their specific needs, which has created widespread variability in the landscape of crisis care. In order to coalesce and optimize alignment of this burgeoning field while supporting expansion and sustainability in a manner whereby crisis care will continue to meet the unique needs of communities, this Model Definitions for Behavioral Health Emergency, Crisis, and Crisis-Related Services (Model Definitions) document was developed. The content of this document, through the development of more uniform definitions, seeks to promote service quality and consistency, and further payer adoption of emergency, crisis, and crisis-related behavioral health services. Achieving these goals will support increased access to quality, equitable emergency, and crisis care for all individualsForeword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Overarching Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Crisis System Component: Someone to Contact. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 1. 2. 988 Suicide & Crisis Lifeline (988 Lifeline) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 Other Behavioral Health Crisis Hotlines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 3. 4. Peer-Operated Warmlines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 Other Behavioral Health Emotional Support Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 Crisis System Component: Someone to Respond. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 5. 6. 7. 8. Behavioral Health Practitioner-Only (BHP-Only) MCT Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34 Co-Responder MCT Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38 Mobile Response and Stabilization Services (MRSS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 Community Outreach Teams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46 Crisis System Component: A Safe Place for Help. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 No-Barrier or Low-Barrier Crisis Stabilization Settings 9. Hospital-Based Behavioral Health Emergency Stabilization Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50 10. High-Intensity Behavioral Health Emergency Centers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53 11. High-Intensity Behavioral Health Extended Stabilization Centers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55 12. Moderate-Intensity Behavioral Health Crisis Centers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58 13. Moderate-Intensity Behavioral Health Extended Stabilization Centers . . . . . . . . . . . . . . . . . . . . . . . . . . .60 14. Behavioral Health Urgent Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63 15. Peer Crisis Respite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65 16. Sobering Centers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67 Referral Based Residential Services 17. Moderate-Intensity Crisis Residential Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70 18. Low-Intensity Crisis Residential Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73 19. Community Crisis Respite Apartments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75 Services Specific to Children, Youth, & Families 20. Children, Youth, and Families . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77 20A. In-Home Stabilization Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78 20B. Youth & Family Crisis Respite Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Behavioral Health Crisis Services Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Endnotes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95en-USAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Behavioral HealthCrisis Care988 Crisis LineCommunity HealthLandscape of Crisis CareAnnual Report