5.5 Crisis Services for Special Populations
An important focus for states trying to improve their crisis response systems is ensuring those services meet the needs of diverse groups. To be effective, crisis response must be available to anyone, anytime, anywhere. This includes availability to populations that are traditionally overlooked in planning, yet who we understand to be especially vulnerable to harm. The federal agency SAMHSA surveys states’ progress toward meeting these goals, helping to identify areas of improvement as well as shortfalls and areas for growth.
In SAMHSA’s 2023 summary report on behavioral health crisis systems nationwide, 21 states reported that their crisis systems “recognized” racially and ethnically diverse communities and acknowledged their overrepresentation in the mental health and correctional systems. However, disappointingly few states were able to “describe how crisis services systems will be tailored to address the unique needs of diverse racial and ethnic communities” (SAMHSA, 2023c). Oregon is one state that has articulated some plans in this area, including the development of a workgroup focused on improving crisis services for Black, Indigenous, and people of color (BIPOC) communities. Likewise, Wisconsin is implementing a peer-run “warmline” to support diverse populations across the state; peers will identify as Latinx, Black, or Hmong. Virginia also reports efforts to improve relationships between the various organizations in the crisis response system to ensure BIPOC leadership and participation in services and research.
The city of Minneapolis has launched efforts to provide mobile crisis teams ready to respond to underserved populations and people of color, with particular recognition of the stigma that may be associated with their services in certain communities. Watch the short video link in figure 5.17 to hear from one Minneapolis crisis responder.
Eighteen states claim engagement in activities related to improving crisis services for Native Americans and/or Alaska Natives. Most of these states are collaborating with tribal communities and governments to ensure that services are culturally relevant and meet the unique needs of tribal populations. Alaska reported a need to address access challenges where roads are lacking and travel is limited to air or water. Access is key to making sure people in these communities who need services do not have to be transported hundreds of miles away from their homes, families, and cultural traditions (figure 5.18).
A minority of states (16, including Oregon and Washington) provide crisis services specifically targeted to individuals in the LGBTQIA+ community. More states reported efforts to address crisis needs in elderly populations, and almost all states currently have specific crisis services in place for children. For children, states have been seeking to expand crisis services in schools and to grow the crisis workforce (including peers) for children and youth. One National Suicide Prevention Lifeline site in Oregon provides youth- and young-adult-specific text services through the Youthline. Mobile Crisis Response is also available for children and youth in Oregon.
Additional special populations that many states consider specifically in crisis planning include veterans, people living in remote or rural areas, and people with co-occuring mental health disorders (e.g., gambling or substance use disorders in addition to mental health needs). Targeting these populations, and all of those discussed in this section, to better understand and meet their needs is critical to an effective crisis response system that avoids the overuse of police responses and criminalization of mental disorders.
Licenses and Attributions for Crisis Services for Special Populations
Open Content, Shared Previously
“Crisis Services for Special Populations” by Anne Nichol is adapted from National Guidelines for Behavioral Health Crisis Care and Snapshot of Behavioral Health Crisis Services and Related Technical Assistance Needs Across the U.S., both by SAMHSA. Modifications by Anne Nichol, licensed CC BY 4.0, include editing, condensing, and expanding upon the content.
Figure 5.18. American Indian and Alaska Native People by Centers for Disease Control and Prevention is in the Public Domain.
All Rights Reserved Content
Figure 5.17. Mobile Crisis Services in Minneapolis by cityofminneapolis is licensed under the Standard YouTube License.
