PREPARED FOR:

Vibrant Emotional Health 

As Funded by the Substance Abuse and Mental Health Services Administration

(SAMHSA)

 This publication was made possible by Grant Number H79SM085392 from SAMHSA.

Its contents are solely the responsibility of the authors and do not necessarily 

represent the official views of the SAMHSA

AUTHORED BY:

Matthew L. Goldman, MD, MS

Preston Looper, MS, LPC-S

Rachel Odes, PhD, RN

2023

Mobile Crisis Teams

National Survey of 
2

Mobile Crisis Teams

National Survey of 2023 

National Survey of Mobile Crisis Teams – Summary Report

Table of Contents

1. Introduction 3-4

2. Methods 4

3. Results

FINDING #1: MCT Geographic Distribution, Areas Served, and Contexts are Diverse 5-6

FINDING #2: MCTs Themselves are Diverse Operationally and Administratively 6-8

FINDING #3: There is a Gap Between the Vision and Reality for MCT Scale and Reach 8-10

FINDING #4: Operational Integration Between MCTs and the Crisis Continuum is Limited 10-12

FINDING #5: MCTs Collaborate with Law Enforcement on Multiple Key Functions 12-13

FINDING #6: Metrics Tracked by MCTs are Incomplete 13-14

FINDING #7: Clinical Best Practices and Partnerships are Unevenly Adopted Across MCTs 15-16

4. Discussion

Policy Implication 16-17

Limitations 18

5. Conclusion 19

6. References 20-21

Appendix A: Definition of MCT Program vs. Team #

Appendix B: Table of recruitment activities #

Appendix C: Table of respondents’ states #

Appendix D: Summary figures for all survey questions #

Appendix E: Survey Questions
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Mobile Crisis Teams

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1. INTRODUCTION

Mobile Crisis Teams (MCTs) have received increased interest and attention prior to and since the 

national launch of the 988 Suicide & Crisis Lifeline in July 2022. MCTs are the “someone to respond” 

component of the three pillars of the crisis continuum, as defined by the Substance Abuse and Mental 

Health Services Administration (SAMHSA): “someone to call, someone to respond, and someplace to 

go.” In this context, policies related to MCTs in the form of guidelines (1–3), regulations and financing 

(4,5) have surged and will likely continue. However, these initiatives and investments have occurred in 

the absence of a clear picture of the reach, operational configurations, and clinical best practices 

currently in place among MCTs across the US. 

This National Survey of MCTs is the most comprehensive national survey of MCTs to date. This survey 

was intended to describe the national landscape of MCTs to inform the development of local, state, 

and federal roadmaps for crisis care systems. By describing a baseline of MCT characteristics and 

identifying gaps, crisis system administrators will be better equipped to develop policies, refine funding 

priorities, and optimize implementation planning. This survey further aims to serve as a stepping stone 

to a national platform that can be used to identify and contact MCTs by referring agencies such as 988 

contact centers, behavioral health providers, first responders, and others. Question sections in the 

survey included service areas and partnerships, program and team structure, clinical scope, technology 

use, financing/billing/revenue, quality, and incentives (see Appendix for a complete list of survey 

questions).

First developed in the 1970s, MCTs have been prioritized by policymakers as a way of addressing 

Emergency Department (ED) boarding of psychiatric patients and inadequate psychiatric inpatient bed 

capacity (6–9). MCTs have a unique ability to respond rapidly in a less restrictive environment and to 

coordinate with community partners such as Law Enforcement, Criminal Justice Systems and EDs to 

divert people from those settings (10–12). Over the years, MCT programs have been implemented to 

supplement existing emergency response systems as a way of reaching high-risk individuals who may 

not otherwise access specialty behavioral health care. Single-site research studies have shown that 

MCTs can decrease emergency department utilization and psychiatric hospitalization among people in 

crisis, thus reducing costs while simultaneously increasing engagement in community-based care (13–

18). MCTs are more favorably perceived by people who receive these services than a law enforcement 

response (12). 

Despite this modest body of research supporting the effectiveness of these programs, there remains a 

large gap in our knowledge of what constitutes MCTs across the United States. Though there is broad 

consensus that evidence should inform both policymaking and program operations, without a better 

understanding of what factors facilitate versus impede the effectiveness and long-term impacts of 

these programs, it is challenging to develop guidance that can be consistently applied across various 

unique contexts. 

Given that national 988 crisis line implementation includes MCT dispatch as a high priority of a wellfunctioning crisis system, there has been a significant increase in interest in MCTs including new 

legislation, significant funding opportunities, and a proliferation of models (e.g., civilian vs. police co-
4

Mobile Crisis Teams

National Survey of 2023 

responder, solo response vs. 2- to 3-person teams, paramedic vs. law enforcement first responder 

partnerships, peer involvement, self-dispatch vs. hotline or 911 dispatch, and others). Our intent with 

the National Survey of MCTs is to be inclusive and survey all typologies. This initial landscape analysis 

lays out a path to begin standardizing nomenclature, setting the foundation for comparison analyses, 

and improving the quality and outcomes of MCT services nationally. 

2. METHODS

The National MCT survey is a 51-question tool developed by the authors of this report in collaboration 

with leadership of Vibrant Emotional Health, the Substance Abuse and Mental Health Services 

Administration (SAMHSA), and the National Association of State Mental Health Program Directors 

(NASMHPD); see appendix for complete survey questions. The survey was open between January 12 

and March 31, 2022. A convenience sampling strategy was used to disseminate the survey directly to a 

list of email addresses associated with MCT programs (see Appendix for a definition of MCT program), 

as well as email listservs and newsletters for national crisis services stakeholder groups such as 

SAMHSA, NASMHPD, the National Council for Mental Wellbeing, and others (see Appendix for a 

complete list of dissemination activities). United States territories were not recruited for the survey. 

To encourage as many responses as possible, all questions were made optional, so the total number of 

responses to each question varies depending on the responses received. Furthermore, programs were 

encouraged to share contact information but were given the option to respond to this survey 

anonymously to mitigate potential reporting bias. Study procedures were approved by the University 

of California, San Francisco, Human Research Protection Program’s Internal Review Board as exempt 

and requiring limited review (IRB #22-36148). 

A total of 1,290 responses were completed by MCT 

programs, however, only the responses that provided their 

state (N=562) were included due to significant missingness 

of data among respondents who did not provide a state 

(728 respondents, which answered on average fewer than 3 

questions). Of those 562 responses, 153 respondents 

indicated a preference for anonymity. Duplicate responses 

(n=8) among identified responses were excluded for a final 

total of 554 responses. Out of the 51 total questions, a mean of 39 and median of 46 questions had 

complete responses in the final sample. 

Respondent roles included MCT Program Director/Manager (43%), Front-Line MCT Clinician (19%), 

MCT Clinical Supervisor (12%), and Executive Director or CEO of the organization that oversees the 

MCT program (10%). 

45 states included at least one response, except for Rhode Island, Washington DC, Minnesota, North 

Dakota, Wyoming, and Hawai’i. 
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Mobile Crisis Teams

National Survey of 2023 

3. RESULTS

FINDING #1: MCT Geographic Distribution, Areas Served, and 

Contexts are Diverse

MCTs across the US states are serving incredibly diverse regions in terms of geographic unit (county, 

region, city, state, etc.), population served (number of persons residing in the catchment area), and 

population density (urban, suburban, rural, and frontier1).

SUMMARY OF FINDINGS

The majority of MCTs provide services for a county or 

region (multiple counties), 51% and 31% respectively. 

The minority provide services for a city or entire 

state, 8% combined. MCTs are evenly distributed 

(approximately 1/3rd each) based upon population 

served (<100,000, 100,000-500,000, and >500,000). 

Mixed population density (both rural/frontier and 

urban/suburban) was more common (43%) than only 

high or low density. The most common factors 

reported as barriers to providing MCT services were 

long distances, poor Wi-Fi/cellular connectivity, 

snow, and traffic.

TAKEAWAYS

MCTs operate in a wide range of service areas and 

population sizes/densities. Three natural cohorts 

were identified based on the population of the 

service area (<100,000, 100,000-500,000, and 

>500,000); we will use these groupings while 

presenting subsequent findings given that these 

cohorts may be leveraged to guide program design, 

implementation, technical assistance, and learning 

collaborative groupings. Variations across frontier, 

rural, suburban, and urban settings suggest that MCT 

programs will need to emphasize different 

competencies to address different population needs 

and presentation patterns. 

One size will not fit all. MCT program design and 

reality-based implementation will require balancing 

standards, best practices, and local-regional context. 

1 The authors acknowledge that “frontier” is no longer the preferred term based on feedback from indigenous 

populations and regret its use in this survey; the decision was made to keep this term in this report to prioritize 

transparent and accurate reporting given that this was the option made available to survey respondents. 

City or 

smaller 72

(13%)

County

278

(51%)

Region 

(more than 

one county)

171 (31%)

State

30 (5%)

Geographic unit served (n=551)

Low density 

(rural/frontier)

124 (23%)

Mixed 

density

229 (43%)

High density 

(urban/suburban)

183 (34%)

Population Density (n=536)

<100,000 

people

162 (32%)

100,000 -

500,000 

people

183 (37%)

>500,000 

people

155 (31%)

Population Served (n=500) 
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FINDING #2: MCTs Themselves are Diverse Operationally and 

Administratively

Given the regional diversity that shapes the service areas of MCTs, it is to be expected that there is 

considerable variability in how MCTs themselves are structured. The national survey identified a wide 

range of operational and administrative approaches.

SUMMARY OF FINDINGS

Nearly 70% of MCT programs 

serve fewer than 200 clients 

per month, and just 10% 

serve more than 500 clients 

per month. MCTs serving 

smaller populations more 

often serve fewer clients, and 

programs serving larger 

populations serve more 

clients monthly, but this 

trend is not absolute–nearly 

half of MCT programs in 

catchment areas larger than 

500,000 people are reaching 

fewer than 200 clients per 

month. 

Regarding MCT staffing 

composition, 98% of 

programs that responded 

to the survey include a 

behavioral health 

provider, which indicates 

that respondents are 

truly mobile crisis and coresponder programs. Law 

enforcement and EMTs 

are more often a part of 

MCT staff in larger 

service areas, whereas 

there are fewer peers 

and more medical 

personnel in smaller 

service areas. 

118

17

7

110

31

11

61

38

24

0 50 100 150 200 250 300

<200 clients/month (N=289)

200-500 clients/month (N=86)

>500 clients/month (N=42)

Number of respondents

Clients served per month (n=417)

<100,000 pop 100,000 - 500,000 pop >500,000 pop

27%

38%

10%

20%

100%

27%

39%

7%

16%

99%

32%

30%

7%

15%

94%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Medical personnel

Peer specialist

EMT/paramedic

Police/law enforcement

Any behavioral health provider

Personnel present on MCT (n=381)

<100,000 pop (N=124) 100,000 - 500,000 pop (N=147) >500,000 pop (N=110)
7

Mobile Crisis Teams

National Survey of 2023 

Another key issue is how 

MCTs provide 

transportation when 

needed. MCT programs 

in smaller service areas 

use personal vehicles 

more often, whereas 

program-owned vehicles, 

police cruisers, and 

ambulances are more 

often used in larger 

service areas. 

Finally, financing of MCT services 

is highly variable. Most MCTs are 

supported by braided funding 

sources, meaning they receive a 

combination of insurance, 

federal block grants, and/or state 

or local general funds. MCT 

programs in smaller service areas 

more often rely on only federal 

block grants, whereas larger 

service areas more often rely on 

only state/regional funding. 

TAKEAWAYS

MCTs vary in their administrative oversight, workflow and dispatch processes, team composition, and 

justification for payment. This finding is unsurprising given the variability of service areas large and 

small, rural and urban, highly resourced and under-resourced. However, the need for local adaptation 

may present a challenge to the goal of eventually setting quality standards and communicating to the 

public about what to expect with an MCT response. By contrast, when someone feels chest pain and 

calls an ambulance, there is a reasonably consistent understanding across the US that an emergency 

medical response will assist with evaluation, triage, and transportation. The variability of survey 

responses suggests that no such consistent understanding currently exists for MCTs. 

To move towards the goal of defining and ensuring high-quality standards among MCTs, there is a need 

for technical assistance for MCT programs to support local tailoring while still meeting public and 

quality expectations. There is also a lack of clear evidence or guidelines regarding optimal team 

compositions, transportation policies, dispatch and triage protocols, and productivity expectations–all 

areas that will benefit from continued research as MCTs are implemented and studied across the US. 

Though operational variation may present a challenge to standardization, there is a clear need to 

define expectations and achieve minimum standards in MCT service delivery across the nation.

24%

21%

55%

50%

16%

17%

46%

58%

11%

13%

42%

68%

0% 20% 40% 60% 80% 100%

Other*

Police cruiser

Program-owned vehicle

Personal vehicle

Vehicles used for client transportation (n=440)

<100,000 pop (N=146) 100,000-500,000 pop (N=160) >500,000 pop (N=134)

*Other includes ambulance, 

paramedicine vehicle, and "other"

27

9

7

82

33

12

10

81

39

5

7

63

0 50 100 150 200 250

State/regional funding only

Federal block-grant only

Insurance only

Braided

Number of respondents

Funding/insurance and population size 

(N=385)

<100,000 pop 100,000 - 500,000 pop >500,000 pop
8

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National Survey of 2023 

FINDING #3: There is a Gap Between the Vision and Reality for MCT 

Scale and Reach

The vision of nationwide availability of MCT services that operate 24/7/365 and demonstrate high 

capacity and responsivity is laudable. Results of this national survey suggest a significant gap between 

this vision and reality. 

SUMMARY OF FINDINGS

MCT staffing in full-time 

equivalents (FTEs) revealed 

that 52.7% of MCTs reported 

<11 FTEs, 14.2% of MCTs 

reported 11.1-16 FTEs, and 

33.0% of MCTs reported >16 

FTEs. 70% of MCTs reported 

24/7 availability, yet only 

40% of MCTs reported both 

24/7 availability and >11 FTEs 

(minimum capacity for 2-

person, on-duty teams 

operating 24/7), suggesting 

that MCTs with <11 FTE may 

not be optimally operating 

24/7 with a 2-person team. 

FTE count demonstrated a 

positive correlation with 

population size: as the 

service area population 

increased, so did the 

proportion of larger teams. 

Capacity enhancers, such as 

shared staffing with affiliated 

programs and use of 

telehealth, are widely used 

across MCTs. The most 

frequently reported staff 

sharing arrangements were 

with behavioral outpatient 

providers, crisis hotlines, and 

58

27

16

5

18

41

48

21

18

19

11

16

17

21

45

0 20 40 60 80 100 120

<6 FTE

6-11 FTE

11.1-16 FTE

16.1-25 FTE

>25 FTE

Number of respondents

Total full time equivalent (FTE) staff (n=381)

44

101

50

112

39

96

0 50 100 150 200 250 300 350

Non-24 hour operation

24-hour operation

Number of respondents

Hours of MCT operation (n=442)

<100,000 pop 100,000-500,000 pop >500,000 pop

141

120

153

0 20 40 60 80 100 120 140 160 180

Crisis receiving/urgent walk-in

Crisis call line

Behavioral health outpatient

Number of respondents

MCT sharing staff with other programs (n=271)
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National Survey of 2023 

crisis receiving facilities. 

MCTs serving smaller 

populations (<500,000) 

reported greater utilization 

of capacity enhancers.

The most frequently reported 

modalities for use of 

telehealth included clinical

supervision, MCT visits, and 

psychiatry or medication 

consults. Utilization of these 

telehealth modalities demonstrated minimal variation based on population size served.

TAKEAWAYS

SAMHSA guidelines (1) describe the vision of connectivity between crisis hotlines and a national 

network of 24/7 MCTs as a consistent, universal behavioral health crisis response. However, the scale 

and reach of MCT programs in present day are far from meeting this vision. Specifically, whereas 70% 

of MCTs report 24/7 availability, when compared with the minimum staffing required for 24/7, onduty, 2-person teams, only 40% truly meet this threshold. 

Workforce shortages and funding limitations loom large in terms of achieving the necessary scale and 

capacity for a nationwide network of MCT programs that are 24/7, on-demand, and provide timely 

crisis response. Crisis service staffing requires scale to achieve the necessary backfill, redundancy, and 

workforce retention needed to meet the expectations and reliability of crisis response. These 

challenges are greater for MCTs programs serving less populated and population dense service areas. 

Additionally, staff retention is more difficult when programs are minimally staffed for 24/7 availability, 

given the increased stresses and demands on the skeleton crews covering all shifts. 

To expand access to MCTs, we believe there is a need for greater adoption of scale enhancers like 

shared staffing, telehealth solutions, and hybrid on-duty/on-call staffing models. Regulatory and 

financing mechanisms are also needed to support such approaches. Our experience suggests that scale 

enhancers have greater impact when augmenting an already strong foundation of staffing for 24/7 

coverage, rather than being used as strategies to achieve minimum capacity for 24/7 availability. 

If these gaps in funding and workforce cannot be closed, it raises the question if MCTs are truly a viable 

or appropriate solution for every community, particularly in low density population areas that are likely 

to be more expensive per capita. If not, then alternative solutions need to be developed to meet the 

needs of people in crisis.

141

181

98

0 50 100 150 200

All MCT visits

Clinical supervision

Psychiatry/medication consults

Number of respondents

Types of telehealth used by MCT (n=391)
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National Survey of 2023 

FINDING #4: Operational Integration Between MCTs and the Crisis 

Continuum is Limited

SAMHSA’s National Guidelines for Behavioral Health Crisis Care describe a continuum of services 

composed of call centers, mobile teams, stabilization facilities, and follow-up care. At the front end, 

this means MCTs should be integrated with crisis call centers, 911 providers, and other first responders 

such as law enforcement and emergency medical services (EMS). 

They also need to be well linked with after care settings to facilitate care transitions, including crisis 

facilities for those who need further stabilization and outpatient services for those who can safely 

remain in the community. It is therefore of interest to what degree MCTs report integration with these 

other components of the crisis continuum. 

SUMMARY OF FINDINGS

MCTs primarily interface 

with call centers that receive 

behavioral health crisis calls 

(e.g., non-NSPL, NSPL, and 

911) regarding requests for 

service and/or dispatch. 

MCTs reported that the way 

callers can reach them is 

variable, with most 

reporting they receive calls 

either from health 

providers, internal or selfdispatch, and 911 or other 

first responder agencies. 

Whereas only 32% of MCTs 

reported being reached via 

the National Suicide 

Prevention Lifeline (NSPL) 

(surveys were collected 

prior to launch of the 988 

Suicide & Crisis Lifeline), 

more than twice as many 

can be reached by other 

non-NSPL crisis lines. 

95

93

41

137

87

104

117

48

153

113

90

79

51

102

129

0 50 100 150 200 250 300 350 400

911 / EMS /

Law enforcement

Self-dispatch

(direct referral)

National Suicide Prevention

Lifeline /988

Health provider

Other crisis line

Number of respondents

How callers can reach a MCT (N=444)

<100,000 pop 100,000-500,000 pop >500,000 pop
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National Survey of 2023 

Community connections to 

facilitate post-crisis care 

were reported by 56% of 

MCTs that had arrangements 

with outpatient providers for 

drop-offs and care 

transitions. Only 24% of 

MCTs report using integrated 

electronic health records 

(EHRs) with systems that 

might be used for 

information sharing during 

care transitions. 

Regarding arrangements 

for care transitions, 59% of 

MCTs reported such 

arrangements with 

behavioral health crisis 

facilities, and 24% with 

psychiatric emergency 

services. 

A higher number of MCTs reported collecting metrics on post-crisis care follow-up, including 73% 

tracking referrals to outpatient-based services and 59% tracking outpatient clinic-based connections 

that followed the face-to-face MCT encounter. 

TAKEAWAYS

To meet the vision of SAMHSA’s crisis continuum guidelines, there is a critical need for coordination 

between MCTs and other continuum components, yet MCTs across the US states report continued silos 

and fragmentation. With so many different care systems involved, there is a need for centralized 

leadership, often at the county or regional level, to engage partners across the crisis continuum and 

develop operational workflows and written agreements that facilitate integration. Finally, the ability of

MCTs to connect people to care may be limited by the inadequate availability and capacity of crisis 

facilities and outpatient services, which suggests a need for investments in and expansions of postcrisis care at a scale commensurate with the crisis services themselves. 

56%

24%

73%

59%

47%

53%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Arrangement with outpatient provider for

drop-off and care transitions (N=395)

Use integrated EHR (N=476)

Track referrals to outpatient-based services

(N=374)

Track outpatient clinic-based connections

after MCT encounter (N=361)

Embedded within a public agency (civil

service) (N=472)

MCT contracted to a community provider

(N=472)

Community connections

24%

59%

0% 10% 20% 30% 40% 50% 60% 70%

Psychiatric emergency services (e.g. CPEP,

EmPATH unit)

Behavioral health crisis facilities (e.g.

residential, respite, stabilization unit)

Arrangements for care transitions with providers 

(N=395)
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Mobile Crisis Teams

National Survey of 2023 

FINDING #5: MCTs Collaborate with Law Enforcement on Multiple 

Key Functions

The role of law enforcement in mobile crisis response has taken many forms across the US. (11) In 

some cases, law enforcement agencies sought and received additional funding to add behavioral 

health clinicians to join their officers on mental health-related calls, termed “co-response” programs. 

In others, communities sought MCTs as a clinical alternative to having armed officers respond to crisis 

calls unless absolutely necessary for the safety of the person in crisis or the public. 

SUMMARY OF FINDINGS

Law enforcement was the 

most reported partner 

agency among MCTs at 87% 

of respondents. Law 

enforcement is a common 

provider of transportation, 

with 84% of MCTs reporting

some transportation by law 

enforcement. 64% of MCTs 

can be dispatched by law 

enforcement. 16% of MCTs 

reported including a law 

enforcement officer as part 

of the team in a co-responder 

model, and the same portion 

reported arriving on scene in 

a police cruiser. 

TAKEAWAYS

This landscape analysis indicates that law enforcement is the primary MCT collaboration partner across 

the nation and remains involved in multiple aspects of MCT work. This finding may reflect the common 

experience among MCT providers that there is a need to ensure safety for all—including providers, the 

public, and person in crisis—and that law enforcement officers provide security during response. 

However, many communities, especially minoritized and historically oppressed communities and 

others who have frequently experienced trauma during police interactions, have described feeling 

unsafe when law enforcement are present as part of a mental health response. While there may be 

consensus that certain cases such as extreme active violence or use of a loaded firearm may warrant 

law enforcement involvement, there remains significant gray area regarding the appropriateness and 

safety for MCT-only first response vs. when law enforcement support is needed for co-response. 

Localities should aim to develop a range of MCT options, including both civilian and police coresponder models, that limit law enforcement’s role only when necessary, with clearly defined triage

criteria that can be transparently communicated to the public. Crisis system administrators should 

increase engagement with communities to better understand local preferences and tailor these criteria 

to meet local needs. 

87%

84%

64%

54%

47%

20%

16%

16%

8%

0% 20% 40% 60% 80% 100%

Law enforcement is partnered agency (N=505)

Use law enforcement for transportation

under some circumstances (N=460)

Can be dispatched by law enforcement

(N=474)

Will not respond when high violence risk

(N=316)

Track when law enforcement support

requested (N=374)

Exclusively use law enforcement for

transportation (N=460)

MCT arrives on scene in police cruiser (N=468)

Include law enforcement as part of team

(co-responder models) (N=400)

Have law enforcement as primary oversight

(N=511)

Relationship with law enforcement
13

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National Survey of 2023 

FINDING #6: Metrics Tracked by MCTs are Incomplete

Quality metrics are foundational for monitoring attainment of programmatic objectives, demonstrating 

contractual compliance, justifying revenue, validating value-based payments, and comparing programs 

across jurisdictions. Core measures of MCTs include performance metrics (e.g., service volumes by 

encounter type, response time), process metrics (e.g., use of clinical best practices, downstream 

connection to community-based services, post-MCT follow-up rates), and outcome metrics (e.g., 

diversion from higher levels of care, symptom reduction, rates of suicide attempts and deaths) (19).

SUMMARY OF FINDINGS

When asked about the collection of 

metrics, 45% of MCTs reported not using 

any metrics to inform incentives or 

payments. As it relates to critical 

incidents, 71% of MCTs track staff 

injuries, 65% of MCTs track suicide deaths 

during and after MCT services, and 56% 

of MCTs track suicide attempts during 

and after MCT services. For point-ofservice outcomes, 44% of MCTs measure 

diversion rates and 23% of MCTs track 

when they are unable to locate clients. 

In terms of productivity, 69% of MCTs 

would be considered small (<200 clients 

served per month), and the minority 

would be considered medium (200-500 

clients per month) or large (>500 clients 

per month), with 20% and 10%, 

respectively. 69% of MCTs reported 

using stand-alone EHRs, and 26% of 

MCTs reporting using Word, Excel, or 

fillable PDFs for documentation (see 

Appendix, figure 37). 

TAKEAWAYS

The ability to demonstrate program performance, measure outcomes and perform continuous quality 

improvement is dependent upon adequate collection of metrics. MCTs have a unique vantage point to 

serve as a system of care barometer that informs ongoing transformation efforts. Yet many MCTs lack 

both the capacity and technological infrastructure to collect or report metrics, which suggests that 

metrics in MCTs are minimally developed or disseminated and may mean that best practices are not 

being utilized. Without collecting metrics, many MCTs are ill-equipped to prove their value or 

objectively advocate for adequate funding, and it is very challenging to compare analogous MCT 

programs across jurisdictions. MCTs would benefit from alignment with quality improvement activities. 

71%

71%

65%

56%

45%

44%

23%

0% 20% 40% 60% 80%

Track staff injuries (N=356)

Measure MCT response time

(N=367)

Tracking suicide deaths

during/after MCT service (N=356)

Track suicide attempts

during/after MCT service (N=356)

Do not use any metrics to inform

incentives (N=298)

Measure point-of-service

diversion rate (N=367)

Track when MCT unable to locate

client (N=367)

Outcome and process tracking

118

17

7

110

31

11

61

38

24

0 50 100 150 200 250 300

<200 clients/month (N=289)

200-500 clients/month (N=86)

>500 clients/month (N=42)

Number of respondents

Clients served per month (N=417)

<100,000 pop 100,000 - 500,000 pop >500,000 pop
14

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National Survey of 2023 

FINDING #7: Clinical Best Practices and Partnerships are Unevenly 

Adopted Across MCTs

Although MCTs have been studied for service outcomes, there is very little literature on clinical best 

practices in MCT settings. Clinical approaches in MCTs are therefore guided primarily by experts with 

experience in crisis service settings who are tasked with adapting general best practices to the unique 

context of MCTs. MCTs were queried about best practice adoption for suicide prevention, decision 

support, and field safety. 

SUMMARY OF FINDINGS

For the three main suicide 

prevention best practices 

(universal screening, safety 

planning, and reducing access to 

lethal means), 98% of MCTs 

reported utilizing any of these 

best practices, and 71% reported 

using all three.

The most frequently reported 

field safety strategies included 

reviewing available background 

data before meeting with the client (76%), requiring 2-person teams (59%), and attempting a phone 

call with the client or family before entering the scene (58%). 71% of MCTs reported using a decision 

support tool for level of care decision-making with the most frequent including the American Society of 

Addiction Medicine (ASAM) criteria, the Adult Needs and Strengths Assessment (ANSA) or Child and 

Adolescent Needs and Strengths (CANS), the Level of Care Utilization System (LOCUS) or its related 

instruments for children and adolescents (CA-LOCUS/CASII), and the DLA-20 Functional Assessment. 

The vast majority of MCTs serve all ages (85%), whereas 11% only serve adults and 4% serve only 

children. Among MCTs that serve children (89%), the most frequently reported collaboration partners 

include schools (84%), child protective services (68%), juvenile justice (63%), and foster care (43%).

98%

76%

71%

71%

0% 50% 100%

Report using any suicide prevention best

practices (N=423)

Review background data prior to visit to

improve safety (N=424)

Report using all 3 suicide prevention best

practices* (N=423)

Report using an identified** decisionsupport tool (N=262)

Safety and decision support

*Suicide prevention best practices include: universal screening (e.g., C-SSRS, ASQ, 

etc.), safety planning, reducing access to lethal means

**Identified decision support tools include: ASAM criteria, ANSA/CANS, 

LOCUS/CALOCUS/CASII, DLA-20

Adults (18 

years +)

11%

Children 

(<18 yrs)

4%

All ages

85%

Age of population served (n=437)

43%

63%

68%

84%

0% 20% 40% 60% 80% 100%

Foster care

Juvenile justice

Child Protective Services

Schools

Services MCT partners with (N=418)
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TAKEAWAYS

Clinical best practices in the areas of suicide prevention, field-based safety tactics, and the use of level 

of care decision support tools are unevenly adopted across MCTs. Although the majority of MCTs 

report serving children, partnerships with child system providers are unevenly adopted. 

There are few tailored, evidence-informed practices studied in the context of MCTs, thus leaving MCTs 

to adopt practices based on existing evidence to improve quality of care. There is a need to better 

define core competencies, continued training, and dissemination of best practices. Children and 

adolescents have distinct needs from adults, and MCTs serving children benefit from collaboration with 

specialized pediatric systems and providers. There is a need for an MCT convening to identify 

promising clinical approaches to guide development of MCT-based best practices and guidelines.

4. DISCUSSION

This national MCT survey provides a first look into the landscape of mobile crisis response across the 

US. These programs are now ubiquitous and serving millions of Americans. The key takeaways 

described above highlight both the significant accomplishments of a nascent component of the crisis 

continuum as well as the major challenges ahead. 

There is a potential reckoning looming on the horizon for MCT services in the US. Given the significant 

gaps between the current state of MCT implementation and the vision for nationwide 24/7 coverage, 

including major structural barriers such as workforce shortages and inadequate insurance 

reimbursements, the question must be considered: is it feasible to have full MCT coverage across the 

entire US? If so, what steps need to be taken to optimize the MCT workforce and streamline best 

practices? If not, what alternatives exist and how should communities without MCTs provide services 

to people in crisis? 

Another major theme in the survey results is the need for standards in the face of contextual 

variability. MCT programs need to have flexibility to adapt their services to best fit their population’s 

needs, physical environment, system components, financing mechanisms, and many other factors. At 

the same time, there is a need for a shared understanding of what to expect when a mobile crisis team 

responds to a person in crisis, similar to how most people know what services are provided by an 

ambulance. To meet the vision of a future state in which all populations have equitable access to high 

quality MCT services, there will need to be a process in place to map out MCT catchment areas, to 

describe the services and characteristics of the MCT program, and to make it easy to locate and 

contact MCTs. 

Drawing on recent federal and local legislative and regulatory definitions of MCTs, we propose that a 

key step towards this objective is to develop a dashboard that can track uptake of MCT best practices. 

Drawing on questions from the survey as an initial iteration of this approach, we demonstrate how 

many respondents are currently meeting each of the following best practices, and how regions across 

the US states are performing in terms of the number of MCT programs that report implementing 7 or 

more of these 10 best practices. 
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Percentage of respondents in each SAMHSA region that report implementing 7 or more of the 10 

best practices (n=398)
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We envision that this national best practice adoption and implementation dashboard will drive funding 

gap estimates, prioritization of focus for system transformation and technical assistance, and as a 

repeat measure barometer to determine the impact of various systemic interventions. 

POLICY IMPLICATIONS

MCTs evidence a high level of diversity across multiple dimensions, and there are many unanswered 

questions about what models are best for what contexts. There remain broad needs for expanding the 

MCT workforce and peer specialist trainings, increasing insurance reimbursement for MCT services, 

and investing in rigorous research and evaluation of ongoing implementation activities to expand the 

evidence base to better inform MCT clinical best practices. 

Multiple entities including crisis hotlines, crisis receiving facilities, 911 Public Safety Answering Points

(PSAPs), outpatient mental health clinics, emergency departments, and others need a simple way to 

contact MCTs and request services. Respondent contact information gathered in this survey can set the 

foundation for the creation of a registry of MCTs across the US states and territories to drive the 

creation of an “MCT Finder” search engine to be used by referring agencies, including the potential for 

988 crisis hotlines to “dispatch” MCTs. Such a registry could further enable outreach to MCT programs 

for participation in convenings, technical assistance opportunities, funding opportunities, and creation 

of learning communities. 

MCTs need to achieve scale to provide 24/7 availability and on demand capacity. However, over 50% of 

MCTs lack the scale and reach to meet these expectations. MCTs need adequate technology to support 

program evaluation, operational integration with collaboration partners, and comparisons across 

jurisdictions, yet only 26% of MCT are utilizing a modern digital platform that integrates with other 

behavioral health providers. Workforce challenges and funding limitations are additional structural 

barriers to achieving such scale, inter-operability, and reporting capabilities. Dedicated efforts to 

modernize MCT platforms are needed to achieve these critical objectives. 

These national MCT survey results represent a baseline for MCTs across the US that was obtained 

contemporaneously to policy and funding surges and prior to the national launch of 988. This context 

creates a unique opportunity for repeated surveys to evaluate the ongoing impact of such guidelines, 

roadmaps, and policy-funding. We are hopeful that these survey results and the additional research 

that follows will propel the field of mobile crisis to a place of evidence-based policy making. 

LIMITATIONS

There are some limitations to survey methods that should be acknowledged. The survey responses are

limited to those MCT programs that could be reached via a convenience sample of MCTs in the US and 

may not be representative of all MCT programs. Incomplete responses may have underreported 

certain questions based on respondent type, further impacting representativeness of the responses. 

Some duplicate responses may not have been detected as a result of allowing anonymous responses. 

Variability in respondent roles may further contribute to disparate responses to survey questions 

based on information available to respondents. 
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5. CONCLUSION

We set out to answer the question, “What is an MCT?” The answer is complex; it depends, and 

numerous unanswered questions remain. Context matters a great deal. While workforce and funding 

are key structural barriers, MCTs operating in different contexts have different needs for technical 

assistance to achieve the vision of a nation-wide network of 24/7, on demand, high performing 

MCTs that are integrated with crisis hotlines and crisis receiving facilities. We hope that these survey 

results will influence further research, evidence-based policy, and funding methodologies.
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REFERENCES

1. Substance Abuse and Mental Health Services Administration: National Guidelines for Behavioral 

Health Crisis Care - Best Practice Toolkit. 2020 [cited 2020 May 4] Available from: 

https://www.samhsa.gov/sites/default/files/national-guidelines-for-behavioral-health-crisis-care02242020.pdf

2. Pinals DA: Crisis Services: Meeting Needs, Saving Lives. Alexandria, VA, National Association of 

State Mental Health Program Directors, 2020 [cited 2023 Aug 14] Available from: 

https://store.samhsa.gov/product/crisis-services-meeting-needs-saving-lives/PEP20-08-01-001

3. Group for the Advancement of Psychiatry: Roadmap to the Ideal Crisis System: Essential Elements. 

Measurable Standards and Best Practices for Behavioral Health Crisis Response. National Council 

for Mental Wellbeing, 2021Available from: https://www.crisisroadmap.com

4. Centers for Medicare & Medicaid Services: New Medicaid Option Promotes Enhanced Mental 

Health, Substance Use Crisis Care, 2021.Available from: https://www.cms.gov/newsroom/pressreleases/new-medicaid-option-promotes-enhanced-mental-health-substance-use-crisis-care

5. State Planning Grants for Qualifying Community-Based Mobile Crisis Intervention Services | 

Medicaid, 2021.Available from: https://www.medicaid.gov/medicaid/benefits/behavioral-healthservices/state-planning-grants-for-qualifying-community-based-mobile-crisis-interventionservices/index.html

6. Zealberg JJ, Santos AB, Fisher RK: Benefits of mobile crisis programs. Hosp Community Psychiatry 

44: 16–17, 1993.

7. Geller JL, Fisher WH, McDermeit M: A national survey of mobile crisis services and their 

evaluation. PS 46: 893–897, 1995.

8. West DA, Litwok E, Oberlander K, et al.: Emergency psychiatric home visiting: report of four years 

experience. J Clin Psychiatry 41: 113–118, 1980.

9. Hoult J: Mobile crisis services. PS 47: 309b–3310, 1996.

10. Balfour ME, Winsky JM, Isely JM: The Tucson Mental Health Investigative Support Team (MHIST) 

Model: A Preventive Approach to Crisis and Public Safety. PS 68: 211–212, 2017.

11. Balfour ME, Hahn Stephenson A, Delany-Brumsey A, et al.: Cops, Clinicians, or Both? Collaborative 

Approaches to Responding to Behavioral Health Emergencies. PS 73: 658–669, 2022.

12. Pope LG, Patel A, Fu E, et al.: Crisis Response Model Preferences of Mental Health Care Clients 

With Prior Misdemeanor Arrests and of Their Family and Friends. PS appi.ps.20220363, 2023.

13. Guo S, Biegel DE, Johnsen JA, et al.: Assessing the Impact of Community-Based Mobile Crisis 

Services on Preventing Hospitalization. PS 52: 223–228, 2001.
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14. Dyches H, Biegel DE, Johnsen JA, et al.: The Impact of Mobile Crisis Services on the Use of 

Community-Based Mental Health Services. Research on Social Work Practice 12: 731–751, 2002.

15. Currier GW, Fisher SG, Caine ED: Mobile Crisis Team Intervention to Enhance Linkage of 

Discharged Suicidal Emergency Department Patients to Outpatient Psychiatric Services: A 

Randomized Controlled Trial. Academic Emergency Medicine 17: 36–43, 2010.

16. Kim S, Kim H: Determinants of the use of community-based mental health services after mobile 

crisis team services: An empirical approach using the Cox proportional hazard model. Journal of 

Community Psychology 45: 877–887, 2017.

17. Bengelsdorf H, Church JO, Kaye RA, et al.: The cost effectiveness of crisis intervention. Admission 

diversion savings can offset the high cost of service. J Nerv Ment Dis 181: 757–762, 1993.

18. Dee TS, Pyne J: A community response approach to mental health and substance abuse crises 

reduced crime. Science Advances 8: eabm2106, 2022.

19. Goldman ML, Shoyinka S, Allender B, et al.: Quality Measurement in Crisis Services. National 

Council for Mental Wellbeing, 2023 [cited 2023 Aug 14]Available from: 

https://www.thenationalcouncil.org/resources/quality-measurement-in-crisis-services/
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APPENDIX A: Definition of MCT Program vs. Team

The National Survey of Mobile Crisis Teams (MCTs) was administered at the level of the MCT program, 

meaning a single entity with potentially multiple team components. 

To define and calculate a mobile crisis "team":

● Ask about the following per program (program should be base unit of measure):

○ Total FTE of front-line responders (also good to know supervisors/consultants but not 

counted towards teams)

○ Hours of operation per week (i.e., 24/7, 40-hours per week, etc.)

○ # of staff responding (i.e., 1- or 2- or 3-person teams)

● To calculate actual teams per program:

○ (responder FTE x 40 hours / 1.3x modifier for staff vacation/sick) / (# hours of operation 

per week) / (# staff responding)

○ For example, a program with 16 responder FTE working on 2-person teams 24/7: 16 x 40 

/ 1.3 / 168 / 2 = 1.5 teams available 24/7, i.e. 2 teams available half the time (during 

peak hours) and 1 team available the rest of the time (low demand hours)

○ Or, a program with 6 responder FTE working on 1-person teams M-F 7am-7pm: 6 x 40 / 

1.3 / 60 / 1 = 3 teams available during business hours

● Additional info that can be factored in:

○ Hours per shift and shifts per week (not needed but can matter operationally)

○ Downtime, travel time, response duration, contact rate, etc. (can help inform response 

capacity as comparison point to actual population needs in the program's service area)
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APPENDIX B: Table of recruitment activities

Dissemination Partner Recipients at the time the survey was shared

American Association of 

Community Psychiatry (AACP) 

General membership listserv with 1,154 members

American Association of 

Emergency Psychiatry (AAEP) 

Listserv with 282 active addresses

Crisis Community Jam Listserv of approximately 2,300 subscribers

Crisis Intervention Teams (CIT) 

International

Contact list had 7,945 addresses

Crisis Residential Association Listserv of about 250 people

Mental Health Liaison Group 

(MHLG)

80+ mental health organizations

National Association for Behavioral 

Health (NABH) 

Weekly member newsletter with 1,547 email addresses

National Association of Mental 

Illness (NAMI)

988 State Crisis Response Advocates listserv with 551 

recipients; state policy and advocacy network with 130 

recipients (potential overlap)

National Association of State 

Mental Health Program Directors 

(NASMHPD)

Newsletter to 1,400 subscribers, additional listservs, 

and discussed at state calls

National Council for Mental 

Wellbeing (NCMW)

Newsletter mailing list of 42,000 subscribers

One Million Moms (1M4) 1M4 listserv has 240 subscribers

The Counsel of State Governments 

(CSG) listserv

Distribution list with approximately 6,000 members

Vibrant Emotional Health Emailed to 892 email addresses
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APPENDIX C: Table of respondents’ states

State Survey respondents

Alabama 3

Alaska 1

Arizona 19

Arkansas 1

California 21

Colorado 16

Connecticut 5

Delaware 6

District of Columbia 0

Florida 7

Georgia 10

Hawaii 0

Idaho 1

Illinois 37

Indiana 5

Iowa 13

Kansas 20

Kentucky 9

Louisiana 2

Maine 2

Maryland 16

Massachusetts 11

Michigan 17

Minnesota 0

Mississippi 18

Missouri 26

Montana 1

Nebraska 6

Nevada 20

New Hampshire 2

New Jersey 3

New Mexico 4

New York 23

North Carolina 6

North Dakota 0

Ohio 38

Oklahoma 5

Oregon 22

Pennsylvania 14

South Carolina 6

South Dakota 1

Tennessee 10

Texas 30

Utah 8

Vermont 12

Virginia 8

Washington 22

West Virginia 8

Wisconsin 39

Wyoming 0

Total 554
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APPENDIX D: Summary figures for all survey questions

Figure 1
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Figure 2

Figure 3
26

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Figure 4

Figure 5
27

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Figure 6
28

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Figure 7

Figure 8
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Figure 9
30

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Figure 10

Figure 11
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Figure 12

Figure 13
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Figure 14
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Figure 15
34

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Figure 16
35

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Figure 17

Figure 18
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Figure 19
37

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Figure 20
38

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Figure 21
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Figure 22
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Figure 23

Figure 24
41

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Figure 25
42

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Figure 26

Figure 27
43

Mobile Crisis Teams

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Figure 28
44

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Figure 29

Figure 30
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Figure 31
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Figure 32
47

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Figure 33
48

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Figure 34

Figure 35
49

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Figure 36
50

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Figure 37
51

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Figure 38

Figure 39
52

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Figure 40
53

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Figure 41

Figure 42
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Figure 43
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Figure 44

Figure 45
56

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Figure 46

Figure 47
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Figure 48
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Figure 49

Figure 50
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APPENDIX D: National Survey of Mobile Crisis Teams Questionnaire

National Survey of Mobile Crisis Teams

We are pleased to announce the launch of this National Survey of Mobile Crisis Teams (MCTs). In the context 

of 988 implementation, efforts to reduce unnecessary involvement of law enforcement in crisis response, and 

wide scale organization around high-functioning crisis systems, MCTs (including co-responder teams) have 

proliferated and been the focus of new legislation and funding. And yet, there remains a large gap in our 

knowledge of what constitutes MCTs. To better understand the organization, operation, and financing of 

MCTs, we are pleased to announce the launch of the first-ever National Survey of MCTs in the United States, 

in collaboration with Vibrant, SAMHSA, NASMHPD, and others.

Confidentiality: Programs are encouraged to share contact information in order to remain connected to 

important and timely national updates on MCT funding opportunities, training and technical assistance, and 

additional information. Your contact information will be kept separate from your response to this survey, 

unless you consent below to have your responses identified. Data from this survey will only be reported 

publicly in aggregate. You have the option to respond to this survey anonymously.

Do you agree to have your program identifying information linked with your survey responses?

o Yes, I agree

o No, I prefer to keep my identifying information separate from my confidential survey response

Do you agree to share your program information or would you rather remain anonymous?

o Agree to identify program

o Prefer to remain anonymous

Please provide your reasons for preferring to stay anonymous. We are hoping to engage MCT programs as 

much as possible and would appreciate any feedback about your concerns with identifying your program for 

this national survey. (free text)

Respondent Information

A. Name of MCT program (optional)

B. MCT program phone number (optional)

C. MCT program contact email (optional)

D. MCT program website URL (optional)

E. Name of respondent (optional)

F. Respondent role with MCT program (optional)

o MCT Program Director/Manager

o MCT Clinical Supervisor

o MCT Clinician (front line, responding in field)

o Executive Director/CEO of organization that oversees the MCT program

o Other
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G. Respondent phone number (optional)

H. Respondent email address (optional)

I. How did you hear about this National Survey of Mobile Crisis Teams? (Select all that apply.)

o Contacted directly by study team

o National Suicide Prevention Lifeline Network/Vibrant Emotional Health 

o Weekly National Crisis Learning Collaborative / Crisis Jam

o National Association of State Mental Health Program Directors (NASMHPD) 

o National Council for Mental Wellbeing

o American Association of Emergency Psychiatry

o American Association of Community Psychiatry

o CIT International

o Crisis Residential Association

o LinkedIn

o Twitter

o Facebook

o Other

A. Service area

1. In what state does your MCT operate?

2. What geographic unit does your MCT serve?

o State

o Region (more than one county) 

o County

o City or smaller

3. In what counties and/or cities does your MCT operate?

4. What is the approximate size of the population served by your MCT?

5. Approximately how many square miles is your MCT catchment area?

6. What is the population density in your catchment area? (Select all that apply.)

o Urban

o Suburban

o Rural

o Frontier

7. What types of barriers frequently impede your MCT’s activities? (Select all that apply.)

o Snow

o Heavy rains 

o Excessive heat

o Dirt roads

o Long distances 

o Traffic

o Mountainous terrain 
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o Wildlife

o Poor wifi, cell reception, other connectivity barriers

o Other/Comments:

B. Partnerships

8. What agency has primary oversight over the operations of your MCT?

o Public Health Department Behavior/mental health agency/authority Law enforcement (police, 

sheriff) Emergency Medical Services (EMS)

o Fire Department

o 911/emergency dispatch

o Other:

9. What agencies does your MCT partner with? (Select all that apply.)

o Public Health Department

o Behavioral/mental health authority

o Law enforcement (police, sheriff)

o Emergency Medical Services (EMS) 

o Fire

o 911/emergency dispatch 

o Other/Comments:

10. What youth services does your MCT partner with? (Select all that apply.)

o Schools

o Juvenile Justice

o Child Protective Services Foster Care

o N/A

o Other/Comments:

11. Is your program embedded within a public agency (civil service) or contracted to a community 

provider?

o Embedded within public agency

o Contracted organization

12. Please rank your MCT program's priorities from most to least important. (Drag options from highest to 

lowest priority.)

o Diversion from law enforcement encounters

o Diversion from Emergency Department

o Diversion from arrest/jail/prison

o Diversion from inpatient psychiatry

o Diversion from ambulance/Emergency Medical Services 

o Reduction in Emergency Department boarding time 

o Reduction in officer wait time

o Retention in community-based services Retention in home/school placements

C. Program Structure

13. What number can someone call to access your MCT services? (Select all that apply.)

o Internal/self-dispatch (direct referral to MCT)
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o National Suicide Prevention Lifeline (NSPL) Call Center 

o Non-NSPL Centralized statewide hotline

o Non-NSPL Regional/County/City hotline(s)

o 911

o 211/311/other non-911 central line

o Law enforcement/EMS

o Emergency departments

o Inpatient/Residential psychiatric facilities

o Jails

o Mental Health Clinics

o Other/Comments:

14. Who is responsible for making the decision about whether your MCT team is dispatched to a call (i.e., 

can your MCT program block a call if needed)?

o Call center dispatches MCT

o MCT self-dispatches and can block calls if needed

o Other/Comments:

15. What are your hours of operation? 

o 24 hours

o Non-24 hour; please specify:

16. What days do you operate?

o 7 days

o Monday-Friday

o Other:

17. Approximately how many patients does your MCT program serve per month?

18. What vehicles do you use to arrive on scene? (Select all that apply.)

o Personal vehicle

o Standard vehicle (car, SUV, van) owned by program 

o Ambulance

o Community paramedicine vehicle (e.g., ambulette, paratransit) 

o Police cruiser

o Other/Comments:

19. Which of the following are used for voluntary and/or involuntary transport? (Select Voluntary and/or 

Involuntary for all that apply.)

o Law enforcement

o Ambulance 

o MCT vehicle

o Secure transport provider

o Voluntary

o Involuntary

o Other:

20. Is your program stand-alone or co-located at a site?

o Stand-alone
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o Co-location with hotline/call center

o Co-location with outpatient behavioral health clinic

o Co-location with behavioral health crisis facility (e.g., residential, respite, stabilization unit, 

psychiatric emergency)

o Co-location with medical Emergency Department 

o Co-location with jail/police station

o Co-location with fire station/EMS dispatch/911 

o Other:

21. With which local services does your MCT have formal arrangements for expedited drop-off and care 

transitions? (Select all that apply.)

o Outpatient behavioral health services (e.g., case management, medication support)

o Behavioral health crisis facility (e.g., residential, respite, stabilization unit)

o Substance use detox/sobering

o Psychiatric Emergency Services (e.g., CPEP, EmPATH unit)

o Inpatient psychiatry

o Other/Comments:

22. Is your MCT service limited to certain insurance carriers? (Select all that apply.)

o No limitations

o Private insurance only

o Public insurance only (e.g., Medicaid, Medicare) 

o VA/Tricare only

o Other/Comments:

23. Does your program prioritize care by payer type? (Select all that apply.)

o No Indigent/uninsured Medicaid

o Medicare VA/Tricare

o Private insurance

o Other/Comments:

24. Does your program share MCT staff with related behavioral health and crisis/emergency services? 

(Select all that apply.)

o Outpatient behavioral health clinic

o Crisis hotline

o Urgent walk in clinic

o Crisis receiving facilities (crisis residential, detox, inpatient, etc.) 

o ED response

o School response 

o Jail response

o N/A

o Other/Comments:

D. Team Structure

25. Please describe the Full Time Equivalents (FTEs) for each member of your team. (Estimates are 

acceptable; enter numbers only.)

o Licensed BH clinician (e.g., psychologist, LPC, LCSW, LMFT, etc.)

o Unlicensed BH clinician
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o Paramedic/EMT

o Law enforcement officer

o Peer specialist

o Psychiatric Medical Director

o Psychiatric prescriber (e.g., MD/DO, NP, PA)

o Nursing (e.g., BSN, RN, LPT)

o Other

o FTEs

26. Are your MCT members working full-time during hours of operation or are they on-call as needed?

o On duty

o On call

o Combination of on duty/on call (Comments optional):

27. Do you have a supervision structure for MCT members to consult with a senior clinician?

o Scheduled

o On demand

o None

o Other/Comments:

28. What type of training modalities do you utilize to train MCT providers? (Select all that apply.)

o On-demand videos

o Self-directed reading

o Classroom: didactic

o Classroom simulation: vignettes, role plays, etc.

o Virtual reality/simulator

o Shadowing/provisional period <1 month 

o Shadowing/provisional period 1-3 months 

o Shadowing/provisional period >3 months

o Other/Comments:

29. Which of the following topics are covered in your MCT training curriculum? (Select all that apply.)

o Suicide risk assessment and intervention

o Violence risk assessment and intervention

o Management of agitation and verbal de-escalation

o Structured brief interventions: SBIRT, CALM, SPI, etc

o Level of care decision-making

o Trauma-Informed Care

o Harm reduction practices

o Safety in the field

o Provider wellbeing

o Other/Comments:

30. Does your program have effective mechanisms in place to prevent, detect, and respond to the 

following experiences among providers? (Select all that apply.)

o Fatigue Burnout

o Traumatic events and vicarious trauma Team dysfunction

o Stress related to understaffing

o None
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o Other/Comments:

E. Clinical

31. What populations do you serve?

o Children (<18 years old)

o Adults (≥18 years old)

o All ages

32. What types of clinical presentations do you respond to? (Select all that apply.)

o Mental illness 

o Substance use

o Intellectual/developmental disabilities

o Co-occurring medical conditions (e.g., delirium, dementia, TBI) 

o Other/Comments:

33. Are there any types of cases that your MCT will not respond to? (Select all that apply.)

o High medical complexity

o High violence risk 

o Homelessness

o Non-resident of catchment area 

o Non-citizens

o Other/Comments:

34. What suicide prevention best practices are used in >70% of appropriate cases? (Select all that apply.)

o Universal suicide screening (e.g., C-SSRS, ASQ, etc.) 

o Safety planning

o Reducing access to means of self-harm

o Other/Comments:

35. Do you use a decision-support tool to assess for service intensity need and level of care? (Select all 

that apply.)

o LOCUS/CALOCUS/CASII

o ASAM Criteria

o ANSA/CANS

o DLA-20

o Other/Comments:

36. What strategies does your MCT use to increase safety during field visits? (Select all that apply.)

o Limiting shift length to <12 hours

o Required 2-person response

o Daily vehicle/equipment inspection

o Reviewing available background data before meeting with the client

o Phone call with client/family before entering the home

o Structured protocol for assessing environmental safety on scene

o Structured protocol for assessing level of agitation/violence risk

o None

o Other/Comments:
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F. Technology

37. What type of clinical record system do you use? (Select all that apply.)

o Stand-alone Electronic Health Record (EHR)

o EHR integrated with other behavioral health systems

o 911/EMS records

o EHR integrated with 911/EMS dispatch

o Microsoft Excel, Microsoft Word, fillable PDFs

o Other/Comments:

38. What type of devices does your MCT primarily use for documentation?

o Wireless tablets/computers in the field 

o Office-based computers

o Paper charts

o Other/Comments:

39. What types of telehealth does your MCT provide? (Select all that apply.)

o All MCT uses telehealth (e.g., tech drives tablet to field for clinician telehealth interview)

o Clinician for supervision/consults

o Psychiatrist for medication consults

o None

o Other/Comments:

G. Financing

40. What types of funding supports your MCT program? (Select all that apply.)

o Federal block grants

o State/county general funds

o Foundation grants

o Medicaid waiver

o Insurance reimbursement/billing revenue 

o Other/Comments:

41. How do you bill for and/or justify funding for services? (Select all that apply.)

o Submit monthly performance reports to county/state

o Medicaid billing

o Medicare billing

o VA/Tricare billing

o Private Insurance billing 

o None 

o Other/Comments:

42. What activities comprise an episode of care for your organization? (Select all that apply.)

o Telephone triage

o Dispatch

o Face-to-face encounter

o Video-based encounters

o Coordination and continuity of care

o Telephone follow-up
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o Face-to-face follow-up

o Other/Comments:

43. What is your average face-to-face encounter cost?

44. Average episode cost

45. What is your total annual budget estimate for MCT?

H. Quality and Incentives

46. Which of the following descriptive metrics do you monitor? (Select all that apply.)

o # Inbound calls (if applicable)

o # MCT dispatches

o # Face-to-face encounters

o # Video-based encounters

o # Care coordination calls

o # Follow-up calls

o # Unique clients served

o Racial/ethnic breakdown of clients served

o None

o Other/Comments:

47. Which of the following performance metrics do you monitor? (Select all that apply.)

o Average speed of answer for inbound calls (if applicable)

o Average abandonment rate for inbound calls (if applicable)

o Average time to dispatch MCT

o Average MCT response time

o Average MCT point of service diversion rate 

o % unable to locate by MCT

o Average officer wait time

o None

o Other/Comments:

48. Which of the following process metrics do you monitor for face-to- face encounters? (Select all that 

apply.)

o Completion of suicide risk assessment

o Completion of violence risk assessment

o Collaborative safety planning

o Removed/reduced access to means of self-harm

o Follow-up in 24 hours

o Referral to clinic-based services

o Referral to peer-based services

o Requested law enforcement support

o Requested EMS support

o Placement of involuntary hold None

o Other/Comments:

49. Which of the following incident types do you monitor? (Select all that apply.)
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o Staff injuries during provision of MCT services

o Client suicide attempts during or after MCT services

o Client suicide deaths during or after MCT services

o Client violence during or after MCT services

o Client victimization during or after MCT services

o Client complaints about services

o Community partner complaints about services

o Provider reports of maltreatment by consumers

o Provider reports of maltreatment by community partners

o None

o Other/Comments:

50. Which of the following downstream outcome metrics do you monitor following face-to-face 

encounters? (Select all that apply.)

o Outpatient clinic-based connections

o Outpatient peer-based connections

o ED presentations

o Inpatient psychiatry admissions

o Law enforcement involvement

o Jail bookings

o None

o Other/Comments:

51. Which of the following metric types described above are used to inform incentives and/or payments? 

(Select all that apply.)

o Descriptive metrics

o Performance metrics

o Process metrics

o Outcome metrics

o None