(C) Missouri Independent
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How does Missouri’s investment in a behavioral health crisis network improve mental health care? • Missouri Independent [1]
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Date: 2025-07-01
For years, Missouri has sought to address a growing mental and behavioral health crisis that touches every corner of the state.
In 2024, Missouri was ranked 38th nationwide when it came to prevalence of mental illness and overall access to treatment. So the state made multimillion-dollar investments to improve responses when Missourians are in moments of crisis.
For decades, calling 911 or going to the emergency room was the norm if a person was experiencing a mental health crisis.
Now, with the rollout of a statewide network in tandem with the national crisis hotline, 988, Missouri’s behavioral health providers dispatch teams of social workers or other specialists to be there for someone experiencing a crisis, at no cost to them.
“Not everything requires a level 10 response,” said Jamie Manning, the vice president of access and urgent care services at Compass Health Network. “Outside of calling 911, there’s now this free, accessible service, and you don’t have to wait until it’s that bad. You don’t have to go to the hospital when you’re at your wits’ end. We can help you before it gets to that point.”
Missouri currently has 20 behavioral health centers in the mobile crisis response network statewide. If a person dials 988 in the midst of a crisis and they need more support than is available through a phone call, the providers in the network will send out a team of two behavioral health workers to help them through their crisis.
“For many, many years, there weren’t other options,” Manning said. “Thank goodness we have new resources so there’s now that in between.”
How mobile crisis came online as part of Missouri’s mental health response
Many behavioral health providers, especially those serving rural patients, had some form of a mobile crisis response in place even before the state launched its network in tandem with 988.
As a caseworker early in her career, Manning remembers the toll that mobile response calls could have on staff. Workers were on call outside of their typical working hours, which meant more work and management for caseworkers outside of their day-to-day responsibilities.
But with the launch of 988 and an investment in the statewide mobile crisis network, behavioral health providers were able to hire full-time staff and create separate mobile teams whose purpose is to go out into the community and respond to the calls.
For fiscal years 2025 and 2026, Missouri set aside about $15 million annually that trickles down to behavioral health providers to staff and fund their mobile crisis teams. And the investment is changing the way the state responds to mental health crises.
“They are trained behavioral health professionals that will respond to a situation without law enforcement,” said KC Rafferty, the director of community engagement at the Missouri Behavioral Health Council.
The goal is to get to the root cause of someone’s crisis moment and get them connected to care that better fits their needs.
“If we’ve seen this person over and over and over again, how can we maybe think differently, think outside the box, to engage with them and ensure that they are getting the appropriate care for what they need?” Rafferty said.
In 2024, the 988 hotline in Missouri answered nearly 85,000 calls, 20,500 texts and nearly 8,800 chats. Of those contacts, about 3,000 — or just over 2.7% — resulted in a mobile crisis team being dispatched.
So far in 2025, 3.08% of contacts result in a mobile team heading out into the state, data provided by the Department of Mental Health shows.
Providers go to a patient’s home or meet them at a more public location, like a library or parking lot. After responding to a call and deescalating the situation, providers offer the opportunity to check back in with patients in the days following a crisis. They offer them options for short- or long-term care and treatment, or other assistance, such as helping them fill out Medicaid applications or making a doctor’s appointment.
But each case is different, and challenges remain when treating behavioral health conditions, especially in rural areas.
“Whenever we’re talking about rural mobile response, it’s the culture,” said Natasha Corkins, the director of crisis services for Burrell Behavioral Health’s southwest region, which covers Springfield and six surrounding counties. “There are people who call and want to speak, and we offer a mobile response and they’re hesitant because they don’t want to invite someone to their home or their location.”
“Consent is very important to us, because a crisis is a very individual and intimate situation,” Corkins said. “We don’t want to show up and possibly escalate a crisis by our presence. We want them to invite us in.”
Another challenge posed in rural communities is access to the internet when people are ready to seek out resources, Rafferty said.
“That can pose its own threat if they don’t have the ability to get where they need help, or to call someone to get assistance, if there is poor coverage in their area,” Rafferty said.
In all behavioral health responses, patience and understanding are key to better outcomes for patients, said Laurie Cox, the director of crisis services at Swope Health in Kansas City.
“If you keep getting in crisis, the only way to stop that is to get the services that you need,” Cox said. “But we also know that it is really hard for people to do. So it takes patience, it takes determination, it takes knowing how hard to push.”
Shifting from 911 and emergency rooms to living rooms and libraries
Emergency responders and behavioral health workers agree that an emergency room or a jail cell isn’t the best place for someone who is experiencing a crisis. But for many years, it was the only option.
Now, if it is safe, emergency medical services and law enforcement don’t need to be on-site at many of the 988 mobile dispatches, because there are mobile responders across the state trained in deescalation.
And they say the number of behavioral health calls they are needed for has dropped as the option becomes better known.
“If we go back and look at repeat patients, a lot of those have significantly decreased because they are getting the follow-up they need,” said Chris Bogguss, the director of EMS in Macon County. “They were given the appropriate resources.”
And for situations where emergency responders are needed at a behavioral crisis call, Missouri is incentivizing them to receive crisis intervention training in how to assess and deescalate crisis calls.
“It’s the education that we’ve received outside of our traditional EMS training that’s really helped us … better understand the patient’s needs,” Bogguss said.
Burrell Behavioral Health’s southwest coverage area has a crisis hotline specialist embedded in the Springfield-Greene County 911 dispatch center.
“We can work on diverting crisis callers from 911 to our crisis team, and hopefully stop the dispatching before it happens,” Corkins said.
Ultimately, providers want Missourians to know they can reach out for help and get connected to support or services through the 988 network.
“The goal is not to provide the Band-Aid in the moment, although that has its benefits,” Manning said. “How can we ensure that this has some lasting impact? It’s not a one and done. We’re here for you in whatever capacity you’re open to.”
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