Prince William County transforms crisis care through "No Wrong Door" approach

Key Takeaways

Prince William County, Va.’s Crisis Receiving Center is bridging the gap between emergency room care and traditional outpatient care in behavioral crisis response and reducing burden on local law enforcement and hospitals, according to Prince William County Supervisor Andrea Bailey. 

The crisis receiving center “creates a safe and supportive and welcoming environment where one doesn’t have to feel ashamed because they’re suffering,” Bailey said Feb. 21 at the NACo Health Policy Steering Committee meeting. “They know that they’re going to be stabilized in an environment where they are protected.”

Prince William County’s Crisis Receiving Center serves both youth and adults, offering wraparound services, including peer support, medication assistance (the center has a pharmacy on-site), drug offender recovery services and homeless outreach, according to Bailey. The center initially opened on a limited basis in October 2025 to adults who received referrals from hospitals and law enforcement and then expanded in January to serve walk-in patients.

Youth are in crisis, Bailey noted. She cited data from the Substance Abuse and Mental Health Services Administration, that shows that 8.8 million young adults reported having a mental health crisis, with only 42% of them receiving treatment, and 5.1 million reported having a substance use disorder, with only 13% of them receiving treatment.

“Any one of us can find ourselves in a behavioral crisis,” Bailey said. 

A mental health system reliant on emergency rooms and law enforcement means that someone experiencing a behavioral health crisis is “on a stretcher, in handcuffs and our policemen are not on the streets,” Bailey said. That also creates a cycle where someone is in and out of emergency rooms and the justice system without receiving proper treatment, harming not only the person in crisis, but also the broader community, noted Robin Cheung, policy advisor to U.S. Rep. Dan Goldman (D-N.Y.). 

Cheung shared the story of Michelle Go, a woman who died after Martial Simon, a homeless man experiencing a behavioral health crisis, pushed her in front of a moving subway train. Last September, Rep. Goldman introduced the Michelle Go Act, bipartisan legislation that aims to build capacity for both inpatient care and crisis response care. 

Simon “was passed between emergency departments and jails without ever receiving the care he needed for schizophrenia,” Cheung said. “And unfortunately, Michelle Go lost her life. Our system failed Michelle Go, but most importantly, our system failed Martial Simon, because people experiencing a mental health crisis are often the victims of violence, not just the perpetrators.”

The federal government currently bans any psychiatric facility from receiving Medicaid funding that has more than 16 beds. The Michelle Go Act would raise the cap to 36 beds. 

“As you all know in your counties, the need is so high,” Cheung said. “And 16 beds is nowhere near enough to meet the moment.” 

Medicaid is the backbone of making the crisis system sustainable, noted Chris Santarsiero, Connections Health Solutions’ vice president of government affairs. 

The Prince William County Crisis Receiving Center has 64 chairs and beds, according to Bailey. It tackles behavioral health crises through a “No Wrong Door” approach, accepting emergency custody orders and temporary detention orders and offering medical detox within the facility, and uses the Crisis Now model, a collaborative approach to behavioral health crisis response that connects people with resources throughout the crisis, with the goal of providing effective care, reducing the need for emergency services and preventing suicide, according to Bailey. 

“County government is leading the transformation in how communities redesign how they intersect behavioral health,” Santarsiero said. 

There were 93 stakeholders involved in making Prince William County’s Crisis Receiving Center a reality, including local nonprofits and mayors, according to Bailey. Counties must partner with state and federal officials to get essential work done at the local level, she noted. 

“The days are gone where we work in siloes,” Bailey said. “It's time for us to come together in a very strong way to serve our communities. What has made [the crisis receiving center] successful is connection … and understanding that it does take a village to create.”