County Behavioral Health Crisis Response
Counties play a critical role in supporting community members living with a behavioral health condition or experiencing a behavioral health crisis, including implementation of the national 988 Suicide & Crisis Lifeline.
One in five adults experiences a mental illness each year, yet over half go untreated. For youth, the need is just as urgent – nearly 1 in 5 children face a mental, emotional or behavioral condition. Counties fund and operate the core services that respond to these needs, from crisis lines and mobile response teams to treatment, housing and justice diversion.
Through technical assistance, national partnerships and member-driven initiatives, NACo’s County Behavioral Health Crisis Response programs equip county leaders with resources, peer learning opportunities and national initiatives that strengthen local behavioral health systems. This work includes the Stepping Up Initiative, cohort programs and peer exchanges and best practice reports and briefs that highlight effective county strategies for investing in and sustaining a robust behavioral health continuum of care.
Get Involved
Subscribe to NACo’s Mental Health Partners Newsletter
Sign up here for NACo's monthly mental health newsletter featuring our latest news and resources.
Join Stepping Up
Since 2015, more than 580 counties have signed on to the national Stepping Up initiative to reduce the number of people with mental illness in jails. To join, pass a resolution in your county using the template available here and then forward a copy of the signed resolution to info@stepuptogether.org. Existing Stepping Up counties are encouraged to become an Innovator County when they can demonstrate a process for obtaining and tracking accurate, accessible data on serious mental illness (SMI) in their jails. Learn more about becoming an Innovator and take the survey to find out which of the three categories your county represents.
What NACo Members Are Saying
Peer Learning
Cohorts and Peer Exchanges
NACo’s Behavioral Health program hosts cohorts and peer learning events that bring together county leaders, behavioral health professionals and justice partners to share strategies, challenges and best practices for improving local behavioral health systems. These exchanges create a collaborative space for counties to learn from one another, explore innovative approaches to behavioral health and crisis response and provide the opportunity to strengthen partnerships that support community wellbeing.
In addition to these events, NACo develops practical, county-focused resources that help counties translate ideas into action, including toolkits, case studies, funding guides, implementation checklists and recorded trainings. These resources are designed to be immediately usable, grounded in real county examples and easily adaptable to local needs.
In September 2025, NACo hosted a peer exchange in Henrico County, Va. for counties involved in behavioral health and crisis response programming, with support from The Pew Charitable Trusts. The program focused on the following themes:
- Mental health prevention and early intervention
- Crisis response service coordination and infrastructure, and
- Effective community and intergovernmental partnerships.
In January 2025, NACo hosted an intergovernmental roundtable in Washington, D.C., with support provided by The Pew Charitable Trusts. The program focused on the following themes:
- Balancing state and local policies and practices in behavioral health
- Local crisis response challenges and intergovernmental solutions, and
- Programming and resources to support residents.
In June 2024, NACo hosted the third Familiar Faces Initiative peer exchange in Orange County, Calif., with support provided by The Pew Charitable Trusts and the Sozosei Foundation. The program focused on the following themes:
- Data-driven systems
- Crisis care, diversion and reentry services, and
- Integrated services for comprehensive community-based care.
In May 2024, NACo hosted a peer exchange in Harris County, Texas for counties in the pursuit and implementation of a coordinated behavioral health crisis continuum of care, with support from The Pew Charitable Trusts and the MacArthur Foundation. The program focused on the following themes:
- The national and local mental health landscape
- Collaboration and integration of 911/988 services, and
- Interdisciplinary efforts in behavioral health crisis diversion.
Share or Request Support
Are you working on strengthening behavioral health or crisis response programs in your county? Do you have successful strategies other counties can learn from? Please submit your information through the following form and NACo staff will be happy to connect with you to learn more and discuss potential next steps.
Related Content
Spotlighting Local Leadership: Strengthening the Behavioral Health Continuum of Care
Counties play a critical role in supporting community members living with a behavioral health condition or experiencing a behavioral health crisis.
Funding Strategies for County Behavioral Health Crisis Care
View NACo's infographic on how counties can leverage diverse funding streams and intergovernmental and cross-sector partners to improve coordination of care for individuals with mental illness and substance use disorders.
County Funding Opportunities to Support Community Members Experiencing a Behavioral Health Crisis
County and local officials play a critical role in funding, implementing and coordinating a local continuum of care to support people during a behavioral health crisis. Counties allocate $100 billion annually to community health systems – including behavioral health support – and provide services through 750 behavioral health authorities and community providers.
Shaping Crisis Response Spotlight Series
The National Association of Counties (NACo), in collaboration with The Pew Charitable Trusts and RAND, hosted a series of conversations with county leaders to understand the progress, challenges and lessons learned from 911/988 interoperability across various models, including embedded clinicians, call transfer and co-located response.
Promoting Health and Safety Through a Behavioral Health Continuum of Care
By forming strategic partnerships throughout health and justice systems, county leaders are better serving residents with behavioral health conditions such as mental illness and/or substance use disorders.
The Stepping Up Initiative
The Stepping Up Initiative is a data-driven framework that aims to reduce the overincarceration of people with mental illnesses in jails through training, resources, and support that are tailored to local needs.
County Countdown – Dec. 15, 2025
Every other week, NACo's County Countdown reviews top federal policy advocacy items with an eye towards counties and the intergovernmental partnership.
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Michelle Alyssa Go Act reintroduced in the 119th Congress, a critical step for county behavioral health systems
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