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. To inform local decision making, the National Association of Counties (NACo) and the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD) developed a chart of funding opportunities across federal, state and county governments and non-government sectors. Counties can blend and braid these resources to build a robust, accessible and sustainable behavioral health crisis continuum of care.
This funding chart can help county leaders identify possible funding streams to build and strengthen local behavioral health crisis response continuums. The funding sources reflect opportunities across behavioral health, criminal legal and related systems. Due to the cross-sector nature of crisis response, some sources focus on certain populations, like youth, while others target a certain supportive piece of the crisis continuum, like workforce or training.
The Behavioral Health Continuum of Care
The three elements of the continuum of care – Someone to Contact, Someone to Respond and Somewhere Safe to Go – are outlined in the National Guidelines for Behavioral Health Crisis Care, a roadmap to develop a robust array of services.
Someone to Contact
The first part of a crisis continuum includes 24-hour staffed crisis call centers that provide immediate care and resources for individuals experiencing a behavioral health emergency. These call centers are equipped to take all calls/texts/chats, triage the immediate concern to assess additional needs and coordinate connections to care.
Someone to Respond
The second part of a crisis continuum includes mobile crisis teams (MCTs). Sometimes called crisis response teams or units, MCTs are community-based, face-to-face interventions that provide the least restrictive services to a resident wherever they are physically located. MCTs provide stabilization and treatment as well as deflect individuals away from the criminal legal system and emergency departments. These teams can include a combination of behavioral health clinicians, paramedics, peer support specialists, social workers and/or trained law enforcement.
Somewhere Safe to Go
The third part of a crisis continuum includes crisis receiving and stabilization centers that offer a different level of treatment than the options available over the phone or through an MCT when experiencing a behavioral health emergency. While the design and details vary, these centers often provide community members with access to out- and in-patient services, peer support networks, withdrawal management, medication adjustment, counseling, therapy and/or longer-term residential care. Many centers offer a dedicated first responder drop-off area and accept referrals and walk-ins.
How to Use the Chart
The chart is categorized by five types of funding sources: federal, state, federal/state and county governments and non-government sectors. The federal funding section is further broken out by federal agency. These sources may provide direct or pass-through funding to counties. Each source is accompanied by a summary, potential uses across the continuum – Someone to Contact, Someone to Respond and Somewhere Safe to Go – and a county example where available.
- Rural Community Toolbox: Funding Programs
- Grants.gov Grants 101
- SAMHSA Grant Resources
- Department of Justice's Grant Resources
- Rural Health Information Hub Mental Health Funding
- Rural Health Information Hub Rural Mental Health Funding
- SAMHSA 988 Partner Toolkit
- Toolkit for Counties: 988 Suicide & Crisis Lifeline
- #ReimagineCrisis 988 Crisis Response State Legislation Map
- How County Elected Officials Can Support Crisis Triage Centers: A Place for Community Members to Go During a Behavioral Health Emergency
- Mental Health in Rural Communities Toolkit
- Rural Suicide Prevention Toolkit
- Rural Health Research Center Publications on Mental and Behavioral Health
- Violence and Abuse in Rural America Topic Guide
- Overview of Crisis Funding Sources Available to States and Localities
Support for this resource was provided by the Sozosei Foundation. The views expressed here do not necessarily reflect the views of the Sozosei Foundation.
This resource was researched and written by Jonah C. Cunningham, President and CEO of the National Association of County Behavioral Health & Developmental Disability Directors with support and guidance from Chelsea Thomson, Senior Program Manager, Behavioral Health and Justice at the National Association of Counties, and Naomi Seiler and Katie Horton from George Washington University.
On November 13, members of NACo's Commission on Mental Health and Wellbeing sent a letter to the U.S. Senate Committees on Finance and Health, Education, Labor and Pensions. The Commission called on Congress to support counties in delivering high-quality, assessible mental health services to address residents' comprehensive behavioral health needs in any mental health legislation package.
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