Crisis Services Beyond the 988 Hotline

When someone is in a mental health or substance use crisis, the choice is not just between calling 911 and suffering alone. A growing network of community-based services — mobile crisis teams, crisis stabilization units, peer-run respite centers, and peer support specialists — offers responses designed specifically for behavioral health emergencies. These services aim to meet people where they are, avoid unnecessary emergency room visits and hospitalizations, and connect individuals to follow-up care.

For an overview of 988 and what to expect when you call, see the mental health and 988 guide. This page focuses on what happens when the call is over — and what other services may be available in your community.

The crisis care continuum

The full range of crisis services is often described as a continuum — a set of options calibrated to different levels of need:

Level of need	Service type	Typical setting
Emotional distress, early crisis	988 phone/chat counseling, warmlines	Remote (phone or text)
Moderate crisis, in-person support needed	Mobile crisis team	Wherever the person is
Stabilization needed but not hospital-level	Crisis stabilization unit (CSU)	Community facility
Voluntary respite from a stressful environment	Crisis respite center	Homelike community setting
Intensive support during transition	Peer support specialist	Flexible — many settings

Not every community has every level available. Availability depends on state funding, local implementation, and whether your area has adopted frameworks such as the Crisis Now model promoted by SAMHSA and the National Council for Mental Wellbeing.

What 988 can dispatch

Since its launch in 2022, the 988 Suicide and Crisis Lifeline has served as the national access point for mental health crisis services. Calling or texting 988 reaches a trained counselor at a local or backup crisis center. Chat is available at 988lifeline.org.

In areas where mobile crisis programs are linked to 988, a counselor can dispatch a team to the caller’s location if an in-person response is appropriate and available. Not all regions have this capability yet — federal investment has been expanding it, but coverage remains uneven. When you call, ask the counselor directly: “Can you send a mobile crisis team to me?”

Veterans, Spanish speakers, and people who are hard of hearing or deaf have dedicated routing options within the 988 system.

Mobile crisis teams: how they work

Mobile crisis teams are the in-person component of community crisis response. They typically include at least one behavioral health clinician — a social worker, licensed counselor, or nurse — and may include a peer support specialist, an EMT, or other professionals depending on the team model.

Common mobile crisis team models:

• Civilian-only teams respond independently of law enforcement. They are typically dispatched by a crisis call center and focus on de-escalation and connection to care.
• Co-responder teams pair a behavioral health clinician with a law enforcement officer. The officer provides safety backup; the clinician leads the clinical response.
• Law enforcement-based teams involve officers who have received mental health crisis intervention training (CIT) but may not include a dedicated clinician.

Research from programs such as Denver’s STAR program and Eugene, Oregon’s CAHOOTS model — among the longest-running civilian crisis response programs in the country — has found that civilian crisis teams can safely handle the large majority of behavioral health calls without police involvement.

When a mobile team arrives, they will assess the person’s safety, conduct a brief mental status evaluation, discuss what support is needed, and make a plan — which might include transport to a CSU, connection to outpatient services, or simply talking through a crisis until it resolves. They do not have the authority to detain someone involuntarily unless the criteria for a psychiatric hold under your state’s law are met.

Crisis stabilization units

A crisis stabilization unit (CSU) is a facility designed to receive people in acute psychiatric or substance use crisis and provide short-term stabilization outside of a hospital emergency room. Most CSUs operate on a 23-hour or 72-hour model, though some states fund longer stays.

At a CSU you can expect:

1. An initial assessment by a clinician to determine your current needs and safety
2. Medical clearance (some CSUs do this on-site; others may need to coordinate with an ED)
3. Psychiatric evaluation and, if appropriate, medication management
4. Peer support and psychoeducation while you stabilize
5. A discharge plan connecting you to follow-up outpatient care, residential treatment, or other services

CSUs are voluntary for most people — you are not locked in and you can leave. Involuntary holds at a CSU are possible in some jurisdictions when safety criteria are met, but most admissions are voluntary. Many CSUs accept walk-ins; others prefer referrals through 988 or a mobile crisis team.

Billing varies. Medicaid pays for CSU services in most states, and many programs have sliding-scale or no-cost options for uninsured individuals.

Crisis respite centers

Crisis respite centers offer a different kind of support — a homelike, voluntary setting where someone can step away from a stressful or unsafe environment for a few hours to a few days. Respite centers are often peer-run, meaning people with lived experience of mental health challenges play central roles in staffing and programming.

You do not need a clinical diagnosis or a referral from a provider to use most respite centers. They are intended for people who feel overwhelmed, need a safe space, or want support without the clinical intensity of a CSU or hospital.

Respite centers vary enormously in what they offer — some provide only a safe place to rest, while others offer peer-led groups, help with daily tasks, and connections to ongoing services. Availability is limited; many communities do not yet have a respite center, and those that exist may have waiting lists or limited hours.

Documents and terms you’ll see

When researching crisis services or reviewing discharge paperwork, you may encounter:

• Mobile crisis team — refers to the in-person dispatch model; your local 988 center or county mental health department can tell you if a civilian mobile team is available in your area
• Crisis stabilization unit — listed as a CSU or sometimes as a psychiatric urgent care center or crisis receiving center depending on how your state defines it
• Peer support specialist — a certified role in most states; state certification requirements and titles vary, but all involve training based on lived experience
• Crisis respite center — sometimes called a peer respite, safe haven, or crisis retreat

Peer support specialists in crisis settings

Peer support specialists play an increasingly important role throughout the crisis continuum. They may ride alongside mobile crisis teams, staff CSU common areas, facilitate groups in respite centers, or work in follow-up after a crisis to help someone stay connected to care.

Their value is distinctive: they can offer something no clinician can — a personal account of having been in crisis, navigated the system, and found a path forward. Research consistently shows that peer support improves engagement with care and reduces re-hospitalization rates.

Medicaid now reimburses peer support services in most states, which has expanded the workforce significantly over the past decade. If you are working with a mental health program that does not yet include peer support, ask whether a peer specialist is available to you.

Finding crisis services in your area

The most direct path is to call or text 988 and ask what community crisis resources are available in your location. Other resources:

• SAMHSA’s findtreatment.gov — searchable database of behavioral health treatment and crisis facilities
• Your state mental health authority — most state behavioral health agencies maintain a directory of funded crisis services
• Your county mental health or human services department — county-level programs are often the direct funders and administrators of mobile crisis teams and CSUs
• Your health plan’s member services line — if you are insured, your plan is required to maintain an adequate network of covered behavioral health services and should be able to direct you to in-network crisis resources