Building a Better Crisis Response: Lessons from Tucson for Texas

In recent years, the conversation surrounding mental health crisis response has gained significant traction across the United States. The tragic events that unfolded in Tucson, Arizona, in 2005, which resulted in the deaths of a sheriff’s deputy, a mentally ill man, and a cab driver, served as a catalyst for change. Local leaders recognized the urgent need for a more effective way to respond to individuals in crisis, leading to the establishment of a comprehensive crisis care system. Today, Texas is looking to Tucson as a model for its own mental health crisis response initiatives.

The Tucson Model: A Response to Tragedy

The impetus for Tucson’s transformation began with a devastating incident involving a mentally ill man who had been dropped off at an emergency room and released shortly thereafter. His subsequent erratic behavior led to a call for police assistance, culminating in a tragic accident that claimed three lives. This incident highlighted the inadequacies of the existing mental health system and prompted local leaders to take action.

In 2005, Tucson voters approved a $15 million bond to fund the construction of a 24/7 crisis center, designed to provide immediate behavioral health care to individuals in crisis. The center aimed to de-escalate encounters with law enforcement and redirect individuals away from jails and emergency rooms, which often lacked the necessary resources to address mental health issues effectively. Instead, officers could bring individuals to the crisis center, where trained staff would assess and treat them.

However, the urgency for reform intensified following the 2011 shooting involving a suspended community college student diagnosed with paranoid schizophrenia. The incident, which resulted in six deaths, including that of then-Congresswoman Gabrielle Giffords, underscored the critical need for a robust mental health response system. Tucson’s leaders accelerated their efforts, leading to the opening of the crisis center in 2013.

A New Era of Crisis Care in Tucson

Today, Tucson’s crisis center serves as a beacon of hope for individuals experiencing mental health crises. The facility treats approximately 12,000 adults and 2,400 youth annually, offering a range of services, including 24/7 walk-in urgent care, short-term inpatient services, and a police drop-off point. The center operates under a “no wrong door” philosophy, ensuring that anyone in need of help can access services regardless of their circumstances.

This model has proven effective in changing the culture of crisis response. Tucson Police Sgt. Jason Winsky notes that officers now have confidence that there is a dedicated facility ready to accept individuals in crisis, regardless of their condition. This shift has the potential to save lives and reduce the burden on law enforcement and emergency services.

Texas Takes Note: A Call for Change

As Texas grapples with its own mental health crisis, local leaders are looking to Tucson for inspiration. Travis County Judge Andy Brown believes that implementing a robust crisis service center similar to Tucson’s could transform the mental health landscape in Austin and Travis County. The county has already initiated a jail diversion program in partnership with Integral Care, which aims to provide 24/7 crisis services and expand access to mental health care.

However, Texas faces challenges that differ from those in Arizona. The state has historically struggled with funding for mental health services, leading to a fragmented system that often leaves individuals without the necessary support. Unlike Arizona, where Medicaid expansion has provided additional funding for mental health programs, Texas has yet to embrace this option, limiting resources for crisis care.

Lessons Learned: Funding and Accessibility

The success of Tucson’s crisis response model can be attributed, in part, to the funding mechanisms in place. Arizona’s decision to expand Medicaid in 2013 allowed for a more integrated approach to mental health care, combining federal, state, and local resources. This funding model enables crisis centers to accept individuals regardless of their insurance status, ensuring that care is accessible to all.

In contrast, Texas’s mental health system remains disjointed, with services often scattered across various agencies. This lack of coordination can create barriers for individuals seeking help, as they may need to navigate a complex web of providers to find the appropriate care. Travis County officials are advocating for a more centralized approach, similar to Tucson’s model, to streamline access to mental health services.

The Path Forward: Building a Comprehensive Crisis System

As Texas moves forward with its mental health initiatives, local leaders are hopeful that the lessons learned from Tucson will guide their efforts. The establishment of new crisis centers, such as the one planned in Galveston County and the behavioral health campus in Uvalde, reflects a growing recognition of the need for comprehensive mental health care.

However, challenges remain. The voluntary nature of some programs in Texas means that individuals may still end up in emergency rooms or jails if they do not meet specific criteria for admission to crisis centers. This is in stark contrast to Arizona’s approach, where law enforcement can drop off individuals in crisis without requiring their consent.

Conclusion: A Call for Action

The mental health crisis in Texas demands urgent attention and action. By learning from Tucson’s successes and challenges, Texas can work towards building a more effective crisis response system that prioritizes the well-being of individuals in need. Expanding Medicaid, increasing funding for mental health services, and creating a centralized system for crisis care are essential steps in this journey.

As Travis County Judge Andy Brown aptly states, “If we had a robust crisis service center like Tucson, it would change Austin and Travis County overnight.” The time for change is now, and with the right resources and commitment, Texas can pave the way for a brighter future for mental health care.