Galveston Expands Access to Crisis Care With New Response Teams

How one Texas community brought together police, mental health clinicians, and paramedics to respond to behavioral health emergencies

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Galveston Expands Access to Crisis Care With New Response Teams
A male clinician, wearing a blue collared shirt and dark pants, is sitting in the passenger seat of a vehicle and types on his laptop. His female colleague, wearing a similar outfit, is also typing on her laptop in the backseat.
Paramedic William Reed, left, and clinician Arielle Gray, complete their notes after responding to a mental health call in Galveston, Texas. The pair are members of the new Compassionate Open Access to Services and Treatment teams, which respond to emergencies involving mental health crises in the city.
Jennifer Reynolds The Galveston County Daily News

Only three months into its existence, new teams created to respond to emergencies involving mental health crises in Galveston, Texas, are showing promising results.

Officially launched on March 13, the teams—called Compassionate Open Access to Services and Treatment (COAST)—are composed of a Galveston Fire Department paramedic, a Galveston police officer specifically trained to respond to mental health emergencies, and a licensed clinician from the Gulf Coast Center, a community organization that provides services for people with mental health and substance use needs.  

By April 30, the teams had responded to 114 calls. Sixty percent of the calls resulted in the persons involved either being connected to appropriate care within the community or were resolved on the scene. Only seven resulted in arrest.

“When people in our community experience an emergency, they deserve to know they will receive the best response and care when they dial 911. I am tremendously proud of this program that was specially designed to meet the needs of Galveston,” Mayor Craig Brown said. In addition to the new response teams, Galveston’s 911 center also launched a “fourth option” for calls—the dispatcher asks callers if they need mental health services alongside police, fire, or EMS.

There are two COAST teams operating, available in 12-hour shifts from 7 a.m. to 7 p.m. Monday through Saturdays, and 9:00 a.m. to 5:00 p.m. on Sundays. When they are not answering calls, they conduct follow-up outreach to individuals in need of services.

“These efforts are particularly important, because teams like COAST also do proactive outreach to get people access to services,” said Max Geron, senior director of health and public safety at the Texas-based Meadows Mental Health Policy Institute, which, in consultation with local officials and stakeholders, designed the response teams. “So while COAST is equipped to handle emergencies as they arise, they also work to prevent those emergencies in the future.”

The COAST team marks a significant change, providing a new approach for first responders, especially law enforcement officers.

“As a police officer, my duty is to protect those who can’t protect themselves, and those suffering from mental health conditions are one of the most vulnerable segments of our society,” Galveston police chief Doug Balli said. “And so initiatives like COAST, where we’re taking a holistic look at how to best respond to these emergencies, is way overdue. This needs to be an effort across the board and at every policing agency throughout our nation.”

Balli also noted that initiatives like COAST can help alleviate the burden police officers have of often being the sole responders to mental health crises and instead have them respond to calls that need a law enforcement response or crime prevention activities.

The Galveston COAST team is based on the multidisciplinary response teams that began in Dallas in 2018. Since then, early data shows that the approach has promise, and the model has expanded to other counties and cities in Texas—including Bexar, Abilene, El Paso, and Austin.

Nationwide, a number of specially trained mental health response teams also have been created by localities as they’ve realized the need for something more than  a law enforcement-led approach. States and cities from Washington D.C., to Chicago,  to Denver have tailored their own approaches to responding to people in distress. This movement is especially crucial at a time when mental health and substance use disorders have increased sharply. Nearly 1 in 4 adults in the U.S. had a mental health condition in 2021, and nearly 1 in 3 adults had a substance use disorder. Research from The Pew Charitable Trusts also showed that people with co-occurring mental health and substance use disorders are 12 times more likely to be arrested than those with no behavioral health conditions.

Promising approaches such as COAST teams are a step in the right direction. But it is also integral to measure results and regularly conduct analyses, to develop data-driven recommendations on how to keep improving responses. And while every team will look different, depending on the needs of a community and the resources it has at its disposal, the rise of new response teams throughout the nation sends the right signal: Health-driven responses to behavioral health emergencies must be the new status quo.

Julie Wertheimer directs research and policy for The Pew Charitable Trusts’ public safety performance and mental health and justice partnerships.

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