When someone in mental health crisis calls 911, the response has traditionally defaulted to law enforcement—often because there’s no one else equipped to respond immediately. But a growing number of communities are experimenting with a different model: embedding behavioral health professionals directly into police crisis response systems.
These partnerships represent a pragmatic attempt to solve a problem that has long frustrated both police departments and mental health advocates. Officers spend hours managing psychiatric crises they’re not trained to handle, while patients in desperate need of clinical care end up cycling through emergency rooms and jails instead of getting connected to appropriate treatment.
In places like Amarillo, Texas, and other forward-thinking jurisdictions, the experiment is showing promising results. The question now is whether these isolated successes can scale into systemic change.
Riding Along: What Embedded Behavioral Health Response Looks Like
Larissa Bernal’s workweek looks different from most behavioral health case managers. She spends 40 hours weekly riding alongside an Amarillo Police Department officer, responding to 911 calls involving suicide threats or mental health emergencies.
The protocol is straightforward: When they arrive at a scene, the officer first ensures safety. Then Bernal takes over, using behavioral health approaches to deescalate the situation and connect the person with follow-up care. She works as part of the department’s crisis intervention team, which includes four officers and one sergeant specially trained in mental health response.
But the impact extends beyond those 40 hours. Beat officers throughout the department now provide steady referrals during nights and weekends when Bernal and her counterpart aren’t on duty. The specialized team has become an informal consultation resource for the broader department.
The results speak to the model’s effectiveness. The program was initially expected to serve at least 191 people annually. Between September 2019 and August 2020, Bernal and her counterpart helped 392 people—more than double the target.
Bernal’s position is funded jointly by Texas Panhandle Centers, the regional mental health authority, and the police department, with support from Texas HB 13 grants designated for community behavioral health initiatives. This hybrid funding structure reflects the cross-system nature of the work.
The Training Gap That Drives Partnership Models
The rationale for these partnerships becomes clear when examining the skills gap. Some states, including Texas, mandate 40 hours of mental health training for police officers. While that training helps, it pales in comparison to the education and clinical experience behavioral health professionals bring.
As XFERALL chief clinical officer Shana Palmieri bluntly observed, traditional crisis response meant “sending an untrained person in mental health out to deal with a person who is erratic, psychotic, you know, maybe flinging a weapon around at you.”
Hospital behavioral health units have protocols, specialized staff, and environmental controls designed for managing psychiatric emergencies. Police officers responding to crisis calls have none of that infrastructure. They’re expected to improvise crisis intervention while also managing public safety concerns.
Even with specialized crisis intervention training, officers continue learning from their behavioral health partners. Bernal noted that her police colleagues are still developing expertise in post-crisis care coordination—understanding the network of inpatient hospitals, psychiatric providers, counselors, and case managers who collaborate to prevent future crises.
This knowledge gap extends to practical matters like insurance verification, bed availability at psychiatric facilities, and appropriate placement based on acuity and diagnosis. These are clinical and administrative functions that fall outside traditional law enforcement competencies.
The Hidden Time Cost of Mental Health Crisis Response
Dalhart Chief of Police David Conner, who has worked in criminal justice since the 1990s, described the traditional model with evident frustration. Officers would respond to crisis calls, detain the person, transport them to a hospital for assessment, then begin the laborious process of finding placement.
That process involved calling behavioral health providers throughout the region to check bed availability and whether they’d accept the patient based on insurance status. Once placement was secured, officers would drive patients to inpatient facilities sometimes five hours away.
The time burden was enormous. Officers spent hours on what amounted to case management and medical transportation, removing them from other public safety duties. Meanwhile, the person in crisis sat in the back of a police car—hardly a therapeutic environment—waiting for placement.
Conner’s department recently began using XFERALL, a platform that functions like a search engine for psychiatric bed availability. Participating behavioral health hospitals indicate what patient profiles they’ll accept, and the system automatically identifies facilities with open beds matching the patient’s needs.
The technology doesn’t eliminate the transportation burden, but it removes the time-consuming placement search. Conner has requested city council funding for a dedicated mental health case manager to further streamline the process, though budget concerns have stalled that initiative.
Technology as Bridge Infrastructure
XFERALL represents a category of solutions attempting to patch gaps in fragmented behavioral health systems. The platform addresses a specific friction point: the information asymmetry between police officers trying to place patients and psychiatric facilities with available capacity.
Without real-time bed tracking, officers resort to calling facilities one by one—a process that can take hours during periods of high demand. For the person in crisis, those hours spent waiting in police custody can be traumatic and potentially destabilizing.
Technology platforms like XFERALL work because they don’t require wholesale system redesign. They create connective tissue between existing institutions, reducing administrative burden while improving placement speed and appropriateness.
However, technology alone can’t solve the core structural challenges. As Palmieri noted, even communities with mental health workers embedded in police departments often have just one or two positions—nowhere near sufficient to respond to every crisis call. And officers still frequently end up providing hours of transportation even when placement is identified efficiently.
The Relationship Management Challenge
National Council for Behavioral Health President and CEO Chuck Ingoglia identified the core barrier to scaling these partnership models: they require buy-in and active participation from multiple stakeholders across fragmented systems.
Mental health providers, police departments, prosecutors, public defenders, hospital emergency departments, and county behavioral health authorities all touch these cases. Each operates within different organizational structures, funding streams, and accountability frameworks.
Creating effective partnerships means building trust and aligned incentives across these silos. It requires sustained relationship management rather than one-time agreements. Stakeholders must collectively believe the partnership approach delivers better outcomes than existing protocols.
This fragmentation helps explain why successful partnership models remain isolated rather than widespread. Each jurisdiction that wants to implement similar programs must navigate its own unique constellation of agencies, funding sources, political dynamics, and institutional histories.
The Funding Puzzle
Financial sustainability represents another significant barrier. As Chief Conner’s experience demonstrates, securing ongoing funding for mental health case managers embedded in police departments can be difficult. City councils and county commissioners face competing budget priorities and may view behavioral health partnerships as optional rather than essential.
Grant funding—like the Texas HB 13 support for Amarillo’s program—can seed initial partnerships, but grants typically expire. Transitioning to sustainable local funding requires demonstrating clear value to multiple stakeholders.
The value proposition exists. Police departments benefit from reduced officer time spent managing psychiatric crises. Behavioral health systems benefit from more appropriate referrals and reduced emergency department utilization. Patients benefit from faster connections to clinical care. Communities benefit from reduced recidivism and better long-term outcomes.
But translating those diffuse benefits into dedicated funding lines requires political will and creative financing across departmental budgets. Few jurisdictions have solved this puzzle systematically.
What Success Could Look Like at Scale
Bernal believes the partnership model she works within could transform crisis response nationwide if implemented broadly. Her aspiration is that these collaborations become mainstream rather than exceptional.
The potential is significant. Law enforcement agencies across the country respond to mental health crisis calls daily. In many jurisdictions, those calls represent a growing proportion of overall 911 volume. The traditional response—armed officers without clinical training attempting to manage psychiatric emergencies—serves no one well.
Scaled implementation would require several elements: dedicated funding mechanisms that don’t depend on competitive grants, training protocols for both police and behavioral health staff working in these roles, technology infrastructure to support placement and care coordination, and governance structures that formalize collaboration across agencies.
Some jurisdictions are experimenting with alternative models where behavioral health crisis teams respond independently rather than embedded with police. Others are creating civilian crisis response units that handle certain call types without police involvement. The optimal model likely varies based on local context, existing infrastructure, and community preferences.
Patient Care and System Benefits
Palmieri emphasized that these partnerships fundamentally serve patient care. When individuals in behavioral health crisis interact with law enforcement, they need pathways to appropriate facilities—whether substance abuse treatment, psychiatric hospitals, or other specialized care.
Without functional partnerships, patients end up stuck in emergency departments or jails because no one can efficiently navigate the placement process. They receive inadequate care in inappropriate settings, often cycling back into crisis.
Collaborative models create smoother pathways from crisis to care. Behavioral health professionals embedded in police response can conduct preliminary assessments, initiate crisis intervention, and begin care coordination while situations are still acute. This front-end triage dramatically improves the likelihood of appropriate placement and engagement with ongoing treatment.
The benefits extend beyond individual patient outcomes. Communities with effective crisis response partnerships experience reduced emergency department boarding, fewer jail bookings for behavioral health crises, and lower recidivism rates. Officers spend less time on extended crisis interventions, returning to other public safety duties faster.
The Broader Context of Police Reform
These partnerships emerge against the backdrop of intense national scrutiny regarding police responses to mental health crises. High-profile cases of fatal encounters between police and individuals experiencing psychiatric emergencies have fueled demands for fundamental reform.
Some advocates argue that armed police officers should not respond to mental health crises at all, proposing entirely civilian crisis response systems. Others support hybrid models where behavioral health professionals and officers respond together, leveraging both clinical expertise and safety management.
The partnership approaches described here represent pragmatic experiments within existing systems rather than wholesale redesigns. They acknowledge current realities—police will continue responding to many crisis calls—while attempting to improve outcomes through specialized training and embedded clinical expertise.
Whether incremental reforms like these suffice or more fundamental restructuring is needed remains contested. But jurisdictions implementing partnerships are gathering data on outcomes, costs, and operational challenges that can inform policy debates.
Looking Forward
The success of programs in Amarillo, Dalhart, and similar jurisdictions demonstrates that police-behavioral health partnerships can work when designed thoughtfully and supported adequately. The challenge is translating isolated successes into systematic change.
That transformation requires addressing persistent barriers: fragmented funding, siloed systems, training gaps, and political will. It requires sustained relationship building across agencies with different cultures and priorities. And it requires creative problem-solving around operational challenges like ensuring adequate staffing to respond to all crisis calls.
Technology platforms, grant funding, and individual champions like Bernal can catalyze change, but sustainable implementation demands institutional commitment. Behavioral health authorities, law enforcement agencies, local governments, and community stakeholders must collectively prioritize crisis response partnerships and fund them accordingly.
For behavioral health providers, these partnerships represent both opportunity and obligation. The opportunity is to extend services upstream, engaging people in crisis before they enter emergency departments or jails. The obligation is to step into challenging operational contexts—riding along with police, working irregular hours, navigating safety concerns—to serve populations in acute need.
As Bernal expressed, this could be the moment when collaborative crisis response becomes mainstream rather than exceptional. Whether that happens depends on scaling the isolated experiments happening in places like Amarillo into systemic infrastructure that serves communities nationwide.
The need is clear. The models exist. What remains is the political and institutional will to fund, implement, and sustain partnerships that recognize behavioral health crises require clinical responses, not just law enforcement intervention.
