Responding effectively when someone experiences an overdose, suicide attempt, or another mental health emergency is a longstanding challenge for communities across Montana. In the past, police or EMS were almost always called to respond, and the person would likely be transferred to the local jail, emergency room, or the state hospital. This approach was expensive, strained local police and emergency resources, and often failed to provide appropriate support to the person in crisis and their loved ones.
Bringing Crisis Now to Montana
Over the last ten years, though, counties and tribes, along with state partners, have been working together to build a more effective, community-driven crisis response system. After a lot of hard work, we are seeing some truly impressive results.
In 2016, the Montana Healthcare Foundation began looking for ways to strengthen the state’s behavioral health system by addressing gaps in the continuum of care. Crisis response was an obvious area of need. Police told us about the lack of personnel trained to provide effective support to someone in crisis, and the time demands of driving them for many hours to a facility that could safely care for them. Hospitals told us about the lack of facilities and staff to de-escalate the situation and provide appropriate support.
To address this need, we started by helping communities convene their responders – law enforcement, EMS, hospitals, and behavioral health providers – and assess their current crisis systems. Based on those assessments, communities formed coalitions focused on adapting the national best-practice model, “Crisis Now,” to meet identified needs.
Crisis Now seeks to provide effective, appropriate care and avoid unnecessary use of emergency medical services and law enforcement for people experiencing a mental health crisis. The components of the framework ensure that in an emergency, there is someone to call, someone trained to respond, and somewhere safe to go.
For the past decade, we have provided strategic leadership, technical assistance, and invested more than $1.5 million to support community planning, development, and the implementation of Crisis Now. Our support has helped communities develop coalitions, complete system mapping to align behavioral health and criminal justice system resources, implement strategies to respond to behavioral health crises more effectively, and identify sustainable funding sources.
Additional funding for this work is provided by cities, counties, and tribes that invest tax dollars in building effective behavioral health systems. The state legislature supports local-driven crisis response work through a myriad of legislative bills, including crisis diversion and mobile crisis grants.
Our partners in this work include the Montana Department of Public Health and Human Services (DPHHS) Behavioral Health and Developmental Disabilities Division (BHDD), which manages state funding and oversees federal grants; the Montana Public Health Institute, which provides technical assistance to coalitions; and JG Research & Evaluation, which provides data analysis on coalition activity and statewide impact.
There are currently 39 counties and four tribal nations working to implement the Crisis Now framework.
What Are The Results?
The first component of Crisis Now is having someone to call when a person or loved one is experiencing a crisis. In 2022, Montana launched the 988 Suicide and Crisis Lifeline, which provides 24/7 phone support. In 2025, there were over 24,000 calls to the crisis line, and 88% of crisis calls were resolved over the phone without needing additional intervention such as a law enforcement response or emergency medical transport.
When a person needs more support than 988 crisis counselors can provide, the second component is having someone to respond. Through the Crisis Now efforts, 15 communities now have access to active mobile crisis response teams staffed by behavioral health professionals who travel to the person to provide care. Based on national research, we conservatively estimated that in 2025, mobile crisis team responses resulted in approximately 800 fewer ER visits and 1,400 fewer jail stays, with a cost savings of nearly $2 million.
The third component is providing a safe place for people to go if the mobile crisis response team cannot stabilize them. The goal is to build community-based crisis centers that provide quick assessment and short-term treatment in a therapeutic environment. There are currently two crisis facilities operating in the state, with at least six new facilities under consideration and in the planning phase. While this component of the model has proven challenging in our largely rural state, coalitions continue working to develop creative solutions that work in each community.
The results of these local and statewide efforts are impressive: more people are getting the care they need through lower-cost, more effective services and are avoiding the ER, jail stays, and the state hospital. In 2025, we saw increased use of 988 and mobile crisis response services, along with a 17% decrease in behavioral health-related EMS incidents.
The impact of Crisis Now can also be seen across the country. A recent national study found an association between increased calls to 988 and a decline in suicide among young people. States that had the largest reduction in suicide (up to 18%) also had the highest 988 call volume and likely the most investment in crisis diversion.
These data show that pairing the Crisis Now framework with state support and dedicated community collaboration is helping Montana address one of the state’s longest-standing and most important challenges. As encouraging as these early results may be, there is more work to be done. To build on the gains we’ve made, state and community partners will need to continue collaboration and optimize funding and reimbursement for crisis services.
