Family Caregiver Experiences with Mobile Behavioral Health Crisis Services: A Qualitative Study.

Mobile behavioral health crisis response services, staffed by clinicians and specialists, can support individuals experiencing urgent mental health or substance use issues. While Medicaid coverage for these services since 2021 has supported growth in their availability, research on family caregivers' experiences with mobile crisis services remains limited. Family caregivers often participate in encounters with crisis services when the person in crisis cannot seek help independently due to their symptoms. This study aimed to explore family members' experiences with a mobile crisis program in the US using qualitative methods. The study examined an expanding, county-level mobile crisis program designed according to SAMHSA guidelines and Medicaid-qualifying standards, staffed by clinicians and peer support workers. We used qualitative methods to understand family caregiver experiences with these services. Data was collected through in-depth interviews with family caregivers (N = 11), the primary source for this analysis, and ethnographic field observations of mobile crisis response teams (N = 29 observation days), which provided contextual information about service delivery and family involvement during crisis. Transcripts and field notes were analyzed for recurrent themes. Family members expressed feeling isolation and being overwhelmed while managing loved ones' constant care. Many worried that without their support, loved ones would face homelessness and worsened mental health. Families identified the mobile crisis service as a substantial improvement over the other options they could turn to for help. They reported that crisis services alleviated isolation, appreciated providers who understood home dynamics, and found comfort in having a safe and responsive resource to call when needed. Families identified the availability mental health responders as a source of relief both during and after crisis episodes. Understanding how features of crisis response service are experienced by family caregivers can inform impact studies by highlighting potential mechanisms of effectiveness.