Community mental health journal · 2026
A Scoping Review of the Peer-Reviewed Research on Alternative First Response for Mental and Behavioral Health Crisis and Homelessness.
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Leickly Emily, Porter Christian, Kriegel Liat
Аннотация
OBJECTIVE: Alternative first response programs (i.e., non-law enforcement teams dispatched to calls involving mental or behavioral health crisis) have expanded rapidly, but implementation has outpaced development of an empirical evidence base. This scoping review assessed the current state of peer-reviewed research on these programs, including how they are defined and studied, and where gaps remain.
METHODS: Guided by PRISMA-ScR, a scoping review of peer-reviewed studies was conducted. Eligible studies described non-law enforcement teams dispatched to calls for service involving mental or behavioral health crises. PubMed was searched using a comprehensive set of keywords, supplemented by author-curated sources and reference list searches. After screening 2,510 records, 16 studies met inclusion criteria. Data extracted included study characteristics, program terminology and definitions, and findings. Content analysis identified recurring themes related to program features and research gaps.
RESULTS: All studies were published since 2019, with most since 2022. Terminology varied substantially, with "alternative first response" and "mobile crisis teams" most commonly used. Programs were typically defined in contrast to police response and staffed by multidisciplinary teams. Most focused on mental health crisis, often overlapping with homelessness and substance use, and emphasized de-escalation, service linkage, and diversion from criminal legal and emergency systems. Research gaps included limited attention to client experiences, particularly among marginalized populations, and a lack of longitudinal, experimental, and cost-effectiveness research.
CONCLUSIONS: There is little empirical research on alternative first response programs. More rigorous, longitudinal, and client-focused research is needed to assess program impacts and inform implementation, policy, and funding decisions.
METHODS: Guided by PRISMA-ScR, a scoping review of peer-reviewed studies was conducted. Eligible studies described non-law enforcement teams dispatched to calls for service involving mental or behavioral health crises. PubMed was searched using a comprehensive set of keywords, supplemented by author-curated sources and reference list searches. After screening 2,510 records, 16 studies met inclusion criteria. Data extracted included study characteristics, program terminology and definitions, and findings. Content analysis identified recurring themes related to program features and research gaps.
RESULTS: All studies were published since 2019, with most since 2022. Terminology varied substantially, with "alternative first response" and "mobile crisis teams" most commonly used. Programs were typically defined in contrast to police response and staffed by multidisciplinary teams. Most focused on mental health crisis, often overlapping with homelessness and substance use, and emphasized de-escalation, service linkage, and diversion from criminal legal and emergency systems. Research gaps included limited attention to client experiences, particularly among marginalized populations, and a lack of longitudinal, experimental, and cost-effectiveness research.
CONCLUSIONS: There is little empirical research on alternative first response programs. More rigorous, longitudinal, and client-focused research is needed to assess program impacts and inform implementation, policy, and funding decisions.