The Socio-Ecological Model for Alternative Crisis Response: A Conceptual Model for Understanding and Evaluating Best Practices for Alternative Mental Health Crisis Response Interventions

Background and Purpose: Reports of mental health crisis responses resulting in harm to the person in crisis where the first responder was law enforcement have elevated calls for inquiry, both from within the mental health community and the general population at large, about the structures in place within our current mental health systems for responding to mental health crises. Are our current response systems best practice for responding safely and effectively to people experiencing a mental health crisis? The appeals to remove police as first responders in mental health crises have advocated instead for the use mental health experts – notably social work, primary care, and other mental health professionals. While alternative crisis intervention models have launched in Canada and the United States as a response to the need for more alternative crisis response options, an awareness of current practices and key facilitators is integral to our informed understanding of successful best practices for developing first responder interventions for mental health crises that minimize harm to the person in crisis. The research this Flash Talk proposal comes from asked the following research questions: 1) What has informed our current mental health response crisis?; 2) What are the components of alternative mental health crisis interventions?; and 3) What have been identified as facilitators and barriers to implementing a successful crisis intervention

Methods: The researcher performed a systematic review of the literature of studies and evaluations of co-response teams and non-policing teams conducting alternative crisis response interventions in Canada and the United States.

Results: As a consequence of their inquiry into the identified facilitators and barriers to implementing a successful crisis intervention the researcher developed the Socio-Ecological Model for Alternative Crisis Response. This model is a tool adapted from the Socio-Ecological Model that focuses on a strength-based approach to understanding the facilitators and key factors needed to build capacity within organizations and communities to support successful alternative crisis interventions and programs. While a deficit approach highlighting barriers to success and well-being is frequently used within research for people with marginalized identities, the Socio-Ecological Model for Alternative Crisis Response shifts away from a deficit approach, focusing on what works and what is needed. For example, if the barrier to a successful intervention is insufficient access to mental health referrals for a region, then what is needed are sufficient regional services; if there is a lack of access points, what is needed is multiple access points. This model provides a structure to understand what facilitators contribute to successful alternative crisis response interventions under the headings: Intrapersonal, Interpersonal, Organizational, Community, and Policy.

Conclusions and Implications: The Socio-Ecological Model for Alternative Crisis Response can be employed by social workers as a lens to critically understand the facilitators needed for successful crisis responses, to inform our approach to crisis intervention and prioritize the root causes and the historical production of harms that contribute to mental health crises and poor intervention outcomes.