Several states are engaged in the development of next-generation systems, with support of the governor’s office, legislators, health department leadership and other stakeholders. Many have launched dedicated websites tracking the developments and road maps.


According to Sheree Kruckenberg, Vice President, Behavioral Health, for the California Hospital Association, the Investment in Mental Health Wellness Act of 2013, created by SB 82 (Steinberg, D-Sacramento), provides grant funds to improve access to and capacity for crisis services for Californians affected by mental health disorders. The provisions of SB 82 (Chapter 34, Statutes of 2013) authorize the California Health Facilities Financing Authority Act (CHFFA) to adopt emergency regulations to provide counties, and counties acting jointly, with grant funds for crisis capacity and program expansion projects.

Status of Implementation


In December 2012, Governor John Hickenlooper and the Colorado Department of Human Services introduced “Strengthening Colorado’s Mental Health System: A Plan to Safeguard All Coloradans.” “For the past five months, in response to the Aurora shooting, we have been working to expand mental health care and services across Colorado,” Hickenlooper said. “No single plan can guarantee to stop dangerous people from doing harm to themselves or others. But we can help people from falling through the cracks. We believe these policies will reduce the probability of bad things happening to good people.”


In November 2013, North Carolina DHHS Secretary Aldona Wos announced the McCrory Administration’s Crisis Solutions Initiative, a new statewide effort to improve mental health and substance abuse crisis services in North Carolina. This initiative will bring healthcare, government, law enforcement, and community leaders together to identify help for individuals experiencing a mental health or substance abuse crisis so they receive the most effective care.

“Improving mental health and substance abuse services is a top priority of our administration,” said Governor Pat McCrory. “By bringing people together to implement strategies that work, we can better serve the thousands of North Carolinans who struggle with mental illness and substance abuse.”

“With today’s announcement, we begin a focused, long-term effort to ensure that individuals and families who are experiencing a mental health or substance abuse crisis know where to turn for the help they need,” said DHHS Secretary Aldona Wos, M.D. “In turn, we can begin to reduce the tremendous burden that these issues place on hospital emergency departments and law enforcement.”

Each year, there are an estimated 150,000 visits to emergency departments in North Carolina related to an acute psychiatric or addictive disorder crisis. 13 percent of patients with a mental health crisis who are treated in an emergency department will return within 30 days. In addition, national studies indicate that about 17 percent of people in jail have a serious mental illness.

Status of Implementation


The 80th Legislature appropriated $82 million for the FY 08-09 biennium. Guided by the Legislature and in response to Rider 69, these funds allowed the state to make significant progress toward improving the response to mental health and substance abuse crises. The first phase of implementation focused on ensuring statewide access to competent rapid response services, avoidance of hospitalization and reduction in the need for transportation. The 81st Legislature continued funding for these crisis services for the FY 09-10 biennium.


At the end of November in 2013, Virginia State Senator Creigh Deeds told CNN that he was alive for just one reason: to work for change in mental health. Just a week earlier, his son “Guss” stabbed him 10 times and then ended his own life by suicide.

This happened only hours after a mental health evaluation determined that Guss needed more intensive services, but unfortunately, he had to be released from custody before the appropriate services could be found.

Implementation Status

  • Medical Press (December 2013) – Report reveals new data on access to mental health crisis care in Virginia