TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion and thought leadership area. Our hot topic today is community mental health crisis response, and the role that telepsychiatry can play in an integrated approach to  prevent crises from escalating. Today’s contribution is from Andy Flanagan of Iris Telehealth. As CEO, he drives strategy, operations, and culture, leveraging his extensive healthcare and leadership experience. A four-time CEO with a background in global health tech, he holds degrees from Northwestern and the University of Nevada, Reno.

Law enforcement is stepping back from mental health crisis response. Sacramento County Sheriff recently announced deputies will no longer respond to non-criminal mental health calls, citing a recent Ninth Circuit Court ruling that questioned police involvement where no crime has occurred.

Sacramento isn’t alone. In Austin, Texas, the police union president declared that “the Austin Police Department must stop responding to mental health calls,” as reported by Fox 7 Austin.

Law enforcement is underequipped for mental health crises. But who should respond instead? How do we build a system that connects people in crisis with appropriate care?

The answer lies in creating integrated crisis response systems that combine trained mental health professionals, community resources and telepsychiatry to ensure people in crisis get immediate access to appropriate care, regardless of location or timing.

The current crisis

In Austin alone, police responded to 34,000-52,000 mental health calls annually since 2020. Nationally, the burden is immense, with behavioral health-related emergency department (ED) visits doubling from 2011 to 2020, now reaching approximately 47 visits per 100 people.

When law enforcement withdraws from mental health response, this pressure shifts to already strained emergency departments. Without alternative systems in place, people experiencing mental health crises have nowhere to turn except hospital EDs, leading to overcrowding, extended wait times and less-than-optimal care environments for behavioral health needs.

First responders face an impossible task. Most receive minimal mental health training — often just 40 to 120 hours — compared to the years of specialized education mental health clinicians receive. This gap creates dangerous situations like the DeSilva case that prompted the Ninth Circuit ruling.

A better approach

Communities are discovering more effective models for mental health crisis response. The nationwide 988 Suicide and Crisis Lifeline provides immediate access to trained counselors, while integrated crisis response systems — like Austin’s approach of offering mental health services as a 911 option — show promising results. When Austin callers select mental health services, they’re connected with Integral Care clinicians who conduct assessments, provide support and deploy mobile crisis teams when needed. According to Fox 7 Austin, 87% of these calls are resolved without police involvement.

Specialized mental health professionals are the cornerstone of these systems. These experts bring the right training and perspective to de-escalate situations, connect individuals to appropriate resources and provide trauma-informed care. Unlike law enforcement, their approach centers on therapeutic intervention rather than control and containment.

Technology bridges access to specialized services. Telepsychiatry enables immediate access to mental health expertise, even when providers aren’t physically present. Digital platforms can connect crisis responders with psychiatrists for real-time consultation, ensuring appropriate assessment and care planning from the first point of contact. This is particularly valuable for rural communities with provider shortages, where in-person mental health specialists may not be readily available.

The role of telepsychiatry

Telepsychiatry platforms connect patients directly to behavioral health expertise before crises escalate. Today’s technology enables immediate access to qualified mental health professionals through smartphone apps, community centers and EDs. Modern systems incorporate AI-driven analytics to optimize patient scheduling and resource allocation without replacing clinical judgment.

The benefits are immediate for patients who receive specialized care within 30-45 minutes versus traditional ED visits taking 2+ hours. Healthcare providers gain psychiatric expertise without maintaining 24/7 in-house specialists, addressing a critical gap where 54% of U.S. hospitals have no psychiatrists available for ED and inpatient consultation services. When telepsychiatry is effectively implemented, health systems experience reduced boarding times, lower admission rates and improved emergency department throughput. One hospital avoided more than $1.7 million in boarding costs with a 281% return on investment, while another reduced psychiatric patient length of stay by 70%.

Technology works best when enhancing human expertise, not replacing it. A recent Iris Telehealth survey found 41% of respondents would feel comfortable receiving treatment recommendations from AI-powered mental health tools, and 33% would leverage these tools if integrated into services they already use (think telehealth platforms or primary care visits).

As law enforcement rightfully steps back from mental health crisis response, we must step forward with integrated solutions that combine human expertise and technology. Telepsychiatry represents one critical piece of a comprehensive approach connecting people in crisis with appropriate care.

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