How Are Leaders Talking About This?

Ohio Republican Mike DeWine and Atlanta Democrat Andre Dickens have each used the same argument about ER overcrowding and jail cycling in their public advocacy for crisis centers. Safer Cities polling tested message performance with 2,414 registered voters and identified which arguments produce the highest net positive ratings.

Three Themes That Appear Across Documented Programs

Theme 1: Right Responder, Right Call

Leaders across documented program launches have used a “right responder, right call” frame that positions the center as clarifying role responsibilities rather than displacing law enforcement.

Hawaii’s Dr. Chad Koyanagi articulated the operational version: the goal is “getting police back to the streets to fight crime.” Before the center opened, “a police officer could end up waiting hours with a patient.” Now they “can be back to the beat in like five or ten minutes.”

Clarksville, Tennessee Police Chief Ty Burdine used an identical frame from the other direction: the center “will help streamline the process of connecting individuals to appropriate care while allowing officers to return to other duties more quickly.”

Theme 2: We Already Pay for Every Crisis

Travis County Judge Andy Brown and Ohio Governor DeWine have each framed the center as redirecting existing spending rather than adding new cost.

Travis County Judge Andy Brown used the Miami example to make this concrete: “$4 million a year was saved because people arrested with mental illness were not taken to jail.”

Ohio’s Republican Governor Mike DeWine at the Dayton center opening: “if your son or daughter or a family member is in crisis, there is a place for that person to go.” This is the human version of the efficiency frame, not about the cost of crisis, but about the absence of a solution.

Safer Cities polling: 92% of voters found the ER overcrowding argument convincing; 91% found the jail cycling argument convincing.

Theme 3: Break the Cycle

The third theme focuses on the revolving door: the same people, the same crises, the same expensive responses, week after week.

The KCCI editorial board in Des Moines: “Addiction can wreak havoc. And people in crisis today tend to end up in an emergency room or jail. When they need mental health support the most, many times, it’s not there for them. And as a result, the cycle continues.”

Fulton County Superior Court Judge Robert McBurney: “I am not the counselor that these folks need to see. I can be nice, but I’m not equipped with the tools that we’ll have in the diversion center.”

Theme 4: Essential Infrastructure, Not a New Experiment

Governor DeWine, Governor Youngkin, and DuPage County Board Chair Conroy have each used an infrastructure frame — positioning crisis centers alongside fire stations and EMS as essential emergency response capacity rather than as social services programs. The argument: communities already fund fire stations to be ready for fires, EMS to be ready for medical emergencies, and police to be ready for crime. A psychiatric emergency is a medical emergency. Not having a facility built for it is an infrastructure gap, not a policy choice.

Governor Mike DeWine has used this logic to justify Ohio’s $90 million statewide investment: the language of investment in permanent capacity rather than piloting a program. Virginia’s “Right Help, Right Now” initiative was explicitly framed as building a system — the same word used for roads, utilities, and emergency services — rather than funding a program that might or might not be renewed. Deborah Conroy, DuPage County Board Chair, described her county’s $25.8 million crisis center as “the missing piece in our system,” not as an experiment or a grant-funded add-on.

Language That Resonates and Language That Doesn’t

Safer Cities polling tested message performance and identified which frames produce broad support.

Common Objections and How Officials Respond

Objection: “This will become a magnet for homeless people and make the neighborhood less safe.”

Fort Collins Police Sergeant Andrew Leslie has a practiced response: “Mental health issues touch way more people and way more demographics than people realize. It’s not just a certain group. I’ve seen it from someone who just comes into town and is experiencing homelessness all the way to somebody who is a well-established business owner with multiple houses.”

Objection: “These people belong in jail / They should be hospitalized.”

Fulton County Superior Court Judge McBurney: “I am not the counselor that these folks need to see… I can be nice, but I’m not equipped with the tools.” This is a judge, not a health advocate, saying the justice system cannot do what it is being asked to do. It is one of the most credible voices available for this objection.

The polling: 82% to 9% prefer spending on “specialized care facilities such as crisis stabilization centers” over “build new jails,” including 75% of Republicans.

Objection: “The evidence isn’t strong enough.”

The Burns et al. 2025 independent study documents statistically significant ED utilization reduction. Arizona’s program-reported data covers 30+ years of operation.

Objection: “You’re coddling criminals and drug addicts.”

This objection conflates addiction with criminal intent and assumes the people reaching crisis centers are there because of bad choices rather than medical conditions. Alabama Department of Mental Health Commissioner Kimberly Boswell put it in clinical terms at the Craig Crisis Care Center opening: “We always want to intervene early in the illness so that people can get access to care and get into recovery a lot sooner and live a life of recovery a lot sooner.”

How Supporters Frame the Issue / How Skeptics Frame It

Supporter framing: Crisis stabilization centers provide immediate, appropriate care at lower cost than ERs and jails, free police to focus on crime, and break the cycle of repeated costly responses.

Skeptic framing: Crisis centers divert resources from proven public safety approaches, rely on limited evidence, and may not handle the complexity that officers currently manage.

The Political Landscape

Christy Lopez of Georgetown Law has articulated the progressive critique: crisis centers address acute episodes but not the underlying shortage of mental health infrastructure.

Safer Cities polling found 75% of Republicans prefer crisis center investment over jail construction.

The Bipartisan Champion Roster: How to Use It

Republican and Democratic officials have each publicly championed crisis centers.

The roster in 2025:

Republican champions: Ohio Governor Mike DeWine ($90 million statewide investment, repeated public appearances at center openings). Former Virginia Governor Glenn Youngkin ($58 million “Right Help, Right Now,” framed explicitly as law enforcement support and ER burden reduction). Georgia DHBDD Commissioner Kevin Tanner (coordinating a multi-center state strategy under a bipartisan state government). Police chiefs from Clarksville, Tennessee; San Angelo, Texas; and Hawaii, all of whom have given on-record endorsements grounded in operational benefits.

Democratic champions: Atlanta Mayor Andre Dickens (reelected November 2025, called the Fulton County center a “game-changer for public safety”). Travis County Judge Andy Brown (cited concrete Miami savings in public testimony). Columbus, Ohio — City Council and County Commission joined hospital systems in funding the Franklin County center. Multnomah County Chair Vega Pederson (Portland) described the behavioral health resource center as “this is something we’ve never had before.”

What Different Stakeholders Want To Know

What Police Leadership Wants To Know

A police chief considering a crisis center is asking operational questions: Will this actually free my officers from psychiatric calls, or will it create a new bureaucratic step while the same calls still tie up my people? Will the facility accept anyone my officers bring, or will I face unpredictable refusals? And will this program suggest that police failed at something they should have been doing all along?

The evidence that speaks to these concerns: Memphis built a dedicated key-card drop-off for officers that completes transfers in 15 to 30 minutes rather than the hours ER transfers require. Hawaii’s Dr. Chad Koyanagi reports that before the center opened, officers could “end up waiting hours with a patient” — after, they “can be back to the beat in like five or ten minutes.” King County established a formal guaranteed-acceptance policy so officers know they will never be turned away mid-transfer. Dr. Margaret Balfour’s research on the “no wrong door” principle — the guarantee that officers are not turned away before assessment — identifies this as the single most important operational assurance for building police department trust. Chiefs who have championed these programs describe them as giving officers somewhere to go, not as reassigning their work. Clarksville Police Chief Ty Burdine: the center “will help streamline the process of connecting individuals to appropriate care while allowing officers to return to other duties more quickly.”

What Hospital and Health System Leaders Want To Know

A hospital administrator or ER medical director is asking: Will this reduce the psychiatric boarding that is costing my department beds and staff capacity? How does the referral pathway work? And is this institution about to compete with us, or complement us?

The evidence that speaks to this: 46% of emergency departments nationally lack psychiatric consultation services; 59% must transfer psychiatric patients elsewhere because they cannot adequately treat them on site. ER administrators do not need to be sold on the problem — they live it. The 2025 Indiana University study documented that crisis stabilization centers are associated with statistically significant reductions in mental-health-related emergency department utilization, the direct operational benefit ER directors want to see. The framing that works with hospital leadership positions the crisis center as the facility that handles what ERs were never equipped for, reducing pressure rather than creating competition. The Arizona boarding cost figure — $2,264 per episode, $37 million annually in Maricopa County before the crisis system matured — gives ER administrators a number from their own cost category to anchor the conversation.

What Fiscal Conservatives and Budget Committees Want To Know

The question from a county commissioner or budget director is not whether the model sounds appealing. It is: Does it pencil out? What does it cost to start, what does it cost to sustain, and where does the money come from when the grant runs out?

The evidence that speaks to this: Every psychiatric boarding episode at a hospital costs an estimated $2,264 in direct costs alone — and hospitals absorb those costs, which means taxpayers ultimately do too. Every jail booking for a mental health call costs more than a crisis center stay. The Maricopa County system’s program-reported projection — $260 million in reduced inpatient expense from a $100 million investment — is the figure most often cited in legislative hearings; officials presenting it should be prepared to clarify that it is a model-estimated cost avoidance, not an independently audited fiscal impact. The stronger argument for budget-minded audiences may be the structural one: Medicaid reimbursement, where states have approved it, covers direct patient encounters and turns an expense into a revenue-generating service. Arizona’s system, operating for over 30 years, now covers a substantial portion of its operating costs through Medicaid billing — demonstrating that the long-run economics are sustainable in a way that grant-funded pilots are not.

Angela Kimball of Inseparable has documented that Medicaid covers billable encounters but not training, standby staffing, or below-threshold contacts — requiring separate funding streams.

What Families and Caregivers Want To Know

A family member who has watched a loved one cycle through ERs and jails is asking a different set of questions: Will the center actually accept my person? Can I bring them myself, without police? Will they be treated with respect rather than restrained or arrested? And what happens at discharge — do they just go home, or is there a plan?

Connecticut’s REST Center, King County, and Columbus’s Franklin County center all document walk-in and family-accompanied admission pathways. Governor DeWine named the family experience directly at the Dayton opening: “if your son or daughter or a family member is in crisis, there is a place for that person to go.”

Franklin County Columbus’s center design explicitly includes medication supply at discharge, appointment scheduling, and peer follow-up calls as standard discharge elements.

What Journalists and Editorial Boards Want To Know

A reporter or editorial board evaluating crisis stabilization centers is asking: Is the evidence real, or is this hype? What are the limits? Are you being honest about the failures, or are you selling a success story?

The Burns et al. 2025 study — 1,002 zip codes across five states, funded by AHRQ, published in Health Services Research — documents statistically significant reductions in emergency department utilization. Beyond that, there is program-reported outcome data from Arizona’s 30-year mature system and a growing set of first-year reports from newer programs. There are also five documented program failures with identified causes: two Arkansas closures, three Montana crises bed suspensions, and Nevada’s Renown center suspension. The honest framing for a reporter is that the evidence supports the core claim (crisis centers reduce ER utilization) and documents real cost savings in a mature system, while long-term revolving-door reduction has not been independently demonstrated and quality variation across facilities has not been studied. Leaders who say that directly — “the evidence supports building this and the long-term outcomes are still being tracked” — are distinguishing the independently verified finding (Burns et al. 2025) from the program-reported projections (Arizona AHCCCS).

Nashville’s 80% non-return-to-jail rate, Maricopa’s $260 million in projected savings, and Arizona’s 63.3% thirty-day non-reutilization are program-reported figures, not independently audited results. The independently verified finding on ED reduction is the Burns et al. 2025 Indiana University study across 1,002 zip codes.

Bottom Line

Safer Cities polling found the ER argument (92% convincing) and jail cycling argument (91% agreement) are the highest-performing messages tested.