Who Are the Key Stakeholders?

Crisis stabilization centers sit at the intersection of behavioral health, law enforcement, emergency medicine, and courts. SAMHSA’s 2025 National Guidelines identify stakeholder engagement as a prerequisite for successful implementation.

Law Enforcement

Police chiefs in multiple documented jurisdictions have publicly endorsed crisis stabilization centers on operational grounds.

Atlanta Police Chief Darin Schierbaum reported his department responded to more than 9,000 mental health crisis calls in 2021: “That is not the role of the court… when you look at the limited resources that an Atlanta police officer carries, you see our frustration.” Hawaii’s Dr. Chad Koyanagi: before the center opened, “a police officer could end up waiting hours with a patient” but now “can be back to the beat in like five or 10 minutes.” Clarksville, Tennessee 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 they need to stay supportive: A reliable “no wrong door” drop-off policy is the most important operational assurance. Dr. Balfour’s research notes that “when officers are turned away, they are discouraged from attempting to drop off in the future.” Officers need consistent acceptance regardless of patient behavior or complexity, a fast transfer process, and confidence that the facility can handle the populations they bring.

Emergency Departments and Hospitals

Hospital emergency departments have operational incentives to support crisis stabilization centers.

What they experience: Dr. Balfour’s research documents 46% of EDs lack psychiatric consultation and 59% must transfer patients they cannot treat. Arizona’s AHCCCS data estimates psychiatric boarding costs at $2,264 per person, totaling $37 million annually in Maricopa County.

What they need: Assurance that the crisis center will accept patients that the hospital would otherwise be stuck with, reliable information transfer when patients transition between systems, and cooperation on the cases where someone stabilizes at the center and then requires inpatient hospital care.

Potential friction: Hospital systems that have built behavioral health capacity of their own (psychiatric units, behavioral health emergency services) may see community crisis centers as competition for Medicaid patients. The Huntsman Mental Health Institute in Salt Lake City, for example, is operated by a university health system, not a community provider, with different institutional interests than a standalone community center.

Courts and Criminal Justice System

Judges in multiple documented jurisdictions have publicly supported crisis stabilization centers.

What they say: Fulton County Superior Court Judge Robert C. 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.” Travis County Judge Andy Brown: Miami saved $4 million annually after routing people with mental illness to crisis centers rather than jail. Johnson County, Kansas mental health director Tim DeWeese: “We’re better able to prevent negative outcomes later in life when we connect youth to treatment instead of detention.”

What they need: Clear protocols for court-directed diversion, reliable communication from centers about client engagement and discharge, and capacity to accept people who have pending charges or criminal justice involvement. Many centers explicitly serve anyone regardless of criminal justice status; the SAMHSA 2025 National Guidelines identify clear communication of eligibility to courts and prosecutors as a coordination requirement.

Families and Caregivers

Family members of people with serious mental illness have documented support for crisis stabilization centers.

Michelle Baker, executive vice president of Behavioral Health Services at Southcentral Foundation in Alaska: “People want their loved ones to receive services in a crisis stabilization program rather than in an emergency room, jail, or in hospitals.” The Seattle Times documents that King County’s centers were designed explicitly to serve people “whether they’re coming by themselves, or are brought by a family member or police.”

Behavioral Health Workforce

The clinicians, peer support specialists, nurses, and case managers who staff these centers have distinct interests in how facilities are designed, funded, and operated.

What they experience: Crisis work is acute and high-demand. SAMHSA’s 2025 National Guidelines identify workforce sustainability — including compensation and supervision — as an implementation prerequisite.

What they need: Sustainable compensation, scope-of-practice protections, and clinical supervision. The Northwest Arkansas CSU collapse accelerated when staff resigned after funding cuts.

Documented risk: Centers that cannot retain qualified clinical staff face quality erosion that undermines the center’s effectiveness and can generate the kind of negative patient experiences that damage community trust. The Northwest Arkansas CSU’s 2024 collapse began with state funding cuts and accelerated when staff resigned, leaving the facility with only four employees, insufficient to safely operate.

Named Critics

Several patterns of documented opposition appear in the record:

Patient experience critics: Calvin Carbello, a 17-year-old from Phoenix, described to PBS NewsHour in 2024 a crisis stabilization stay in which he was placed in a room with other youth in chairs, with little therapeutic intervention and disturbing conditions overnight. His mother Kelly described the experience as functioning more as a holding space than a treatment facility. These are not critics of the model in principle; they are critics of the quality of implementation at a specific facility. PBS NewsHour reported the Carbello account as illustrating that facility-level quality is not guaranteed by system-level investment.

Progressive structural critics: The same “band-aid on a bullet wound” framing that applies to mobile crisis teams applies here: crisis stabilization centers address acute episodes but do not address the shortage of long-term community mental health infrastructure, housing, and outpatient treatment that would prevent many crises from occurring.

Media and Editorial Boards

Local editorial boards in multiple cities have endorsed crisis stabilization centers.

The KCCI editorial board in Des Moines endorsed the Polk County center: “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.” The Columbus Dispatch editorial board: “People in a mental health or substance abuse crisis deserve care in a warm, welcoming, safe and appropriate place.”

The Accountability Chain

SAMHSA’s 2025 National Guidelines identify a governance structure for crisis stabilization centers that spans multiple institutional stakeholders: behavioral health authorities who set clinical standards, managed care organizations that administer Medicaid billing, law enforcement agencies with formal drop-off agreements, and hospital systems that provide backup capacity for acuity escalation. Each institutional relationship requires a documented memorandum of understanding or operational protocol to function reliably.

Dr. Balfour’s research identifies what happens when these relationships break down: “when officers are turned away, they are discouraged from attempting to drop off in the future.” The same logic applies to other referring stakeholders — courts, hospitals, and mobile crisis teams that encounter unpredictable acceptance criteria revert to previous defaults. The reliability of the center’s acceptance policy and the clarity of its referral protocols are institutional products, not individual decisions, which is why SAMHSA identifies stakeholder engagement as a prerequisite for implementation, not a post-launch communication task.

The funding relationship is itself a stakeholder relationship. Angela Kimball of Inseparable describes the structural gap that produces program collapse: crisis centers are funded for encounters while their capacity costs — staffing between calls, supervision, administration, facility maintenance — require separate and deliberate funding decisions by the government stakeholders who control appropriations.

Bottom Line

Documented support comes from police chiefs, judges, hospital administrators, families, editorial boards, and elected officials across party lines. Documented friction points are operational: Dr. Balfour’s research identifies officer refusal incidents as trust-eroding events; the Northwest Arkansas CSU documents how funding instability produces workforce collapse.