Accessing Mental Health Crisis Intervention Services: A Content Analysis Approach

Overview: This research identifies a gap in infrastructure when transportation options decrease during mental health crises leaving law enforcement as the primary transportation support. This content analysis approach assessed how transportation options are communicated and what online support exists in mental health crises by reviewing the websites of Texas counties (Nf245).Proposal text: Background
Accessing transportation during a mental health crisis is critical, particularly during emergencies. Individuals in mental health crises may exhibit violent behaviors and cannot consent to treatment. The transportation infrastructure for emergency mental health crises is limited in options, with law enforcement posing as the primary resource (Hedmen et al., 2016). Law enforcement responds to a call for service and determines their ability and necessity to provide transportation. In every state, policy enables law enforcement to initiate holds for persons in a mental health crisis (Hedman et al., 2016). Thus, a critical need arises for individuals, families, and caregivers to know the law and policies to access transportation resources during a mental health crisis. Federal government agency guidelines advise that individuals in mental health crises require transportation to mitigate the crisis, and this information should be provided publicly (Substance Abuse and Mental Health Services Administration, 2020). The existing gap in knowledge of these systems poses a threat of environmental and social injustice. Using Texas as an example, it ranks high in the prevalence of mental illness and low in funding and access to treatment (Reinert et al., 2021); it is imperative to understand how crisis mental health resources are communicated. This research aims to answer two questions: 1) how are instructions on accessing law enforcement support for transportation during a mental health crisis provided on local government websites? 2) to what extent is there online support for mental health crises that require emergency transport?

Methods
To answer the research questions, the researchers used a qualitative approach to examine all the county government websites in Texas (Nf245). The primary researcher screened each website using a single Google search command to identify key terms: mental health crisis and mental health. This command identifies the specific text, its contextual location, and how often used throughout the site. Direct content analysis provided the framework for review and coding.

Results
Researchers identified the following themes: 1) information on accessing mental health treatment located on the front webpage (n=0) 2) Explicit instructions on accessing transportation, whom to call, who is responsible for transportation, required criteria for transportation (n=1), and 3) local mental health crisis number (n=34).

Conclusions
County websites are missing essential information about transportation resources during mental health crises. This gap in information raises concern, as a lack of transportation remains a barrier in accessing mental health treatment (Ebert et al., 2019; Johnson et al., 2020). Study findings bolster support for future research in assessing the extent to which information about emergency transport during mental health crises is shared with the community and service providers through other information platforms, if at all. A need develops for social workers to advocate for increased awareness of and access to emergency transportation during mental health crises. Finally, given the issues related to the over-incarceration of persons with mental illness, there is a need to understand better the intersection of law enforcement, emergency transportation, and mental health services.