“It’s Possible and There’s People Doing It Now”: Examining Experiences of Organizers and Health Professionals in Creating Community-Based Alternatives to Emergency Crisis Care

Abstract

While medicalized interventions for mental health crises, especially those involving police or other carceral institutions, have been broadly criticized, there is limited implementation of non-medicalized community-based alternatives to emergency crisis care. The purpose of this study was to provide pilot research into the underlying logic and principles of non-carceral approaches to emergency mental health care, looking specifically at the motives and practices of existing alternatives to medicalized emergency care. A reflexive thematic analysis approach was utilized to analyze the interviews of 5 community organizers and healthcare providers in an examination of how organizers and professionals engage in their positions with attention to defining their philosophy of alternative care and tangible aspects of advocacy work (i.e., skills, goals, and training). The analysis resulted in three main themes with 10 subthemes: (1) commonalities in the concepts and principles guiding participants’ work; (2) environmental and social influences; and (3) barriers to creating alternative care. Implications for research and practice are provided, including the need to further define “alternative care” across a diverse range of services and the consideration of social location and broader political influences on the provision of alternative care.