Travis County-funded crisis teams and diversion pilot sharply cut arrests and detentions but face capacity constraints

Integral Care officials told the Travis County Commissioners Court that county-funded crisis teams, 911-integrated clinicians and a new Therapeutic Diversion Program (TDP) have diverted most crisis encounters away from police response and emergency detention, producing large reductions in arrests and emergency detentions — but that limited bed capacity and a multi-week waitlist are constraining the program’s reach.

The briefing, delivered by Integral Care staff and program leads, focused on crisis-response expansions the county funds: an embedded 911 clinician program, field mobile crisis outreach teams (EMCOT/MCOT), a Psychiatric Emergency Services (PES) diversion pilot and the Therapeutic Diversion Program, a 25‑bed crisis respite facility built to provide alternatives to incarceration.

Integral Care described strong program outcomes and operational limits. Marissa Malik, director of crisis services and justice initiatives at Integral Care, said the EMCOT field team “received over 3,000 dispatches with over 90% of those outcomes diverted from incarceration, emergency department admissions, as well as the police officers emergency detention.” Malik also said clinicians in the 911 center handled almost 5,000 calls with roughly 80% diverted from police response. She cited an independent study by UT’s LBJ School of Public Affairs and Cornell University showing statistically significant reductions where 911 clinicians were involved, including “reductions in emergency detentions, reducing that 40 to 62%, arrests at anywhere from 37 to 58%.”

Malik and other speakers described the diversion pilot’s hospital- and community-facing components: PES provides 24/7 intake, medication evaluation, peer support and three 23‑hour observation beds and acts as a drop-off point for first responders. The Therapeutic Diversion Program (TDP) is a 25‑bed crisis respite site that opened during the pilot. Integral Care reported TDP had served 83 unique individuals through March and that all initial referrals came from defense attorneys/Jail-originating pathways; the program had 42 unplanned discharges and an active interest list averaging about four weeks to admission from jail. Malik said the site is opening a pathway for PES referrals so referrals will not be limited to jailed clients.

County-funded justice-involved services also showed early positive outcomes. Integral Care’s jail in-reach and intake team served 539 individuals and connected 85% to outpatient services within Integral Care, with the court‑embedded outpatient competency restoration (OCR) program reporting that, for clients who completed the program, 97% were either restored to competency or had criminal charges dropped. Marlene Buchanan, Integral Care’s chief programs officer, described the county‑funded Travis County ACT Expansion Team (an assertive community treatment model) that served 94 high‑need adults in FY24 and “had a 90% decrease in emergency room and crisis utilization visits,” exceeding the program goal.

Speakers emphasized practical constraints and next steps. Malik said the diversion pilot has an interest list and “we're already seeing capacity constraints with the need in our community.” Staff are training first responders (Austin Police Department training completed; Sheriff’s Office training starting), allocating bed sets for PES referrals, and planning peer follow-up when clients leave unplanned to attempt reengagement. Integral Care also noted that many diversion referrals come from people experiencing homelessness and that preserving clients’ housing status while in respite was a planning priority.

Integral Care presenters also described related county‑funded services: child and family programs in schools and Manor/Pflugerville areas, IDD in‑home respite (77 clients, 227 completed appointments, Travis County investment $296,247 in FY24) and an IDD crisis respite program that served 80 individuals in FY24 with a 95% success rate of returning people to residence within 14 days (Travis County investment $570,595). Britney Whittington, director of accountable care services, said Integral Care serves over 28,000 Travis County residents annually, with more than 400,000 services and over 1,000 staff.

Discussion vs. decision: the presentation was informational. Commissioners and attendees asked for additional data (average OCR length of stay; reasons behind unplanned discharges at TDP; AOT compliance outcomes). Integral Care repeatedly offered to provide follow-ups by email and to return with additional statistics; no formal county motions or votes were taken during the briefing.

What’s next: Integral Care staff said they will expand PES→TDP referral pathways, continue training sheriff’s office personnel, analyze unplanned-discharge drivers and report follow-up statistics requested by commissioners.

Ending: Commissioners praised the results and asked for future briefings and data on outcomes (AOT compliance, OCR length of stay, TDP re‑engagement). Integral Care said it will return with the requested details and noted that scaling the programs will require additional capacity and continued funding.