By Grace Da Rocha
Las Vegas Sun
CLARK COUNTY, Nev. — Clark County commissioners on Tuesday heard results from a pilot program that tested a new crisis response model to assist people experiencing mental or behavioral health emergencies — a step that could lead to the county joining other Southern Nevada jurisdictions with permanent teams dedicated to those calls.
Deputy County Manager Abigail Frierson presented data showing the Clark County Fire Department’s “CRT 18" unit, launched last year with a $535,000 federal grant, responded to more than 750 incidents over six months. The three-person team — a paramedic, an EMT and a licensed clinical social worker — helped divert most patients from emergency rooms and reduced the need for involuntary mental health holds.
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Clark County is the only major jurisdiction in the valley without a standing crisis response team. Las Vegas, North Las Vegas and Henderson already operate similar programs that pair medical professionals and social workers to handle behavioral health emergencies outside traditional law enforcement responses.
The commission did not vote Tuesday on making the program permanent, but Commissioner Justin Jones urged action within 30 days, estimating a $1.5 million annual cost to maintain year-round service. Frierson said the county could offset expenses through Medicaid reimbursements and state funding.
First created in Eugene, Ore., three decades ago, mobile crisis teams have spread nationwide as communities seek alternatives to police intervention in mental health calls. More than 2,700 jurisdictions now have such programs, according to the National Alliance on Mental Illness.
Frierson said the fire department “stepped up and wanted to pilot this model,” securing a grant from the Substance Abuse and Mental Health Services Administration for about $535,000 to create the CRT 18 pilot program.
The program was operational 12 hours a day, seven days a week between April 13 and Sept. 29.
Prior to the program, the fire department would typically respond to calls involving a behavioral health crisis — known as a Card 25 call — using the same protocols for physical illness or injury under the Southern Nevada Health District’s emergency medical response guidelines.
“This creates a limited ability to assess behavioral health conditions, which are the purpose of those calls,” Frierson said. “CRT 18 provided immediate support, appropriate interventions, short-term stabilization and case management services.”
The program was modeled after one in use since 2018 in the city of Las Vegas.
When responding to a call, the responding EMT and paramedic identify any medical conditions that can mimic mental illness, and the social worker conducts a behavioral health assessment to diagnose psychiatric or substance use disorders if no injury or illness are detected.
In 2022, Congress released a report analyzing how law enforcement agencies respond to mental health crises. The report determined that crisis intervention, co-responder and mobile crisis teams “may improve some outcomes” during law enforcement interactions with people experiencing mental health emergencies. But “it remains less clear whether these changes translate into actual improved outcomes for people with mental health needs,” the report said.
Frierson, in her presentation, said the county had already seen some positive results from the pilot program.
Frierson said the team responded to 758 incidents with 673 patient contacts during its months of operation, freeing up the availability of emergency services crews for more urgent medical incidents.
The team also de-escalated 94% of clients and prevented 572 mental health crisis holds, where a person can be held involuntarily in a health care facility for up to 72 hours if they meet the criteria for substantial likelihood of serious harm to themselves or others.
Las Vegas Valley emergency rooms also saw reduced strain, Frierson said. Of the 673 patients contacted, 472 — or, 70% — were diverted from an emergency room.
Prior to the pilot program, 82% of Card 25 calls in 2024 and 72% in the first nine months of 2025 ended up in an emergency room.
Jones called mobile crisis teams the vital “middle piece” of a three-part crisis response system — alongside the state-led 988 suicide and crisis hotline and crisis stabilization centers run with University Medical Center — to divert people facing mental health or substance use emergencies.
“This is necessary,” Jones said. “We shouldn’t wait until the next budget cycle to make it operational.”
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Should fire departments lead mobile crisis response teams for behavioral health calls? What challenges such as staffing, training, funding or medical oversight, would your department face in adopting a paramedic-EMT-social worker model?
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