Impact of a New Street Crisis Response Team on Service Use Among San Francisco’s Homeless Population with Mental and Substance Use Disorders​

Principal Investigator (PI): Dr. Matthew Goldman, Dr. Phillip Coffin (San Francisco Department of Public Health)

Research Model

The San Francisco Crisis Response Team (SCRT) is dispatched by 911 and provide real-time response in public spaces to provide support in paramedics and behavioral health to Medicaid-eligible adults experiencing homelessness in mental health and/or substance use crisis.

Evaluation Approach

An interrupted time series design will be used to measure key impact on key outcomes pre/post-implementation, an equity analysis will be conducted by stratifying outcomes by race and ethnicity, and qualitative semi-structured interviews with targeted population will be conducted to understand linkage to outpatient mental health or substance use treatment, acute service utilization, and assessment for supportive housing or long-term placement.

Contribution to HSTRC’s Research Agenda 

  • Provide new insights into the overall effectiveness of an increasingly popular mental health crisis services model (CAHOOTS) in a field that lacks rigorous research
  • Focus on the impact of a new program aimed at serving San Francisco’s highly vulnerable Medicaid-eligible homeless population in reducing disparities and advancing equity
  • Critically examine the impact of a prominent publicly financed social services initiative designed to decrease the role of law enforcement in non-criminal mental health crisis response
  • Demonstrate the power of data integration by utilizing San Francisco’s Care Coordination Management System that links public EHRs (behavioral health and medical) to housing, jail, and public assistance data