As part of our Return on Response campaign, a coalition-founded initiative highlighting the life-saving, cost-effective impact of partnerships between behavioral health providers and first responders, we’re spotlighting programs that are making a difference in communities across Washington state. One of these programs is Frontier Behavioral Health’s co-response program, which pairs behavioral health professionals with law enforcement and paramedics to address mental health crises across Spokane County.
Over the past six years, Frontier Behavioral Health has transformed its partnerships with first responder agencies, integrating behavioral health professionals into emergency response and serving more community members than ever before.
This approach – known as the co-response model – focuses on delivering the right response at the right time, meeting people where they are, and providing care that is appropriate for their needs. According to Rayanne Paget, program administrator for Frontier’s co-responder and mobile rapid response teams, it has fundamentally changed how behavioral health crises are addressed in Spokane.
“Co-response is about dignity and stabilization in the least restrictive way possible,” said Paget. “When behavioral health professionals and first responders work together, people get help faster, and outcomes improve for everyone involved.”
Teams on the ground
Frontier currently operates three co-responder teams with the Spokane Police Department and three with the Spokane County Sheriff’s Office. Within each team, behavioral health professionals ride along with law enforcement officers throughout the day and, together, respond to 9-1-1 calls that include a mental health component.
Separately, the Behavioral Response Unit (BRU), a co-response partnership between Frontier and the Spokane Fire Department, consists of two paramedics and two behavioral health clinicians. The BRU gets dispatched – or can self-assign – to calls that could benefit from mental health support.
The BRU was the first firehouse-based diversion team established in Washington state. Designed to reduce unnecessary hospital transports, the team distinguishes between psychiatric emergencies that require medical attention and non-emergent behavioral health crises that can be managed on-scene, followed by community-based outpatient treatment programs or short-term inpatient care.
Across all these partnerships, the co-responder teams are focused on de-escalation, assessment, safety planning, and connection to services, including crisis stabilization and detox.
What the data shows
The goal of the co-response model is diversion – keeping people out of jail and the emergency department, which are both traumatic and expensive settings that are rarely clinically appropriate for behavioral health needs. Instead, the co-responder teams are focused on connecting people to appropriate mental health and substance use supports, such as crisis stabilization, detox, outpatient therapy, and more.
When you look at the data over the years, it’s clear that diversion is happening.
For instance, in 2024, Frontier’s co-responder teams embedded in the Spokane Police Department and the Spokane County Sheriff’s Office made contact with 2,148 individuals, 73 of whom were incarcerated and 368 transported to the emergency department. 881 were either diverted from those settings to community-based supports, or they were stabilized on-scene without further system involvement.
Similar patterns of success have been seen for the BRU within the Spokane Fire Department. In the last six years, the number of contacts made has increased by 1,400 percent. As an emergency response unit, some individuals still need to be transported to the emergency department, but the team has been able to divert hundreds of others to alternative resources.
This growth reflects both the increasing need for these services and the effectiveness of the model. In 2019, the first year of the program, Frontier’s co-responder teams made contact with approximately 94 community members. By 2025, those teams – now significantly expanded – made contact with more than 4,500 community members, representing a nearly 4,000 percent increase in community members supported through the model.
Jan Downing, chief operating officer at Frontier Behavioral Health, says the numbers simply reflect what people see on the ground every day.
“It has taken time to establish the co-responder teams in the community, but now people know who we are and why we’re there,” said Downing. “Our teams are trusted, integrated, and focused on getting people the right help in the moment – and they’re doing real impactful work every day.”
One Piece of a Robust Crisis Network
Connection to immediate and long-term supports is essential for individuals in crisis. Frontier’s co-responder teams are highly skilled at managing the immediate moment, but when it comes to making ongoing care connections, that’s where the organization’s Crisis Diversion Unit (CDU) comes in.
The CDU was created to provide short-term follow-up to individuals after their initial contact with a co-responder team. This group ensures seamless linkage to services at Frontier, such as outpatient therapy, substance use treatment, and psychiatric care, as well as other community resources that support housing, basic needs, and long-term stability.
Contact with the co-responder teams and the CDU all starts with an initial point of outreach, oftentimes to 9-1-1 or 9-8-8. In fact, Frontier Behavioral Health operates the local 988 Suicide & Crisis Lifeline, as well as the Regional Crisis Line. The organization also has an interagency partnership with Spokane Regional Emergency Communications (SREC) to divert mental health-related calls from 9-1-1 to 9-8-8.
Calls to 9-8-8 and the Regional Crisis Line are then transferred to Frontier’s newly formed Mobile Dispatch Unit (MDU), which was established to streamline how people in crisis are triaged and to help take advantage of the spectrum of services available. The MDU is about making sure people get the right response, from the right team, at the right time.
The MDU is comprised of clinicians who have comprehensive knowledge of Frontier Behavioral Health’s entire system of care and can match callers to the appropriate resources — whether that’s immediate crisis intervention and stabilization through the organization’s Mobile Crisis Assessment and Triage (MCAT) program or the Children, Youth and Family Mobile Crisis (CYFMC) team; referral to a Designated Crisis Responder (DCR), who is authorized to evaluate individuals for involuntary inpatient psychiatric treatment; to a co-responder team; to outpatient services; to other providers; or even back to 9-1-1, if needed.
This is a powerful example of a fully integrated crisis system that meets people where they are and stays with them through stabilization.
“No single program or support works in isolation,” said Downing. “What makes this system effective is how each piece is connected – dispatch, co-response, follow-up, and ongoing care – so that no one falls through the cracks.”
A return on response
Frontier Behavioral Health’s co-responder programs show that when behavioral health and public safety work together, time, money, and lives are saved. And when that collaboration is embedded in a coordinated crisis system like Spokane County’s, the impact is magnified across the entire community.
“We’re incredibly proud of our local crisis response,” said Kelli Miller, CEO of Frontier Behavioral Health. “By investing in partnerships and building systems that work together, we’re improving outcomes for individuals, supporting first responders, and strengthening the community as a whole.”
Learn more about the Return on Response campaign here.