Jeff White, who struggles with depression and schizophrenia, used to wind up in hospital or jail when agitated. Now he can call a state-run hotline and get help from mental health professionals dispatched by a program that serves 18 mostly rural counties in central and northern Iowa. While cities have had such programs for a while, it’s often a new approach for rural areas. A South Dakota program, Virtual Crisis Care, equips law enforcement officers with iPads to set up video chats between people in crisis and telehealth counselors. The Iowa program always has six pairs of mental health workers on call, dispatched via the statewide crisis line or new national 988 mental health crisis line. The program averages between 90 and 100 calls per month, and the teams respond in their own cars, which matters in small towns where everyone knows each other. Arizona has crisis response teams throughout the state, including very rural regions, because settlement of a 1980s class-action lawsuit required better options for people with mental illnesses.

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