“We just need to get used to each other”: Responder perspectives of training and knowledge development in alternative behavioral health crisis response.

Behavioral health (BH) crises pose unique challenges for emergency responders, health care systems, and individuals with BH needs. In the United States, traditional BH crisis response approaches disproportionately burden first responders and emergency departments while providing inconsistent results for patients, prompting the development of alternative BH crisis response strategies. The evolving landscape of alternative response approaches highlights the importance of training and knowledge development for institutions collaborating at various levels of alternative response systems. Specifically, efforts must prioritize the experiences of responders at the grass-roots levels of alternative response approaches to facilitate a more holistic understanding of the training-associated assets and barriers that may catalyze or constrain responders' ability to support individuals experiencing BH crises. The present study used qualitative interviews with 911 call-takers, police officers, and alternative responders conducted during the first 12 months of a 16-month pilot implementation of a Crisis Call Diversion Program in Louisville, Kentucky to explore responders' training and corresponding knowledge of alternative response processes and protocols. The study findings report the challenges, successes, opportunities, and recommendations regarding training and knowledge development for responders engaged in the implementation of an alternative BH crisis response system. Responder narratives convey the importance of interorganizational cross-training, experiential learning opportunities, and interorganizational rapport building. (PsycInfo Database Record (c) 2026 APA, all rights reserved).