Mental Health Care System · Continuum
Crisis and ER entry
Many people first meet higher levels of care through a crisis line, a mobile team or an emergency room, not through a calm referral. Here’s how those doors work.
In short
- 988 is the national Suicide and Crisis Lifeline: call, text or chat, 24/7. You don’t have to be suicidal to use it.
- It has handled more than 23 million contacts since July 2022, now more than 600,000 a month.
- Mobile crisis teams and walk-in crisis centers can often help without an ER visit.
- Every crisis door should end with a plan for the next level of care.
If you need help right now
988 Suicide & Crisis Lifeline24/7
Call or text 988, or chat at 988lifeline.org. Trained counselors listen, help with safety planning, and connect you to local services. Veterans can press 1; for Spanish, text AYUDA to 988.
Crisis Text Line
Text HOME to 741741.
911
For immediate danger. In Wake County you can ask for a CIT-trained officer.
The crisis doors
From least to most intensive.
Crisis lines
Talk it through, de-escalate, make a safety plan, get referrals. Most contacts end without anyone being sent anywhere.
Mobile crisis teams
Trained staff come to you to assess and help, and can often avoid an ER trip.
Walk-in crisis centers and behavioral health urgent care
Places built for mental health crises, often calmer and faster than an ER.
Emergency department
Evaluates medical and psychiatric needs. Outcomes range from going home with follow-up, to observation, to inpatient admission, to referral for PHP or IOP.
In Wake County
Verified local options.
Alliance Health crisis line
24/7 help and referrals for Wake County. 877-223-4617
Mobile crisis (Therapeutic Alternatives)
A team that comes to you, 24/7. 1-877-626-1772
Wake Recovery Response Center
24/7 walk-in crisis care for adults. 107 Sunnybrook Rd, Raleigh 27610. 919-975-5396
Monarch Behavioral Health Urgent Care
Walk-in behavioral health urgent care, ages 4 and up. 319 Chapanoke Rd, Suite 120, Raleigh. 919-703-2845
The Retreat @ Fernwood (Promise Resource Network)
A voluntary, unlocked, peer-run alternative to the ER or hospital. 919-307-8149
Also
NC Peer Warmline 855-733-7762 · Hope Center for youth 877-888-7849 · ask 911 for a CIT-trained officer · dial 211 (NC211) for services.
Listed by Wake County, checked October 2026: wake.gov, “Having a crisis”. Call ahead when you can; hours and services change.
Which level might fit?
For after the immediate moment, or for a calmer day.
Which level might fit?
A few plain yes/no questions. Nothing is saved or sent anywhere.
This is not a diagnosis or a placement decision. It’s a conversation starter. A clinician weighs safety, symptoms, health, supports and what you want, using tools like LOCUS and ASAM. Bring your answer to a therapist, prescriber, your primary care doctor, or 988.
What comes next
A crisis doesn’t always mean a hospital.
Step up, step down
Pick a story, then tap Next or Play. Tap any level to see when people move to it or away from it.
Illustrative paths, not rules. People skip levels, repeat them, or never need more than outpatient care. Moves are decided with your care team, and the goal is the least intensive level that keeps you safe and moving forward.
988 by the numbers
National figures: KFF, 2026, from SAMHSA and Vibrant data; see also SAMHSA’s 988 performance metrics. North Carolina: 8,996 of 12,698 calls answered in-state in September 2026, average answer time 29.4 seconds; calls not answered in-state roll to the national backup network (988 In-State Report).
After the acute moment
Ask for a written discharge or safety plan, a medication list, and a scheduled follow-up, not just “call someone Monday.” If you leave without a plan, contact 988 or your clinician, and see After a crisis.
Sources
All sources, linked6 references⌄
- KFF (July 14, 2026). 988 enters its fourth year as demand grows. www.kff.org/mental-health/988-enters-its-fourth-year-as-demand-grows-and-the-mental-health-and-substance-use-landscape-shifts/
- U.S. GAO (July 2026). GAO-26-108114, 988 Suicide and Crisis Lifeline. www.gao.gov/products/gao-26-108114
- SAMHSA. 988 Lifeline performance metrics. www.samhsa.gov/mental-health/988/performance-metrics
- 988 Lifeline. September 2026 In-State Monthly Report (KPIs by state). 988lifeline.org/wp-content/uploads/2026/10/September-2026-988-In-State-Monthly-Report.pdf
- Wake County. Having a behavioral health crisis. www.wake.gov/departments-government/behavioral-health/having-crisis
- SAMHSA (July 27, 2026). 2025 National Survey on Drug Use and Health, press release. www.samhsa.gov/newsroom/press-announcements/20260727/samhsa-releases-annual-national-survey-on-drug-use-and-health
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