Crisis Intervention Response Team 2024 Annual Report

Highlights of 2024 include:

• CIRT responded to 1,645 calls for service, 219 information calls, and 558 follow ups.
• Case managers had 1,226 contacts.
• Demand data indicate that overall CIRT program hours are well matched to hours when the service is needed in the community.
• About 1 in 5 CIRT encounters involved a person experiencing homelessness. Another 5.2% (125) involved an individual at risk of losing housing.
• CIRT interacted with 852 distinct clients in 2024. This total does not include clients who asked to remain anonymous. 243 (28.5%) distinct clients had more than 1 encounter with CIRT, with the top 10 high utilizer clients interacting with CIRT an average of 13.1 times in 2024.
• CIRT Clinicians initiated emergency mental health holds 37 times (2.3% of calls) in 2024. One of the benefits of CIRT clinical expertise on behavioral health calls is the reduction of unnecessary involuntary treatment, which lessens negative impacts to people by preserving their autonomy, and reduces avoidable utilization of Emergency Medical Services (EMS) and emergency departments.
• Of the 1,645 CIRT calls for service the team responded to in 2024, six (0.4%) involved use of force by an officer.
• 21 (1.3%) of CIRT’s calls for service in 2024 involved an arrest.
• CIRT facilitated return of Fire/EMS to service 168 times (40.6% of applicable interactions).
• CIRT facilitated return of police to service 679 times (49.0% of applicable interactions).

CIRT assists a wide variety of people in the City of Boulder.

Age

The median age of CIRT clients during 2024 was 39 years, with a range from 5 years to 97 years.

Figure 1: CIRT Encounters by Age

Gender

Of the 2,143 clients who reported their gender, 47.1% identified as male, 44.9% as female, 2.7% as transgender, 0.7% as non-binary, and 0.1% as gender fluid.

Figure 2: CIRT Encounters by Gender

Race and Ethnicity

Race and/or ethnicity are typically self-reported by clients as CIRT staff do not necessarily know how an individual identifies. This results in limited reporting of this demographic category, particularly since crisis situations are not always conducive to discussions about race/ethnicity. Figures 3 and 4 show available race/ethnicity data for 2024 in further detail.

Figure 3: CIRT Encounters by Race

Of the 2,422 clients who reported their race, 65.4% identified as White, 4.6% as Black or African American, 1.9% as Asian, 1.6% as multiracial, and 25.6% were unknown. Less than 1% of clients identified as other race, American Indian/Alaskan Native, or Pacific Island/Native Hawaiian.

Figure 4: CIRT Encounters by Ethnicity

Housing Status

Most CIRT clients have a form of housing in the community. 1 in 5 CIRT responses involved someone without housing, indicating that unhoused community members, who make up less than 1% of the City’s population, are over-represented in crisis response. An additional 5.6% of CIRT encounters involved people at risk of losing housing. The clinicians on the team have observed some relationships between behavioral health crisis and loss of housing, as behavioral health crisis can impact housing stability and vice versa. In cases where individuals were seen multiple times by CIRT in 2024, housing status was recorded each time, reflecting 2,249 housing status entries for 967 unique individuals which can be seen in Figure 5.

People who are living in a shelter, motel, or vehicle are considered unhoused. An individual experiencing unsheltered homelessness is a person living in a place that is not meant for human habitation, such as living in a tent, on the streets, in their vehicle, or in an RV without access to basic necessities (e.g., water, heat, toilet, shower).

Figure 5: CIRT Encounters by Housing Status

People with Multiple CIRT Calls for Service

• 28.5%, or 243 of 852 unique clients, had more than 1 encounter with CIRT in 2024.
• The 10 clients with the highest number of CIRT calls for service interacted with CIRT an average of 13.1 times in 2024.

CIRT works with clients, as well as a wide variety of related community service providers, to connect people with ongoing community support. However, some individuals have a combination of serious mental health and substance use issues that make it difficult to consistently engage in non-emergency care. In addition, care for some situations – such as methamphetamine use – is limited and not easy to access for all populations. Finally, it can be difficult for people without stable housing to engage in mental health treatment or substance use recovery, as the basic need for safety, food, and housing will typically overshadow other needs.

CIRT responds when dispatched by the communications center or requested by a police officer. CIRT can also assign themselves to calls in instances where they are familiar with the person involved or otherwise recognize that there is a behavioral health component.

• The team responded 1,645 times to calls for service during 2024. This number does not include follow up calls made by the team after initial contact.

Figure 6: CIRT Unit Responses by Month

Follow Ups

Follow up notes are used by clinicians to document follow up interactions. Common examples include a clinician following up with a client after a call for service (e.g., via phone or in person) or a clinician responding to a voice mail message that was left on the team phone line.

Figure 7: CIRT Follow Ups by Month

Information Notes

Information notes are created by clinicians when they receive clinically relevant information from a third party about someone in the community and that information does not require an immediate response or follow up. An example of when this note type would be used is when a police officer sends an email with information about an individual in case CIRT comes into contact with them in the future, but there is no current need for the person to be contacted.

Figure 8: CIRT Information Notes by Month

CIRT seeks to align service with highest volume times for behavioral health calls.

Service hours for CIRT in 2024 were:

• Monday through Friday from 8 a.m. to 11 p.m.
• Saturday through Sunday from 9 a.m. to 9 p.m.

Figure 9 displays the total number of calls during each hour of different days of the week in 2024 when analysis of key words in dispatch data indicates the call may have been appropriate for CIRT response.

Overall, CIRT hours match well with high volume times for crisis calls to Boulder Police and Fire Communications (BPFC).

Figure 10 demonstrates the number of calls CIRT responded to by hour of day and day of week during 2024. There are several reasons for the difference between the 9,689 calls considered appropriate for CIRT response, and the 1,827² calls responded to by CIRT.

1. At times, CIRT clinicians were unable to go to calls if they were already assigned to another call.
2. There were 9,869 total calls that may have been appropriate for CIRT in 2024 based on keywords in dispatch’s Computer Aided Dispatch (CAD) system. 2,636 calls matching key words for CIRT response fell outside of planned CIRT hours (36.4%). This means an average of approximately 7.2 calls per day fell outside regular CIRT hours.

Figure 9: CIRT Unit Demand by Day of the Week and Hour of the Day

Figure 10³: CIRT Unit Responses by Day of the Week and Hour of the Day

Community members seek assistance for a wide variety of behavioral health situations, with some people experiencing multiple concerns. Most common primary concerns in 2024 included delusions and situational reactions. Situational reactions are circumstances where the person’s behavior is driven by a reaction to a specific situational stressor rather than a mental illness or substance intoxication. Examples include a relationship breakup, failing a test, or being fired from a job. Situational reactions are often paired with underlying issues that make people more vulnerable to behavioral or emotional dysregulation such that external events precipitate a crisis reaction. 239 clients, 14.5% of encounters, had a primary concern related to delusions and another 238 clients, 14.5% of encounters, had a primary concern related to situational reactions in 2024. The least frequently cited concerns for CIRT encounters were substance withdrawal (0.3%) and developmental disorder (0.2%).

Figure 11: Primary Concern at Time of Encounter

259 (32.7%) clients interacting with CIRT reported that they were already receiving behavioral health services from a provider; 167 (21.1%) clients reported not receiving any behavioral health services; 17 (2.1%) reported being in the process of obtaining behavioral health services.

Figure 12: Already Receiving Behavioral Health Services at Time of Encounter

CIRT Referrals

CIRT refers clients to a variety of community resources and ongoing treatment options. In some cases, people have an immediate need for further treatment. Immediate treatment includes being transported to a hospital emergency department or accessing the walk-in crisis clinic/detoxification facilities operated by Clinica Family Health & Wellness.

The team also tries to connect people with ongoing community treatment and other support resources (e.g. food banks, homeless services, etc.). Many non-emergent referrals are done as part of follow up calls because people are not always able to engage in conversations about follow up care while experiencing a behavioral health crisis. In some cases, people do not wish to participate in follow up discussions or cannot be reached for a follow up. Figure 13 displays the distribution of referrals where this data is available for CIRT contacts.

Figure 13: Types of Referrals After CIRT Intervention

Mental Health Holds

CIRT clinicians initiated emergency mental health holds 37 times (2.3% of calls) in 2024. An emergency mental health hold is a process where someone can be detained for up to 72 hours if they meet certain criteria due to a mental illness. One of the benefits of CIRT clinical expertise on behavioral health calls is the reduction of involuntary treatment. While involuntary treatment has a place in the continuum of care, it can have significant negative impacts for people. This can include decreased trust in care providers, trauma from being confined, restrained and medicated against one’s will, the financial burden of ambulance transport and inpatient treatment, disruption to relationships, education and employment, as well as the stigma of being placed on a mental health hold and being taken to the hospital.

Emergency Commitments

An Emergency Commitment (EC) is a process for involuntary treatment if someone meets certain criteria due to their use of alcohol or substances. People are usually taken to an emergency department or a detoxification facility and released once they are sober.

Use of Force and Arrests

Of the 1,645 CIRT calls for service the team responded to in 2024, six (0.4%) involved use of force by an officer. Four of the uses of force were takedowns, one was a TASER display, and one is unknown because the report is sealed and our records do not describe it. 21 (1.3%) of CIRT’s calls for service in 2024 involved an arrest. Fifteen of the arrests were for domestic violence, warrants, or violation of a protection order. Four arrests were for felonies and three of those involved multiple charges. One arrest was for harassment, and one was an arrest by an outside agency, so information about specific charges was not available.

Remaining in the Community

The preferred outcome in mental / behavioral health crisis response is typically for the community member to remain in the community. That means the situation was able to be resolved without someone going to a higher level of care. Remaining in the community has several advantages over hospital stays, including providing care in a less disruptive manner, improved recovery rates, easier access to support networks, lower health care costs, and reduction of stigma. 64.0% of CIRT calls for service in 2024 ended with the client remaining in the community.

Figure 14: CIRT Response Outcomes

Facilitating Return of First Responders to Service

One goal of the CIRT program is to facilitate a response that meets the needs of the community. One of the ways the team supports this goal is by clearing first responders from calls that CIRT is on so those first responders can be available to respond to other emergencies.

A facilitated return of Fire/EMS to service indicates that the clinician on the call was able to clear Fire/EMS from the call and return them to service, allowing them to respond to other calls for service. If the clinician was unable to return Fire/EMS to service this indicates that Fire/EMS stayed on the scene through the completion of the call for service. CIRT facilitated return of Fire/EMS to service 168 times (40.6% of applicable interactions).

A facilitated return of law enforcement to service indicates that the clinician was able to address a contact that otherwise would have been assigned to an officer, or the clinician was able to clear one or all officers assigned to the call for service from the scene. If the clinician was unable to return law enforcement to service this indicates that officers remained on the scene for the duration of the contact. CIRT facilitated return of police to service 679 times (49.0% of applicable interactions).

An essential part of the crisis response program is connecting people with ongoing services in the community. Most of this connection work is done by the team’s case managers following a crisis. Case managers worked with 273 clients in 2024 and had an average of 4.5 interactions per client throughout the year.

Case Management Referrals

Case management consists of resource navigation, where people are directed toward resources, and more intense active case management. Resource navigation is for people who are able to access services with minimal support. These clients may be able to meet their needs using existing services but could use some support in redirection or problem-solving during a period of crisis. Resource navigation clients may also not want more active case management but will accept resource navigation. 

Figure 15: Resource Navigation Case Management Clients Needs Assessment

There were 480 needs addressed by case managers with resource navigation clients. The most common needs addressed by resource navigation were mental health services (26.0%), benefits (15.2%), and housing (14.8%). Figure 15 shows the number of resource navigation sessions that addressed each need. More than one need can be addressed in a session. 109 people received resource navigation services during 2024. 

Figure 16: Active Case Management Clients Needs Addressed

Active case management clients receive more intensive coordination of services, typically over a longer time period. Case managers enroll clients into active case management when clients need more support to connect with service providers in the community and address their goals. Case managers meet with clients as often as needed. Forty-one people received these services over 649 interactions; some of these people also received resource navigation. The needs addressed for active case management clients were different from those of resource navigation clients. Other health services (19.3%), mental health services (17.7%), and benefits (16.6%) were the most common needs addressed for active clients. 

The case management team assists a wide variety of people in the City of Boulder.

Age

The median age of case management clients during 2024 was 46 years, with a range from 6 years to 95 years.

Figure 17: Case Management Clients Age

Gender

Of the 273 clients who reported their gender, roughly 48.7% identified as male, 47.6% as female, 1.8% as transgender, 0.7% as non-binary, and 1.1% were unknown.

Figure 18: Case Management Clients Race

Figure 19: Case Management Clients Ethnicity

Figure 20: Care Management Clients Housing Status

1. In the third quarter of 2025, CIRT was combined with the former Community Assistance Response and Engagement (CARE) team, to form the current Behavioral Health Crisis Response Team.
2. The 1,827 CIRT responses recorded in CAD includes CIRT calls for services, CIRT follow ups, and CIRT case management follow ups. Some follow ups completed by the team do not appear in CAD because they are not calls in the emergency system. Therefore, some numbers in this section appear different than response and follow up numbers included earlier in the report.
3. Figure ten includes duplicate calls for service, which is why the grand total included in the graphic is 2,587. With duplicates and canceled calls removed, the total number of unit responses recorded by BPD was 1,827. These responses include CIRT calls for service and follow ups.