Virtual crisis care helps rural communities access mental health resources in emergencies

This article first appeared on The Daily Yonder and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

In rural counties where access to emergency mental health resources is limited, Virtual Crisis Care programs are giving law enforcement on-demand access to behavioral health professionals, reducing unnecessary hospitalizations or confinement in jail. 

Supported by the Helmsley Charitable Trust, Virtual Crisis Care has been active in South Dakota for over five years and adopted by more than 30 rural law enforcement departments. And in 2025, Wyoming launched a Virtual Crisis Care pilot program. 

Through Virtual Crisis Care, law enforcement can connect people to behavior health professionals from the telemedicine network Avel eCare for video-based assessments, intervention, and stabilization. Clinicians guide officers through complex mental health situations, minimizing the need for costly holds, transports, and hospitalizations.

Since Virtual Crisis Care was implemented in South Dakota in 2020, 86% of people encountering law enforcement through the program have been able to remain safely at home, accessing local follow-up care and successfully avoiding hospitalization or incarceration.

Roberts County, South Dakota, was one of the first communities to pilot the program, first implementing Virtual Crisis Care in the summer of 2020. 

“Virtual access has been extremely beneficial in addressing rural service gaps,” said Roberts County Sheriff Tyler Appel. “In our rural communities there is just simply no possibility of getting mental health professionals on site.” 

Prior to the adoption of Virtual Crisis Care, Appel said Roberts County faced very limited access to mental health professionals, especially after hours. Deputies often had to make critical decisions alone and manage lengthy hospital or evaluation transports.

The Virtual Crisis Care program gave deputies real-time clinical guidance, helping them make more informed decisions on involuntary holds and hospitalizations, leading to more tailored, long-term care and fewer individuals in crisis ending up in jail.

“Having immediate access to mental health professionals has significantly enhanced de-escalation efforts by allowing individuals in crisis to speak directly with trained clinicians,” Appel said. “This often helps lower anxiety, build rapport, and reduce the adversarial nature that can sometimes occur when law enforcement is the sole responder.”

Amber Reints, a psychiatric nurse practitioner and director of behavioral health at Avel eCare, is one of the clinicians that answers these crisis calls. 

“We will see patients wherever law enforcement is activated,” Reints said. “That initial call can come from inside someone’s home. It can come from within a jail, from a school, or from the side of the road—wherever law enforcement is present—and it can involve individuals of any age group.”

When law enforcement encounters someone in crisis, they call the central hub, share basic information, and connect the individual to a clinician via tablet or a secure link for an immediate virtual assessment. Avel eCare nurses have, on average, 17 years of clinical psychiatric experience and answer calls from around the country. The clinician de-escalates, conducts a risk evaluation, creates a safety plan, and works with officers on next steps. Across the country, these services help about 80% of individuals remain safely in place rather than go to inpatient care. 

“As a clinician, I recently connected with a man in a very rural area who was using substances and experiencing suicidal thoughts after losing a loved one to an opioid-related death just a month earlier. We were able to de-escalate the situation and bring his mom into the conversation,” Reints said. “He was able to receive care right there in his home, without being put in a cop car, taken to a hospital, and left waiting in an emergency room, potentially losing the courage it took to reach out in the first place.” 

But Virtual Crisis Care isn’t just an emergency response, it’s designed to create sustained support through a network of community health centers that serve as critical local partners. 

“This program would not be as successful as it is, if not for the partnership of all of our community mental health centers,” Reints said. “When we go live [with a consultation], a step in that process is identifying who is going to be the connection point for this person who's in crisis.”

Avel eCare clinicians identify the designated, county-specific resources and after the virtual consultation, the nurse sends a confidential report to the patient’s local community health center, which follows up to connect the patient with local resources. 

Especially in rural areas with low call volumes, these community partnerships make telemedicine 24/7 crisis support possible while also delivering ongoing treatment locally.

“That’s what I value most about this program: it meets people where they are in their most vulnerable moments,” Reints said. “As a clinician, I never lose sight of how courageous it is to ask for help, and as a system, we have to keep removing barriers so that when people do reach out, they’re met with both expertise and compassion.” 

Wyoming Pilots Virtual Crisis Care Program

Now, a pilot Virtual Crisis Care program is underway in Wyoming. In 2025, The Helmsley Charitable Trust granted the Wyoming Association of Sheriffs and Chiefs of Police (WASCOP) a $2.4 million grant to bring Virtual Crisis Care to the state. 

“People who are experiencing a behavioral health crisis need professional help, and Virtual Crisis Care gets them that help immediately,” said Walter Panzirer, a Trustee of the Helmsley Charitable Trust. “In the simplest terms, Virtual Crisis Care saves lives, time, and money. We need more innovative models like VCC, especially in rural areas where there are limited behavioral health resources.”

Allen Thompson, executive director of WASCOP, said Virtual Crisis Care is already transforming mental health services in rural Wyoming. 

“When I started my career 25 years ago, some of our jails across the state were the only option to place somebody in an emergency detention,” said Thompson. Since then, options have improved, but now, Virtual Crisis Care is both expanding on-demand access to clinicians through telehealth, and building more robust systems for local resources.  

“Through Virtual Crisis Care, we've built out this network of community mental health providers in Wyoming so that each county has an entity that is supposed to provide that mental health at the community level and provide outpatient services for people and be that [local] resource for them,” Thompson said. 

WASCOP recruited law enforcement agencies across Wyoming to join the Virtual Crisis Care pilot, aiming for 75% participation within three years and already reaching about 25% in the first year. WASCOP connected interested agencies to their local community mental health providers, provided  a grant-funded tablet and data connection, and facilitated targeted training with Avel eCare. Agencies that are now actively implementing Virtual Crisis Care will have ongoing check-ins and data collection to track outcomes and measure the program’s impact over time.

“I think if you look at serving in rural America, not only on the criminal side but on the mental health side, you deal with the same people over years and decades. If you can get someone struggling with addiction or mental health into treatment and help them change their life, then we’re not seeing them anymore on the law enforcement side of things,” Thompson said. 

While questions of sustainability remain beyond the three-year grant period, Thompson is committed to expanding early intervention and finding a path for long-term Virtual Crisis Care programming. 

“My long-term hope is that we can get in on the early side of mental health treatment and at the same time reduce the stigma that we’ve always fought with, especially in rural Wyoming, and get people into the right treatment that provides them with the best services,” Thompson said.