The U.S. is at a time of promise for a historic transformation in mental health care. For decades, systemic problems have persisted—including high levels of unmet need, underdevelopment of community-based supports, and inequities in access and quality of care. 

As part of this path forward, the community of Galveston has rolled out an innovative paramedicine model for behavioral health emergencies. The Galveston COAST initiative aims to navigate behavioral 911 emergencies and change mental health emergency response in Galveston, bringing transformation to scale across Texas and influencing the national debate about how to change mental health emergency response in U.S. communities.

COAST (Compassionate Open Access to Services and Treatment) is a community paramedicine approach that brings together licensed mental health professionals, paramedics, and specialized law enforcement officers to better address the health care or social needs often front center in these emergencies. At the same time, first responders can ensure the safety of the person in crisis, others involved, and the responders themselves.  

The COAST teams consist of a licensed clinician from the Gulf Coast Center (Galveston's mental health authority), a paramedic from Galveston Fire Department, and a Galveston police officer specially trained in mental health emergency response. The model is designed to provide on-site mental health assistance and connect patients to ongoing care.  Additionally, 911 call takers and dispatchers are trained to recognize and triage mental health emergency calls. Galveston’s 911 Call Center also offers a “fourth option,” asking if the caller needs mental health services alongside police, fire, or EMS.

COAST was designed by the Medows Mental Health Policy Institute. The initiative is a collaboration between Meadows and The Pew Charitable Trusts, and is funded and supported by the Cynthia and George Mitchell Foundation and several Galveston-based foundations.

The city of Galveston announced COAST last summer and soft-launched the initiative in late fall 2022. The program will be publicly introduced on May 4, 2023.


A roundtable discussion with Q&A is scheduled for Thursday, May 4, 2023 at 10:30 am Central at Fire Station No. 1 in Galveston as part of Mental Health Awareness Month in the United States. 

Journalists may attend this briefing in person and virtually. If you would like to view by Zoom, please register in advance. After registering, you will receive a confirmation email containing your briefing link:

Opening remarks by Mayor Craig Brown, City of Galveston. The conversation will be moderated by Dr. Tony Fabelo, Meadows Mental Health Policy Institute.



Galveston's mental health unit making a difference, officials say

José Mendiola | The Galveston Daily News | May 5, 2023 

Galveston launches the COAST program

News Release | Meadows Mental Health Policy Institute | May 4, 2023 

How Meadows is diversifying crisis response in Texas

Will Maddox | D Magazine | March 21, 2023 

Editorial: It's time for the state to step up on mental health care

The Galveston Daily News | June 4, 2022 

Galveston to introduce mental health response unit

John Wayne Ferguson | The Galveston Daily News | June 2, 2022 

Galveston officials announce commitment to improving behavioral health emergency response

The Pew Charitable Trusts | June 2, 2022 

Dallas program shows signs of effectively navigating behavioral health emergencies

The Pew Charitable Trusts | December 9, 2021

Galveston COAST is funded and supported by the Cynthia and George Mitchell Foundation in collaboration with the Meadows Mental Health Policy Institute, The Pew Charitable Trusts, and Galveston-based foundations, including the Moody FoundationHarris & Eliza Kempner Fund, Ippolito Charitable Foundation, Mary Moody Northen Endowment, and the Sasser Family Foundation.

For additional information about Galveston COAST and to schedule a ride-along with a COAST team, please contact Brett Holmes at  

© 2012-2023 Cynthia and George Mitchell Foundation.