What Austin Adults Can Actually Do During a Mental Health Crisis
A reported access guide explaining what happens when you walk into Integral Care, call the crisis line, or show up at Seton Behavioral — intake, cost, wait times, and what comes next, for adults wi…
A reported access guide explaining what happens when you walk into Integral Care, call the crisis line, or show up at Seton Behavioral — intake, cost, wait times, and what comes next, for adults without a referral or a four-figure ER bill.
If you are in immediate danger right now, call 988 or go to the nearest emergency room.
This guide wasn’t written for a mental health awareness month landing page. It exists because no current Austin-area source clearly explains what an uninsured or underinsured adult actually does during a mental health crisis — not a crisis weeks away when a therapist intake might open up, but a crisis happening now, on a Tuesday night, when you have no diagnosis on file, no referral, and no idea whether showing up somewhere costs $150 or $4,000.
Austin has real crisis infrastructure. It’s confusingly named, poorly documented in plain language, and most people who need it have no idea how it works until they’re already in it. This piece maps the actual entry points — what intake looks like, what it costs, how long you wait, and what happens when you leave.
Integral Care and ATCIC Are the Same Organization
Search “mental health crisis Austin” and you’ll find references to Austin Travis County Integral Care, ATCIC, Integral Care, and occasionally the old “Austin Travis County MHMR” name the agency retired years ago. These all refer to the same organization — the local mental health authority for Travis County, operating under a state contract to provide publicly funded behavioral health services.
The naming confusion matters more than it might seem. When someone in crisis is trying to find the right address at 11 p.m., search results listing the same facility under three different names create real delay. For clarity throughout this piece: the organization is Integral Care. ATCIC is its initialism.
The Crisis Services Center is at 7000 N. Mopac Expressway, Austin, TX 78731. This is the primary walk-in crisis location for adults in Travis County — the correct destination if you need crisis stabilization without a prior appointment.
Cap Metro Route 983 reaches the N. Mopac corridor, but service frequency varies and the facility isn’t a terminal stop. If someone is in crisis and can’t drive, a rideshare to N. Mopac is more reliable than a late-night bus connection. Don’t gamble on the bus at 1 a.m.
The Crisis Services Center operates 24 hours a day, seven days a week, including holidays. Calling 512-472-HELP (512-472-4357) before traveling is worth doing when time permits — both to confirm they’re operational and to talk with someone before you arrive.
Can You Walk In Without an Appointment or a Referral
Yes. No appointment. No referral. No prior diagnosis.
This is the fact most Austin adults don’t know, and it’s the one that matters most. The assumption that a mental health facility requires a therapist referral, an existing client relationship, or a specific insurance card before it will see you — that assumption is what sends people to emergency rooms. And in an ER, the same care costs dramatically more, if it’s available at all.
Here’s what actually happens when an adult walks into the Crisis Services Center: a staff member conducts an initial safety screen. Not a clinical assessment — a brief check to determine whether you’re in immediate physical danger or need emergency medical intervention. Then a clinician conducts a structured clinical assessment: the presenting crisis, any history of treatment, current medications, substance use, your current support situation. The conversation is the primary tool. There’s no required paperwork before being seen, though forms are completed during intake.
That assessment leads to one of two primary outcomes. The first is placement in the Crisis Stabilization Unit — a short-term residential setting where adults can stabilize in a clinical environment without being admitted to a psychiatric hospital. The second is same-day outpatient stabilization: you’re seen, receive crisis counseling and a safety plan, and leave with a follow-up appointment already scheduled.
On wait times: the walk-in center is busiest on weekday evenings and weekend afternoons. Weekday mornings before 10 a.m. tend to move faster. Take that as general guidance — crisis centers don’t run on fixed scheduling, and one complicated intake can back everything up. Calling before you arrive won’t get you a time estimate, but it does let you talk with someone about whether now or an hour from now makes more sense.
What Crisis Care Actually Costs at Integral Care
Integral Care operates on a sliding-scale fee structure tied to household income and family size, using federal poverty level guidelines updated annually.
The floor is zero dollars. Adults at or below 100% of the federal poverty level pay nothing. No insurance required, no deposit. Above 100% FPL, fees increase on a graduated scale. The agency accepts Medicaid, CHIP, Medicare, and most commercial insurance.
One thing to confirm directly with the agency: whether the sliding scale applies to Crisis Stabilization Unit stays. Outpatient crisis services are covered under the sliding scale, but CSU billing follows different rules because it’s residential care. Call 512-472-4357 and ask specifically before you arrive.
The 23-hour observation model matters for billing. A stay under 23 hours is classified as crisis stabilization. A stay that extends beyond 23 hours can shift into inpatient psychiatric hospitalization classification, which triggers different insurance rules and different client responsibility. For someone without insurance, that distinction can mean the difference between a sliding-scale fee and a bill in the thousands. The 23-hour mark isn’t a hard discharge deadline — stays can extend when clinically appropriate — but it’s the threshold where the billing category changes, and you should know it exists.
The ER costs substantially more. An uninsured adult presenting to Dell Seton or St. David’s in a psychiatric crisis faces a base ED charge well into the hundreds before any psychiatric hold, inpatient transfer, or overnight observation. Hospital systems have financial assistance programs, but those are applied after discharge, through applications you submit later. In the moment, an uninsured patient at an ER faces the full bill first. Ascension Seton Behavioral Health at 1165 W. 38th Street has a national charity care policy that can eliminate costs for qualifying low-income patients — but that determination also happens after the fact, not at triage.
Bottom line: if you’re uninsured and your situation doesn’t require emergency medical treatment alongside psychiatric stabilization, Integral Care’s sliding-scale model will almost always cost less. Sometimes far less.
988 vs. Integral Care vs. the ER — These Are Different Pathways
These three entry points get described as interchangeable options. They’re not.
When an Austin adult calls 988, the call routes to a crisis call center. Texas 988 calls from Austin are intended to route to Texas-based counselors, but volume spikes can push calls to out-of-state backup centers that can’t dispatch local resources. What the call center does: telephone crisis counseling, triage, and routing to local services. It does not automatically send anyone to your location. If you want a mobile crisis team instead of a police car, say so explicitly. Tell the counselor: “I want mobile crisis outreach, not a police response.” If you don’t make that request, the default escalation for an imminent-safety call may involve a 911 dispatch. 988 is also available by text, and chat is available at 988lifeline.org — useful for anyone who can’t speak privately.
Integral Care’s Crisis Services Center on N. Mopac is the destination for adults who need in-person clinical assessment and aren’t experiencing a concurrent medical emergency. No referral, no appointment, no insurance card at the door. The sliding scale lives here. The CSU beds are here.
The ER is the right call when the psychiatric crisis involves a concurrent medical emergency — overdose, self-injury requiring treatment, a medical condition affecting mental status, or when someone can’t safely get to or wait somewhere else. For a purely psychiatric crisis without medical complications, the ER offers no advantage over Integral Care’s crisis center and costs significantly more. A psychiatric patient in an ER may wait hours for a psychiatric consult, and that consult may result in a transfer to Integral Care anyway. EDs are built for medical emergencies. Psychiatric stabilization is not what they’re designed to do efficiently.
MCOT — How to Request a Clinician Instead of a Patrol Car
Most Austin residents don’t know how to access the Mobile Crisis Outreach Team, even though it’s been operational for years and is precisely what people want when they’re afraid a mental health call will result in a police response that makes things worse.
MCOT is a licensed clinician paired with a peer support specialist — someone with lived experience of mental health or substance use challenges, trained to provide support in crisis situations. They arrive as a two-person mental health team.
To request MCOT, call 512-472-HELP (512-472-4357) and tell the call-taker you want mobile crisis outreach. You can call on behalf of yourself or someone else. You can also request it through 988 — ask explicitly for mobile crisis response.
MCOT operates in Travis County, though coverage gaps have historically existed in some county areas. Overnight staffing is a consistent limitation — if you’re calling at 3 a.m., response times may be longer and the team may be reduced. Worth knowing before you need it.
MCOT is designed for adults in mental health crisis who aren’t in a concurrent medical emergency, don’t require physical restraint, and are somewhere the team can safely operate. MCOT can’t provide medical treatment and can’t involuntarily transport someone. If the situation involves active violence, call 911 — MCOT can respond concurrently or as a follow-up once the immediate danger has passed.
MCOT also does follow-up wellness checks for people recently discharged from a crisis setting. Ask for this explicitly when the team is still with you. Most people don’t know to ask.
Same-Day Outpatient Options — Getting Help Without a Hospital Bed
Not every crisis requires a CSU bed. For adults in acute distress who aren’t at immediate risk of harming themselves or others, same-day outpatient crisis counseling exists — and most people don’t know to ask for it.
At Integral Care, after a walk-in assessment, clients who don’t need CSU-level stabilization can receive same-day crisis counseling and leave with a written safety plan and a scheduled follow-up appointment. The client is seen, stabilized, and connected to next steps without entering the unit.
The CSU itself is worth understanding clearly. It’s licensed as a crisis stabilization unit, not a psychiatric hospital. A stay up to 23 hours keeps the client in the short-term crisis care billing category. The practical experience is simpler than the billing language: a safe, staffed clinical environment with beds, meals, and around-the-clock monitoring, ending with a discharge plan. Stays can go longer when clinically appropriate; the 23-hour mark affects billing classification, not when you have to leave.
CommUnity Care Health Centers — the primary Austin-area FQHC network — provides behavioral health services including psychiatric medication management and counseling on a sliding scale for uninsured and underinsured patients. CommUnity Care doesn’t run a 24/7 walk-in crisis center, but same-day appointments may be available for situations clinic staff triage as urgent. Contact them directly for current scheduling.
People’s Community Clinic on North Lamar also operates as an FQHC with sliding-scale behavioral health services. Neither People’s nor CommUnity Care is a crisis center — but both are real options for adults who’ve stabilized from a crisis and need ongoing care they can actually afford.
The distinction is simple: if you’re in active crisis right now, go to Integral Care’s crisis center. If you’ve stabilized and need ongoing outpatient care, call CommUnity Care or People’s Community Clinic.
The Funding Picture and What It Means for Capacity Right Now
Integral Care holds Certified Community Behavioral Health Clinic designation — a federal certification that unlocks enhanced Medicaid reimbursement rates under a SAMHSA demonstration program. CCBHCs must provide specific services, including 24/7 crisis services, mobile crisis response, peer support, and same-day crisis appointments.
The CCBHC demonstration program has faced budget pressure in recent congressional cycles, with reauthorization and SAMHSA’s administrative capacity subject to ongoing decisions in Washington. Readers who want current detail on Integral Care’s federal funding status should contact the agency directly or check SAMHSA’s published grant award lists.
At the local level, Travis County has treated behavioral health as a genuine budget priority in recent cycles — partly because adequate crisis services reduce ER utilization and jail diversion costs, and those savings are measurable. The MCOT program and the crisis center’s capacity both reflect county investment layered on top of state and federal funding. When federal demonstration grants face cuts, local county budgets often backfill the gap. Sometimes they don’t.
Texas HHSC Medicaid rate changes are relevant here too. Integral Care bills Medicaid for many of its clients. When HHSC adjusts reimbursement rates for behavioral health services — which happens through the biennial legislative cycle — it directly affects staffing and CSU bed capacity. A rate cut that looks small in percentage terms can translate into real hiring freezes or bed reductions.
The crisis center is open and operational as of this writing. MCOT is running. The CSU has beds. But this infrastructure runs on a combination of county contracts, state Medicaid, and federal CCBHC grants. A significant reduction in any one of those streams hits capacity — and the people who feel it first are exactly the ones this guide is written for.
After the Crisis — Getting Connected to Ongoing Care
Being discharged from a crisis setting is not the same as being connected to care. The gap between the two is where people fall through, and it’s a real gap.
Before a client leaves Integral Care’s CSU, a clinician completes a discharge plan that includes a follow-up appointment — either with Integral Care’s outpatient services or with a community provider. The follow-up is scheduled before discharge, not handed to you as a phone number to call later. You leave with written documentation of the appointment and a number to call if it needs to change.
Adults who want to establish ongoing outpatient care with Integral Care — therapy, psychiatric medication management, case management — can enter through the same crisis line (512-472-4357) or through the intake request on the Integral Care website. If you accessed crisis services through the walk-in center or CSU, ask for a warm handoff to outpatient intake while you’re still there, rather than navigating the system again from scratch after discharge. Don’t assume it will be offered automatically. Ask before you leave.
Hospital EDs are required to provide discharge planning, but the quality of behavioral health discharge planning in an ER varies a lot. Before you leave, ask specifically for a referral to Integral Care’s outpatient intake and for the crisis line number. Some hospitals have a direct referral connection; others hand you a photocopied resource list. If you entered through the ER because of a medical complication, ask whether the hospital’s social work team can make a direct referral to Integral Care. Don’t leave without written follow-up information.
If MCOT was your entry point, the team completes a safety plan and care connection document at the end of each response. If you need follow-up outpatient care, MCOT can start the referral to Integral Care’s outpatient intake during the same visit. They also offer follow-up wellness checks — ask for one while the team is still with you.
For adults who aren’t Medicaid-eligible and can’t afford private therapy, Integral Care’s sliding-scale outpatient services and CommUnity Care’s behavioral health program together cover most income situations. NAMI Austin operates a peer support warm line and can connect callers with low-cost therapy options in the community.
Quick-Reference Card
Verify hours and addresses directly before traveling. Call ahead to confirm operational status.
CRISIS LINE — INTEGRAL CARE / ATCIC 512-472-HELP (512-472-4357) Available 24/7 — crisis counseling, MCOT dispatch, CSU referral, intake routing This is the primary local crisis number.
INTEGRAL CARE CRISIS SERVICES CENTER (Walk-In) 7000 N. Mopac Expressway, Austin, TX 78731 Open 24/7, 365 days a year — confirm by phone if time permits Sliding-scale fees; $0 floor for adults at or below 100% FPL; no insurance required No appointment, no referral required.
988 SUICIDE AND CRISIS LIFELINE Call or text 988 | Chat: 988lifeline.org Available 24/7 Routes to Texas-based counselors from Austin-area calls. Request MCOT explicitly if you don’t want police dispatch.
MOBILE CRISIS OUTREACH TEAM (MCOT) 512-472-4357 (same as Integral Care crisis line) Clinician + peer support specialist; no police. Request by name when you call. Primary hours: days and evenings; overnight coverage limited. Service area: Travis County — confirm coverage for your location when you call.
ASCENSION SETON BEHAVIORAL HEALTH 1165 W. 38th Street, Austin, TX 78705 Inpatient psychiatric services; accepts emergency admissions. Financial assistance available after discharge through application — not applied at crisis triage. Verify current intake process by phone before arriving.
DELL SETON MEDICAL CENTER (ER — use for medical emergency concurrent with psychiatric crisis) 1500 Red River Street, Austin, TX 78701 Open 24/7. Correct choice when medical emergency and psychiatric crisis are happening simultaneously. Significantly higher cost for uninsured patients than Integral Care.
COMMUNTY CARE HEALTH CENTERS (FQHC — outpatient behavioral health, sliding scale) Multiple Austin locations. Sliding-scale fees; uninsured accepted. Not a 24/7 crisis center. Use for: establishing outpatient care after crisis, medication management, ongoing counseling. Contact directly for current scheduling and locations.
PEOPLE’S COMMUNITY CLINIC (FQHC — outpatient behavioral health, sliding scale) North Lamar, Austin Sliding-scale fees; uninsured accepted. Not a 24/7 crisis center. Contact directly for current address, phone, and hours.
NAMI AUSTIN (Peer support, referrals, warm line) Not a crisis line. Use for community connection, peer support, low-cost therapy referrals. Contact directly for current phone and hours.
If you or someone you know is in immediate danger, call 911 or go to the nearest emergency room.
CityDesk Austin will update this guide when facility hours, addresses, or fee structures change. If you have firsthand experience with any of these services — as a client, family member, or provider — we want to hear from you.
