Can county’s new mental health center break the negative cycle of crisis care? Fawad Taj

In Cuyahoga County, we’ve made a habit of funding reaction over recovery. Building crisis centers has become our blueprint; sustaining recovery, our afterthought.

During his recent State of the County address, County Executive Chris Ronayne outlined a vision for “a stronger, more welcoming Cuyahoga,” highlighting new housing initiatives, workforce investments, and the launch of a proposed $28 million behavioral health crisis center. For those of us who have spent nights in Cleveland’s psychiatric ERs, it represents progress but also déjà vu. We have built crisis facilities before. What we haven’t yet built is a way out.

Under the proposed county budget, the county’s Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board now faces $8.5 million in cuts over two years. Beyond that county-level cut, the board is withdrawing $4 million in annual funding from MetroHealth’s psychiatric emergency department and $1.5 million from FrontLine’s Stricklin Crisis Stabilization Unit. These dollars will be reallocated to sustain the county’s new behavioral health crisis center, beginning with $2.9 million in 2026 and increasing to $10 million annually by 2027. MetroHealth has since announced the closure of its psychiatric emergency department. And, despite roughly $32.5 million invested in the facility since May 2021, the county’s Diversion Center, once hailed as a humane alternative to jail, will close when the new crisis center opens.

We’ve been here before: facilities built with optimism, only to falter under the structural weight of treating crisis in isolation. Each program attempted to bridge the gap, but without robust outpatient and community-based follow-up, stabilization became a pause, not a pathway. Too often, individuals left with a prescription but no coordinated wraparound plan. Others waited days or weeks for an inpatient bed, until they gave up, or the system quietly did. These are not mere budget adjustments; they are reminders that crisis-response infrastructure, when siloed from a broader continuum of care, inevitably erodes under its own isolation, stabilizing the moment but never securing the future. A polished door is still just a door.

This is the quiet epidemic of recidivism in behavioral health, individuals cycling through hospitals, shelters, and courts in a tragic rhythm that masquerades as care. Every loop carries a hidden invoice. Nationally, untreated mental illness drives roughly $26 billion to $48 billion a year in avoidable medical expenditures, while untreated depression among patients with chronic disease inflates total health care costs by 30% to 50%.

Yet when behavioral health is fully integrated, the return on investment is undeniable. Collaborative-care models yield $4 to $6 for every $1 invested; employers gain about $2,000 per employee per year through improved well-being and productivity. Mental health isn’t a cost center, it’s the value multiplier we continue to overlook.

The irony is that, while the county proposes a new crisis center to expand access, its budget simultaneously trims human-services allocations in anticipation of rising health care costs. This is cost-containment at the expense of prevention, like patching a roof while letting the foundation rot.

Still, there’s a silver lining worth holding onto. The proposed center’s third floor will house outpatient behavioral-health services, the connective tissue between crisis and recovery. If adequately resourced, staffed, and aligned with housing, peer-support, and long-term case-management programs, that floor could become the fulcrum that finally shifts our system from reactive to preventive care.

Because the true measure of mental health isn’t how many crises we contain, but how many lives we help rebuild.

Cuyahoga’s next real innovation won’t rise from architectural blueprints or budgets alone; it will come from the courage to fund what follows: recovery, connection, and continuity.

True value, in dollars, dignity, and human potential, isn’t created in moments of crisis. It’s built in the quiet, continuous work that keeps people from reaching one. The resource allocation is already there; what’s missing is the will to finally end the revolving door of crisis care. Let us focus on restoration, not just reaction, and on resilience not just crisis.

Dr. Fawad Taj, M.D., is a psychiatrist, Cleveland resident, and community advocate.

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