Mental health crisis response services are an important component of any mental health service system. A well-designed crisis response system might serve as backup for community providers, connect first-time users to appropriate services, and reassure the public that their demands will be met in a mental health emergency. This is especially important for getting treatment during a crisis.
What Makes An Effective Mental Health Crisis Service?
Depending on where you live, mental health emergency services will be different. Getting to know about the available resources and how to use them is an important stage in being ready for a psychiatric crisis. The happier a person is when confronted with a crisis, the better the result. An effective response system includes the following components.
- Many suicide prevention hotlines are open 24 hours a day, 7 days a week for people in distress or their loved ones. Telephone crisis services offer assessment, screening, triage, preliminary counseling, and information and referral services.
- Walk-in crisis centers, such as clinics or psychiatric urgent care centers, provide prompt assistance. They concentrate on resolving the issue in a less intensive environment than a hospital does, although when appropriate, they might suggest hospitalization. Walk-in clinics can be used by law enforcement to prevent needless arrests as drop-off locations.
- Mobile crisis teams respond wherever a catastrophe occurs, often working in coordination with the police, crisis hotlines, and hospital emergency personnel. Mobile workers can give pre-screening assessments or act as gatekeepers for inpatient hospitalization and may also connect an individual with community-based services and other services.
Respite Care And Residential Services
Residential services and crisis respite might assist a client in regaining control, resolving issues, and finding potential sources of continuing support. Physical and psychiatric assessment, daily living skills training, social activities, counseling, treatment planning, and connecting to resources are all examples of services that may be supplied. Residential care may be used as an alternative to hospitalization.
Short-term aid for persons who are caring for family members who may require more assistance outside of the house is also beneficial because it can give individuals short-term relief.
There are a variety of models for providing respite care, depending on the level of assistance required:
- A family-based crisis support home functions as a “professional family” for the person in crisis, with a tested and trained “professional family.” In addition to practical and empathetic help from “family” members, mental health experts come to the house on a daily basis for treatment planning.
- The goal of crisis respite centers and apartments is to offer 24-hour supervision and assistance by crisis workers or trained volunteers until a person is stabilized and linked with other resources. Peer support experts in some areas provide encouragement, support, guidance, and role models in a non-threatening atmosphere.
- In-home support is similar to a crisis apartment, but it may be used if a lack of separation from the routine setting is not required.
Crisis Stabilization Units
CSUs (Crisis Stabilization Units) are small, short-term inpatient facilities with fewer than 16 beds that may be used to treat individuals experiencing a mental health crisis who cannot be properly cared for in residential service settings. When the person requires the need of a safe, secure environment that is less restricting than a hospital.
Extended Observation Units (23-Hour Beds)
23-hour beds, also known as extended observation units (EOUs) are a stand-alone service or can be incorporated into a CSU. When the emergency can be addressed in less than 24 hours, admission to an EOU is appropriate. EOUs are built for people who require short, intensive therapy in a secure setting.
Hospitalization
There may be instances when a person is admitted to the hospital for intensive therapy. Psychiatric hospitals, including general hospitals with a psychiatric floor or state mental hospitals, are built to be secure environments for intensive mental health care. This might include monitoring, diagnosis, adjustment or supplementation of drugs, ECT treatments, stabilization efforts, and other activities.
If a patient and their doctor believe it is in their best interests to go into treatment as an inpatient, they will be admitted on a voluntary basis, which means that they have chosen to do so. Some private hospitals will only take voluntary patients.
In certain situations, involuntary hospitalization may be an option if a person is very sick and refuses to go to the hospital or accept treatment. A person must be assessed as a “threat to self or others” under the legal standard for involuntary hospitalization. This kind of confinement generally lasts less than three days but can occasionally extend for a week or more if needed.
To extend an involuntary hospitalization, a court hearing must be held, and a judge and two physicians must agree that the patient’s condition necessitates confinement. The state has the authority to regulate involuntary hospitalization. The initial criteria are typically based on whether there is an immediate safety hazard to him- or herself or others. Other states’ laws may define other criteria, such as being severely disabled, for involuntary hospitalization.
It is critical to create a discharge strategy with a social worker or case manager when a person leaves the hospital. If the individual is going home or will require significant assistance, family members should be included in discharge planning. A good discharge plan guarantees that patients continue to receive continuous therapy and have an easy transition back into their normal lives.
Partial Hospitalization or Day Hospitalization
Partial hospitalization is therapy and monitoring for a person who is having acute psychotic symptoms but does not pose a danger to themselves or others. It allows someone to go home at night, which is much more comfortable. It can also be used as a bridge from inpatient hospital care into full-time home care.
Emergency Rooms
If a person is experiencing mental health issues or requires medical attention but does not want to go to a mental health center or private doctor, an emergency room visit may be the only alternative.
Situations that might require a trip to the emergency room include:
- A suicide attempt
- Assault or threatening actions against another person
- Hearing voices, paranoia, confusion, etc
- Drugs or alcohol use
If you’re phoning 911, be sure to identify it as a “mental health emergency” and request for CIT-trained responders. If they know what to anticipate, many first responders would approach a mental health scenario differently.
After arriving at the emergency department, he or she will be identified. This will involve filling out forms and giving information about insurance, medical history, and other relevant details. A psychiatric evaluation will establish a “working diagnosis” and devise a strategy of action. Medical personnel will then make an assessment to see how serious the situation is right away. A psychiatric examination will provide a “working diagnosis” and recommend strategies for treatment. After discharge, most patients will receive tranquilizing medications, crisis counseling, and an explanation of what’s going on as well as a referral to therapy.
Having a plan in place that details how to respond to and prevent crises can assist avoid emergencies from getting out of hand.