The Crisis Now Library

Making better crisis care available in your area is closer than you think.
1. WHITE PAPER – Crisis Now Policy Recommendations Report

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2. ASSESSMENT – Framework for State/Region Self-Assessment

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BUSINESS CASE – Quantifying Improved Crisis Continuum Outcomes

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INFOGRAPHIC – Outcomes for Expense, Hospital & Law Enforcement Impacts

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The Challenge

After reviewing approaches to crisis care across the United States, the Crisis Services Task Force of the National Action Alliance for Suicide Prevention (Action Alliance) believes now is the time for crisis care to change. The Task Force, established to advance objective 8.2 of the National Strategy for Suicide Prevention (NSSP), comprises many experts, including leaders who have built and operate many of the most acclaimed crisis programs in the nation.

EDs Face Challenges Addressing Behavioral Emergencies

 

The Task Force has studied elements of successful programs and reviewed their effectiveness. While some communities are crisis-ready, there are very few communities where all key elements of crisis care are in place, and many where even the “parts” of crisis care that exist are inadequate. In short, core elements of crisis care include:

  1. Regional or statewide crisis call centers coordinating in real time
  2. Centrally deployed, 24/7 mobile crisis
  3. Short-term, “sub-acute” residential crisis stabilization programs
  4. Essential crisis care principles and practices
  5. Develop and implement protocols for delivering services for individuals with suicide risk in the most collaborative, responsive, and least restrictive setting

These elements are discussed in more detail in the report (download here). Effective crisis care that saves lives and dollars requires a systemic approach, and these key elements must be in place. The report also reviews proven key components of good crisis care and demonstrates that piecemeal solutions are unacceptable.

Four Core Elements For Transforming Crisis Services

High-Tech Crisis Call Centers

These programs use technology for real-time coordination across a system of care and leverage big data for performance improvement and accountability across systems. At the same time, they provide high-touch support to individuals and families in crisis.

24/7 Mobile Crisis

Mobile crisis offers outreach and support where people in crisis are. Programs should include contractually required response times and medical backup.

Crisis Stabilization Programs

These programs offer short-term “sub-acute” care for individuals who need support and observation, but not ED holds or medical inpatient stay, at lower costs and without the overhead of hospital-based acute care.

Essential Principles & Practices

These must include a recovery orientation, trauma-informed care, significant use of peer staff, a commitment to Zero Suicide/Suicide Safer Care, strong commitments to safety for consumers and staff, and collaboration with law enforcement.

Crisis Readiness Statistics


The Crisis Now Report

Transforming services is within our reach

Effective Crisis Care Must Be Comprehensive and Include The Core Elements of Crisis Care

  1. Regional or statewide crisis call centers coordinating in real time
  2. Centrally deployed, 24/7 mobile crisis
  3. Short-term sub-acute residential crisis stabilization programs
  4. Essential crisis care principles and practices
  5. Recovery orientation
    • Trauma-informed Care
    • Significant Use of peer staff
    • Commitment to Zero suicide/Suicide Safer Care
    • Strong commitment to safety of consumers and staff
    • Collaboration with law enforcement

Crisis Call Services Should Participate in and Meet the Standards of the National Suicide Prevention Lifeline, and crisis Intervention Systems Should Adopt and Implement Zero Suicide/Suicide Safer Care Across all Program Elements

  • Leadership-driven, safety-oriented culture committed to dramatically reducing suicide among people under care, which includes survivors of suicide attempts and suicide loss in leadership and planning roles
  • Develop a competent, confident and caring work force
  • Systematically identify and assess suicide risk among people receiving care
  • Ensure every individual has a pathway to care that is both timely and adequate to meet his or her needs and that includes collaborative safety planning and reducing access to lethal means. Use effective, evidence-based treatments that directly target suicidal thoughts and behaviors
  • Provide continuous contact and support, especially after acute care
  • Apply a data-driven quality improvement approach to inform system changes that will lead to improved patient outcomes and better care for those at risk

State and National Authorities Should Review the Core Elements of Air Traffic Control Qualified Crisis Systems, Apply them to Crisis Care in their Jurisdictions, and Commit to Achieving These Capabilities Within 5 Years, So That Each Region of the U.S. has a Qualified Hub for Crisis Care:

Link mobile crisis and crisis beds to the call center.  Use air traffic control objectives:

      • Always know where the individual in crisis is (in time and space) and never lose contact
      • Verify the hand-off has occurred and the individual in crisis is safely in the hands of another provider

Status Disposition for Intensive Referrals

      • 24/7 Outpatient Scheduling
      • Shared Bed Inventory Tracking
      • High-tech GPS-enabled Mobile Crisis Dispatch
      • Real-time Performance Outcome Dashboards

To view the remaining recommendations Download The Full Crisis Now Report:

Watch The Video

Transforming Crisis Services in Arizona

Crisis Providers Improve Care, Reduce Cost, And Relieve ER Overload

Good crisis care reduces and prevents suicides while providing more immediate and targeted help for the person in distress. In addition, it cuts cost of care substantially by reducing the need for psychiatric hospital bed usage, emergency department visits, and law enforcement overuse. In general, mental health crisis care in the U.S. is inconsistent and inadequate. Members of the Crisis Services Task Force of the National Action Alliance for Suicide Prevention (Action Alliance) created the Crisis Now concept and authored the Crisis Now paper; identifying the exceptional practices desired in a crisis services.

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Responses to questions will be answered by representatives of agencies involved in the creation of the Crisis Now Report.