Beaver County Single Point of Accountability

1. Beaver CountySingle Point of Accountability Crisis Response Protocol

2. SPA Crisis Response • What is a Crisis • Crisis Intervention • Goals • How to Respond • Proactive Intervention / Community Intervention

3. What is a Crisis? The term 'CRISIS'has its roots in a Greek word meaning 'decision', or more broadly speaking, 'a turning point'. "A crisis occurs when a person faces an obstacle to important life goals that is for a time insurmountable through the use of her/his customary methods of problem solving.“ A person in crisis, at that particular time, is unable to rely on their familiar coping mechanisms and is faced with an acute sense of disequilibrium and disorientation. The stress of a crisis upsets the balance between thoughts, feelings and behavior.

4. What is a Crisis? (cont’d) • The consumer is identifying that they need to be hospitalized psychiatrically. • He/she cannot, or will not, accept other possible alternatives or solutions (e.g. relaxation techniques, crisis counseling etc). • The he/she is verbalizing intent to harm self or others or is displaying an inability to care for self. • He/she is acting out in the community • Consumer, family, or residential staff, etc. are in need of assistance (or feel hospitalization is necessary).

5. Crisis Intervention • Fundamental Task • Restore the confidence of an individual in their coping abilities, as well as to provide the possibility of new coping mechanisms. • Intervention techniques are to be face-to-face if hospitalization is being considered as an option. • SPA must educate residential staff on how to help the person deescalate, or deal with their symptomology and redirect behaviors.

6. Crisis Intervention: Goals • The goals of a crisis intervention relate to the immediate crisis situation: • Reduction in disequilibria or relief of symptoms of crisis • Restoration to pre-crisis level of functioning • Some understanding of the relevant precipitating events • Identification of remedial measures for the person and/or family through community resources • Connecting the current situation with past life experiences and conflicts • Initiating new modes of thinking, perceiving, and feeling, and developing new adaptive and coping responses which are useful beyond the immediate crisis situation, leading to an emancipated maturation and empowerment.

7. Crisis Intervention: How to respond • In addition to being nonjudgmental, flexible, objective, supportive and empowering, the following are considered to be essential requisites to enable an individual to journey from a vulnerable crisis state to equilibrium and empowerment: • Ability to create trust via confidentiality and honesty • Ability to listen in an attentive manner • Provide the individual with the opportunity to communicate by talking less • Being attentive to verbal and nonverbal cues • Pleasant, interested intonation of voice • Maintaining good eye contact, posture and appropriate social distance if in a face-to-face situation • Listening for feelings, hearing what is said and not said, focusing on what person is feeling • Remaining undistracted, open, honest, sincere • Being free of prejudice and abstaining from stereotyping • Asking open-ended questions • Giving feedback and receiving feedback whenever possible if the person is prepared to hear • Asking permission, never acting on assumptions • Checking out sensitive cross-cultural factors • Being aware of one's own prejudices

8. Community Intervention/Proactive Prevention: • Providers should contact SPA staff in the event of a crisis. • Community intervention is preferred whenever imminent danger to the person or others is not a concern, rather than sending someone directly to the Emergency Department, which prompts admission. • Blended Case Managers will respond to the provider and the person in crisis, assessing for imminent danger, and then enhance the efforts of the formal crisis response team. • CTT/FACT staff will proactively respond to the crisis in the community rather than waiting to meet a client in the Emergency Department. • SPA staff are also expected to accompany formal system crisis responders, such as mobile crisis, and respond to emergent crisis requests within one (1) hour on average in the community (includes mobile crisis, as well as CTT, FACT, Blended CM, etc.). • SPA staff should follow up on a crisis response after any crisis intervention to prevent further decompensation of the individual. • Community Intervention and Proactive Prevention expectations and procedures are reinforced by Beaver County provider contract language.

9. THANK YOU You have completed the Crisis Response protocol. Please insert the following link into your web browser to take a short test for this competency: https://www.surveymonkey.com/r/CrisisResponse16 You can also find this information at www.BC-Systemofcare.org In the SPA section.