Crisis 101: Let Us Help You

1. Crisis 101: Let Us Help You Overview of Crisis Services for Bergen County School, Community and Mental Health Liaison Initiative Bergen Community College January 22, 2010 Care Plus NJ, Inc.

2. Objectives for Today * Define “crisis” * School’s role in crisis intervention * Overview of crisis services in Bergen County * What do school staff need to know to gain access to services for their students, families and school community

3. What is Crisis and Crisis Intervention? • Crisis: • An acute emotional upset arising from the situational, developmental, or socio cultural sources • Results in a temporary inability to cope by means of one’s usual problem-solving devices • Crisis management: • The entire process of working through the crisis until there is a resolution • This process usually involves assistance for the individual and members of that person’s natural and institutional social network * Information obtained from People in Crisis: Clinical and Public Health Perspectives by Lee Ann Hoff

4. Crises Must Be Resolved • Whether the resolution of a crisis is positive or negative often depends on the crisis intervention • Crisis intervention is referred to as “The short-term helping process”. It focuses on resolution of the immediate problem through the use of personal, social and community resources • If stress overwhelms us and we are unable to find a way out of our predicament, a crisis may result • If crises are not resolved constructively, emotional or mental illness, addictions, suicide or violence against others can be the unfortunate outcome * Information obtained from People in Crisis: Clinical and Public Health Perspectives by Lee Ann Hoff

5. Steps In A Crisis • 1. Assessment • Information on source and degree of crisis • 2. Planning • Where can I access help? What resources are needed? • 3. Implementation • Are there any barriers to get access to needed resources/services? • 4. Follow-up • Crisis is stabilized or is the child/family in need of more resources? * Information obtained from People in Crisis: Clinical and Public Health Perspectives by Lee Ann Hoff

6. PESP/262-HELP • 262-HELP is the Designated Screening Center for Bergen County • The screening law applies to individuals 18 and over • 262-HELP does not have legal authority over minors and therefore can only provide recommendations for services • 262-HELP does not provide school clearance • 262-HELP bills for all services rendered

7. How To Use 262-HELP Information 262-HELP will need The minor’s: Name Address Telephone number Date of birth Social Security number The parent’s Name Address (if different from minor) Contact numbers The basis for the crisis assessment Is the child a danger to self or others? Do you think the minor needs hospitalization to prevent harm to self or others? Any current medical conditions (including known allergies)

8. 262-HELP Outreach Services for Minors • 262-HELP will provide a clinical assessment for a child in Bergen County that presents as dangerous to themselves others or property • 262-HELP asks that the school make every effort to locate parent/guardian and request their presence during an outreach • 262-HELP does not have the legal authority to provide a crisis assessment against a parent’s wishes • 262-HELP can provide an assessment if verbal authorization from the parent/guardian is provided • If hospitalization is necessary and the parent is not available, police will contact the Juvenile Family Crisis Intervention Unit for authorization to transport child to the hospital

9. Juvenile Family Crisis Intervention Unit • The goals of this unit are to help adolescents and their families, divert family crisis situations from the court, and keep families together • JFCIU is not designated to work with families in which the primary issue is risk of suicide or child abuse or neglect • Services are free to Bergen County residents

10. JFCIU And The Police • Referrals for assistance come from families, schools, police, and other agencies • If a child receives a crisis assessment from 262-HELP and it is determined that the child is in need of hospitalization but the parents could not be located, the police will contact JFCIU for authorization to transport

11. Children’s Mobile Response and Stabilization System • Services are available to Bergen County children who are in crisis but are not in imminent danger • Services are activated when the parent/guardian contacts the Contracted System Administrator (PerformCare at 877-652-7624) • The CSA will determine if CMRSS services are needed • If the crisis is not imminent but the family is in need of assistance, the CSA may authorize other services, such as a “needs assessment” • Mobile outreach services are available 24/7 and usually within a one hour response time • Crisis intervention is provided for up to 72 hours • Development of individual crisis plans • Clinically-based interventions for up to 8 weeks to stabilize the crisis • Development of community-based support system

12. Bergen County TLC for Youth • To assist schools in preparing to respond to the mental health needs of their students following traumatic events • Dedicated to excellence in suicide prevention and in providing a collaborative, coordinated mental health response following critical incidents affecting our school-aged youth • The TLC has a trained Lead Response Team who can respond to a school following the sudden, traumatic loss of a child • The Lead Response team members are all trained in the newest evidenced-based model

13. Traumatic Loss Coalition Role of the TLC Services provided What to expect with TLC involvement Announcement Letter Containment and Suicide Prevention

14. What Trauma Services Does the TLC Offer? • County coalition meetings for the purpose of networking, disseminating information and reviewing best practices in the areas of mental health, trauma, and suicide prevention. • Educator Professional Development Credits are provided at meetings with an educational component • Suicide Awareness Training for Educators • Fulfills the professional development requirement per Assembly Bill 3931 • There is a fee for this presentation

15. What Trauma Services Does the TLC Offer? • Assistance in the development of prevention and post-vention services for school crisis teams. There is a fee for this training • School Wide Prevention: Bullying/Violence Prevention • Threat or Mental Health Assessment

16. What is a Threat Assessment? • It is an approach to violence prevention originally developed by the U.S. Secret Service based on studies of persons who attacked or threatened to attack public officials • In 1999, the FBI issued a report concluding that schools should use a threat assessment approach • In 2002, a joint report of the US Secret Service and Department of Education recommended that schools train threat assessment teams in order to respond to student threats of violence

17. Crisis Plan vs. Threat Assessment • “Crisis plans” are interventions to increase security in schools. Such interventions focus on crisis response • “Threat Assessments” are prevention strategies to generate interventions to prevent violence

18. Principles of Threat Assessment • Effective threat assessment is based on facts, rather than characteristics or “traits” • An “integrated systems approach” should guide threat assessment investigations • The central question of a threat assessment is whether a student poses a threat, not whether they made the threat

19. What is a Threat? • A threat is an expression of intent to harm someone • Threats may be spoken, written, or gestured • Threats may be direct or indirect and need not be communicated to the intended victim(s) • I’m going to get him after school • Weapon possession is presumed a threat unless circumstances clearly indicate otherwise • Need credible corroborating information • When in doubt, assume it is a threat

20. Threat Assessment Involves: • Identification • Identify threats made by students • Evaluation • How serious is the threat? • What is the danger it poses to others? • Recognizing that not all threats are the same • Intervention • Taking action to reduce the risk of violence • Referrals – Police, DYFS, 262-HELP • Follow-up • To assess intervention results

21. Liability Issues • “From a legal liability perspective, these guidelines provide school districts with a means of demonstrating that they have adhered to the developing standard of care in responding to potentially dangerous students.” **Dewey Cornell, Ph.D from the University of Virginia • “These Guidelines represent legal ‘best practices.’ School districts that follow these guidelines will reduce their liability exposure.” **Michael Smith, Past President of the California Council of School Attorneys

22. Schools are Safe • Despite Columbine, Virginia Tech and more recent school violent incidents, the level of violent crime in our schools and colleges is low • As per the National Crime Statistics (2004), students are safer in school then at home or on the street • More common are issues of bullying, fighting and threatening behavior • School-based mental health programs, in-school counseling, and violence prevention programs that focus on helping students resolve problems and resolve conflicts are effective

23. For More Information: Sue Heguy, LCSW Bergen County TLC Coordinator Care Plus Violence Prevention Educator Care Plus NJ, Inc. 17-07 Romaine Street Fairlawn, NJ 07410 (201) 797-2660 x129 sueh@careplusnj.org