What do I do if my child has a crisis?
If your child has a mental health crisis, and your child and family receive mental health services and have a crisis plan (formal or informal) developed with your mental health service provider, you should be able to follow the plan that was developed.  These crisis plans are individualized to the needs of the person and their particular situation.

If there is a crisis and you believe it is both a medical and mental health crisis, seek immediate medical care. This can be done with your primary care physician, a walk-in or urgent care clinic or hospital, depending on your assessment of the seriousness of the medical situation.

Who do I contact?
If your child is in mental health treatment, contact your service provider.  Clearly state that you believe your child is in a crisis. If you cannot speak to the service provider directly, leave a message saying you have a crisis situation and give the date, time and number where you can be reached. At the same time, follow any emergency contact instructions that are given, for example calling an “on-call” number, pressing “0” for the operator, or contacting a designated “after hours” crisis response number.  If you do not have an opportunity to speak to someone directly, and you have a “main number” for the organization, contact that number and tell them you have a crisis and need to speak to a service provider and do not want to leave a voice mail message.

In a crisis it is helpful to be able to work with the service provider with whom you already have a treatment relationship and who will be most able to address the situation considering what he or she already knows about the resources and challenges your child and family experience. Because crises are not planned, directly reaching your treatment provider may be difficult due to schedule conflicts, time off and illness and after-hours and weekend/holiday contact needs. Organizations handle this differently.  Some rotate an after-hours on-call crisis response,  some have a crisis phone number that responds to the initial call and then links a provider to the person in need, service providers are “on-call” for the persons they serve.

What is the protocol for a crisis assessment through Community Mental Health (CMH)?
At a CMH, you should expect to speak to someone within 60 minutes of the time you call.  A face-to-face crisis assessment can occur at the location where the crisis is occurring; for example, at the school, the home, or other community site, as well as at the hospital or a detention site.  The parent or legal guardian needs to be present for the crisis assessment.

The crisis assessment will examine the current condition of the child, the recent events for the child and family, and the immediate situation with the family and in the living environment.  The assessment may or may not include assessment for inpatient hospitalization. During the assessment, the mental health provider may consult with others involved in the child’s life or in their treatment; for example, a child’s relative who sometimes provides child care, the child’s physician or psychiatrist, or the mental health supervisor.

The person providing the assessment will give a recommendation to the parent or guardian. This could range from:

• remaining in the home with a follow-up safety plan,
• going to an extended family member who will provide the supervision and support needed for a brief period,
• having formal crisis respite for one to three nights,
• recommending the child have an inpatient psychiatric hospitalization.

If the child will remain in the home, a home of extended family, or have a crisis respite option, the mental health provider will develop a safety plan with the family and/or the respite provider.

If the results of the assessment indicate a need for hospitalization and the child has commercial insurance, the mental health provider will share the results with the parent/guardian and the insurance provider. The insurance provider will make the determination as to whether hospitalization is “authorized.” The mental health assessor will also provide information on availability of beds at various locations.

If the results of the assessment indicate a need for hospitalization and the child has public insurance, the mental health service provider will locate the nearest child/adolescent hospital with an available bed, while still considering family choice.  The mental health provider will also work with the family to explain the admission procedure, as well as providing support and assistance as the family arranges transportation.  The mental health assessor prepares the documents needed for the hospitalization.

If the recommendation is for crisis respite, the mental health assessor works with the parent in preparing the crisis respite materials packet, communicates with the respite provider agency and the respite provider about the plan of service related to the child and how situations are to be handled in the respite location during the brief respite period.  They provide support and assistance as the family arranges transportation to the respite site.

The person providing the mental health assessment will communicate with the doctors and other mental health treatment providers about the crisis assessment so that follow-up can be provided on the next business day.  Respite providers will have information as to contact resources if there are difficulties during the respite stay.

If the child remains in the family home, the family is instructed as to contacting CMH if there is a further need for crisis services.  The family is also instructed to call their mental health provider the next day to set up an “aftercare” appointment as follow-up to the crisis situation.  In most situations this face-to-face appointment would occur on the next business day.

If the child has not been receiving mental health services at the CMH, the person doing the crisis assessment assists the parent with contact numbers to set up an appointment to begin the assessment and treatment process.  CMH crisis services remain the point of contact until the initial assessment with a treatment provider.

Where do you go or who do you talk to if you are not satisfied with the results?
If you are not satisfied with the results of a crisis assessment the parent or guardian may request a second opinion.  They may also contact  Northern Lakes Customer Services at  1-800-337-8598 or 231-775-3463.  The mental health assessor provides information on obtaining a second opinion and accessing Customer Services.