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SAMHSA’s Award-Winning Newsletter
November/December 2009, Volume 17, Number 6 

Guidelines: Responding to Mental Health Crises

People with mental illnesses are vulnerable to repeated clinical and life crises that can have profound effects on the individual, families, and communities.

“These crises are not the inevitable consequences of mental disability,” said Paolo del Vecchio, M.S.W., Associate Director for Consumer Affairs at SAMHSA’s Center for Mental Health Services. “Rather, they represent the combined impact of additional factors, such as lack of access to essential services and supports, poverty, unstable housing, coexisting substance use, other health problems, discrimination, and victimization.”

A new resource from SAMHSA, Practice Guidelines: Core Elements for Responding to Mental Health Crises, defines appropriate responses to mental health crises.

Developed by a diverse expert panel that includes individuals with and without serious mental illnesses, the crisis guidelines promote two essential goals:

  • Ensure that standards consistent with recovery and resilience guide mental health crisis interventions.
  • Replace today’s largely reactive and cyclical approach to mental health crises with one that works toward reducing the likelihood of future emergencies and that produces better outcomes.

Situations involving mental health crises may include intense feelings of personal distress (anxiety, depression, anger, panic, or hopelessness), obvious changes in functioning (neglect of personal hygiene), or catastrophic life events.

Individuals experiencing mental health crises may encounter an array of people who try to intervene and help, including family members, peers, health care personnel, police, advocates, clergy, educators, and others.

Safe Interventions

Several principles are key to ensuring that crisis intervention practices are enacted appropriately.

  • Access to supports and services is timely, allowing for 24/7 availability and a capacity for outreach when an individual cannot come to a traditional service site.
  • Services are provided in the least restrictive manner, which avoids the use of coercion, but also preserves the individual’s connectedness with his or her world.
  • Peer support is available, affording opportunities for contact with others whose personal experiences with mental health crises allow them to convey a sense of hopefulness.
  • Adequate time is spent with the individual in crisis.
  • Plans are strengths-based, which helps to affirm the individual’s role as an active partner in the resolution of the crisis by marshalling his or her capabilities.
  • Emergency interventions consider the context of the individual’s overall plan of services.
  • Crisis services are provided by individuals with appropriate training.
  • Individuals in a self-defined crisis are not turned away.
  • Interveners have a comprehensive understanding of the crisis.
  • Helping the individual to regain a sense of control is a priority.
  • Services are congruent with the culture, gender, race, age, sexual orientation, health literacy, and communication needs of the individual being served.
  • Rights are respected.
  • Services are trauma-informed.
  • Recurring crises signal problems in assessment or care.
  • Meaningful measures are taken to reduce the likelihood of future emergencies.

Download Practice Guidelines: Core Elements in Responding to Mental Health Crises.

Mental Health Resources



  News & Updates  
Pamela S. Hyde Sworn in as New Administrator

Pamela S. Hyde Sworn in as New Administrator

Read more, view Webcast, and see photos.

Parity Law: Lessons Learned from California

Parity Law: Lessons Learned from California

Study may help to highlight the need for public education about the Federal parity law.

Voice Awards Honor Consumer Leaders

Voice Awards Honor Consumer Leaders

Entertainment industry and consumer leaders honored in Hollywood. Photo gallery.


  Publications  
TIP 52:  Treatment Guide to Clinical Supervision

TIP 52: Treatment Guide to Clinical Supervision

Improving counselors’ skills takes coaching and mentoring.

Guidelines: Responding to Mental Health Crises

Report offers principles for safe interventions.

Substance-Exposed Infants: How States Help

Substance-Exposed Infants: How States Help

Cross-agency, unified approach is recommended.


  Grants  
Funding Opportunities

Funding Opportunities

Call for applications include Peer-to-Peer Recovery program.

Tribal Grants Awarded

In Montana, a tribal group recently accepted a “big check.”


  Homelessness  
New Research Available on Parenting

New Research on Parenting

SAMHSA staff recently guest-edited 11 articles that focus on parenting.

Web Site Update on Co-Occurring Disorders

Web Site Update on Co-Occurring Disorders

New, interactive Web site features a library of tools.


  Adolescents & Substance Use  
“Influencers” Prevent Prescription Drug Misuse

“Influencers” Prevent Prescription Drug Misuse

Online toolkit helps family, teachers, and doctors keep teens from abusing prescription drugs.

Youth Tobacco Trends Show Decline

Youth Tobacco Trends Show Decline

Fewer youth are using tobacco products.

Perceptions of Risk from Substance Use

Perceptions of Risk from Substance Use

Age relates to teens’ perception of the danger of substance use.


  Suicide Awareness  
Suicide Prevention Update

Suicide Prevention Update

Lifeline’s Twitter, Facebook numbers rise.


  Prevention Update  
Native American Center for Excellence

Native American Center for Excellence

Recent event included a hoop dancing demonstration.



  Also in this Issue  
Gender Differences in Adolescents

Gender Differences in Adolescents

State reports on behavioral health problems presented by gender.

New Wallet Cards for 1-800-662-HELP

New Wallet Cards for 1-800-662-HELP

Order free wallet cards in English and en español.



  


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