The U.S. Department of Health and Human Services (HHS), through the Substance Abuse and Mental Health Services Administration (SAMHSA), today released a new report, National Guidelines for Child and Youth Behavioral Health Crisis Care, which describes the urgent need to improve crisis response services for children, youth, and families and provides guidance on how communities can address the existing gaps in care for youth.
“America’s youth deserve appropriate, well-informed and effective behavioral health crisis services. All too often, children and youth experiencing a behavioral health crisis face hospitalization or justice system involvement, instead of receiving the home-based care and community-based services that are in many circumstances best for de-escalating and stabilizing a crisis,” said Miriam Delphin-Rittmon, Ph.D., HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA.
The National Guidelines for Child and Youth Behavioral Health Crisis Care offers best practices, implementation strategies, and practical guidance for the design and development of services that meet the needs of children, youth, and their families experiencing a behavioral health crisis. Additional technical guidance is provided in a companion report produced by SAMHSA in conjunction with the National Association of State Mental Health Program Directors, A Safe Place to Be: Crisis Stabilization Services and Other Supports for Children and Youth. This report is part of a 10-paper compendium “From Crisis to Care” that will be released in the coming weeks.
As the national guidelines outline, the need for developmentally and culturally appropriate crisis response services for youth is crucial, and yet while many crisis response systems have robust services in place for adults, there are often considerable gaps in capacity to serve youth and families.
SAMHSA’s guidelines recommend that youth in crisis from mental health and substance use disorders receive care in the least restrictive setting possible, and if it is safe, at home and in the community. Whenever possible, hospitalizations and justice system involvement should be safely reduced or prevented.
As with adults, the guidelines recommend that crisis services for children and families ensure that youth and families have:
- Someone to Talk To: Crisis Call Centers, including the new national 988 Suicide & Crisis Lifeline, offering 24/7/365 access to counselors with specialized training to respond to youth and families
- Someone to Respond: Mobile Response Teams, to respond to crises at homes, schools and elsewhere in the community, keeping youth in their homes when safe to do so
- A Safe Place to Be: Crisis Receiving and Stabilization Services, including in-home services, at crisis care facilities, emergency departments and hospital settings
According to SAMHSA’s recommendations, crisis response systems should partner with agencies across the continuum of care for children and youth: including schools, family and peer support, community organizations, child welfare and foster care, juvenile justice, pediatricians and other primary care providers, and law enforcement when appropriate.
The guidelines further recommend that crisis care providers be trained to respond to the diverse needs of all youth, including those of different age ranges, races and ethnicities, sexual and gender identities, immigration status, homelessness and intellectual or developmental disabilities. They also recommend that clinicians and peers reflect the diverse communities they serve.
Last year, the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP) and the Children’s Hospital Association (CHA) joined together to declare a National State of Emergency in Children’s Mental Health, and the U.S. Surgeon General issued an advisory (PDF | 1 MB) highlighting the urgent need to address the youth mental health crisis, which has been exacerbated by the COVID-19 pandemic.
Between 2016 and 2020, the number of children ages 3-17 years diagnosed with anxiety grew by 29% and those with depression by 27%, according to data from the HHS Health Resources & Services Administration’s National Survey of Children’s Health. In 2020, suicide was the second leading cause of death for young people aged 10-14 and 25-34, and among the top 9 leading causes of death for people ages 10-64, according to a report by the HHS Centers for Disease Control and Prevention.