Values-Based System and Program Design
Measurable Criteria for an Ideal System
Services Address The Continuum of the Crisis Experience
Creating Safe Spaces That Are Warm, Welcoming and Therapeutic
Measurable Criteria for an Ideal Crisis Space
Safety and Security Practices That are Both Safe and Welcoming
Measurable Criteria for Safety and Security Practices That are Both Safe and Welcoming in an Idea System
Treat Law Enforcement as a Preferred Customer
Measurable Criteria for an Idea Crisis Continuum That Treats Law Enforcement as a Preferred Customer
Crisis Center of Crisis Hub
Call Centers and Crisis Lines
Deployed Crisis-trained Police and First Responders
Medical Triage and Screening
Mobile Crisis
Behavioral Health Urgent Care
Intensive Community-based Continuing Crisis Intervention
23-hour Evaluation and Extended Observation
Residential Crisis Program Continuum
Role of Hospitals in Crisis Services
Transportation and Transport
This section describes the components, elements and capabilities of an ideal crisis continuum serving any community or catchment area. The organization of criteria in this section falls into five major subheadings.
These design elements relate to the creation of a crisis continuum that operationalizes core values, organizes crisis responsiveness to the full continuum of crisis experience and provides crisis space that is warm, welcoming, safe and secure, in which walk- in customers as well as law enforcement and everyone in between, feel that their needs can be appropriately met.
This section addresses the need for the crisis continuum to be responsive to a full range of populations in need: individuals of all ages, ranging from children to elders; individuals with various comorbidities, such as mental health/substance abuse disorder (SUD), behavioral health/cognitive disabilities and behavioral health/medical conditions and disabilities; and individuals with cultural and linguistic challenges, including immigrants, hearing impaired populations, veterans and LGBTQI/gender-non-conforming individuals.
This section addresses the core characteristics of a service continuum versus discrete and disconnected components, with the ability for both clients and information to flow smoothly through that continuum, as well as the ability to engage family members and other collateral informants (e.g., caregiver, friends, faith-based providers) and community providers and services, together with the individual client as part of their journey through the continuum, both with face-to-face services and application of telehealth capabilities throughout the continuum as needed.
This section describes the many specific components of an ideal continuum of crisis services. The centerpiece of this continuum is often an on-site crisis center sometimes termed a crisis hub or “crisis response center, that may include or coordinate with a full array of other components ranging from a call center, to the roles of first responders, to various types of mobile crisis, to various types of crisis beds, to acute inpatient beds, to various mechanisms for ongoing crisis intervention. There is a description of a centralized mechanism or point of accountability through which all the components of the continuum are coordinated, as well as capability to ensure that individuals and families in crisis do not get lost and are engaged effectively in needed services.
The final section discusses the general staffing capacity needs within the crisis continuum, including the amount and types of staff needed, the types of clinical leadership needed, and the need for specialty expertise. This section does not, however, attempt to define the specific staffing pattern requirements for each component of the crisis system; that level of detail is beyond the scope of this document.
