Crisis Services

Planning

Being proactive and having things in order during a crisis is the best way to get through any of life’s challenges, and this is no different when it comes to a mental health crisis. Having a prior directive that people can follow can make a mental health crisis more manageable and may even avert the event by enabling close friends or family members to see the early warning signs. Learning to create your own Wellness Recovery Action Plan (WRAP) can help you plan for and prevent future mental health crises. Click here for more information on WRAP. Another option is this link to the SAMHSA website that has information on developing your own crisis plan. Taking the time to do this when you are feeling well can make all the difference. The link below is to the Tennessee Department of Mental Health and Substance Abuse Services' website page for the “Declaration for Mental Health Treatment.” This page links to a downloadable form for filling out a legal directive on what kind of treatment you want to receive in the event you are unable to make informed decisions about your mental health treatment due to a mental illness.
https://www.tn.gov/behavioral-health/topic/declaration-for-mental-health-treatment


Crisis Definitions and Goals

Crisis services include 24-hour, seven days a week, toll-free telephone triage, mobile crisis services, crisis stabilization units, crisis respite beds, medically monitored crisis detoxification units, Mandatory Pre-screening Agent services and peer support services. Peer support specialists work with crisis specialists to assist adults in alleviating and stabilizing crises and to promote the recovery process. The goals of crisis services include:

  • Promoting the safety and emotional stability of individuals with mental illness or emotional crises;
     
  • Minimizing further deterioration of individuals with mental illness or emotional crises;
     
  • Assisting individuals in developing and/or enhancing better coping skills and a natural support system;
     
  • Helping individuals with mental illness or emotional crises obtain ongoing care and treatment; and
     
  • Encouraging services in the least restrictive setting that is clinically appropriate to meet the individual’s needs. 

A mental health crisis is an intensive behavioral, emotional, substance use, or psychiatric situation which, if left untreated, could result in an emergency situation.

Telephone Triage

Mental health crisis services are initiated following telephone or walk-in triage assessment. Occasionally, following telephone triage, it is determined that a face-to-face assessment is required in the community at the location of the individual in crisis. A triage screening determines the seriousness of the crisis situation and determines the appropriate intervention needed to alleviate or stabilize the crisis. The triage screening can be completed on the phone or face-to-face for those who utilize the walk-in triage center (see Walk-In Triage Center information below). The triage screening also helps to determine the individual’s current status such as:

  • If there is a behavioral health provider treating the individual;
     
  • The existence or availability of a support system;
     
  • The existence or availability of a treatment plan; and
     
  • If a face-to-face crisis assessment or other services are needed.

Crisis Services Intervention

An intervention is a face-to-face, short-term, intensive mental health service that occurs during a mental health crisis or mental health emergency to help the person cope with immediate stressors, identify and utilize available resources and strengths, and begin to return to the person’s usual level of functioning. At the time of intervention, the needs of the individual are assessed, including the need for active, supportive listening, the need for referrals to additional services or treatment or the need for emergency hospitalization.

Mandatory Pre-screening Agent (MPA)

Tennessee law requires a face-to-face evaluation, known as pre-screening, of each individual in crisis to assess eligibility for emergency involuntary admission to a Regional Mental Health Institute (RMHI) and to determine whether all available, less drastic, alternative services and supports are unsuitable to meet the individual’s needs. If an MPA is unavailable within two hours, an MD or Ph.D. with health service provider designation may provide this pre-screening in consultation with the mobile crisis team.

Crisis Respite

A voluntary service that offers 24-hour, seven-days-a-week support with behavioral health treatment, including medication management and illness management and recovery services, with a focus on short-term stabilization (up to two days) to adults 18 years of age or older. The purpose is to separate the person from the stressor or environment that contributed to the crisis. Trained crisis respite staff members typically provide crisis respite; however, others who are deemed appropriate by crisis staff members may render respite services.

Crisis Stabilization Unit (CSU)

A voluntary service that offers 24-hour, seven-days-a-week, intensive, short-term stabilization (up to 72 hours) and behavioral health treatment for those persons 18 years of age and older whose behavior health condition does not meet the criteria for involuntary commitment to a psychiatric hospital or other treatment resource.

  CSU Locations  
     
Frontier Health Helen Ross McNabb Center Volunteer Behavioral Health
Johnson City, Tennessee Knoxville, Tennessee Cookeville, Tennessee
877-928-9062 865-541-6958 800-704-2651
     
Volunteer Behavioral Health Mental Health Cooperative Pathways of Tennessee
Chattanooga, Tennessee Nashville, Tennessee Jackson, Tennessee
800-704-2651 615-726-0125 731-541-8330
     
Cherokee Health Southeast Mental Health Center  
Morristown, TN Memphis, Tennessee  
(423) 586-5074 or (855) 602-1082 901-577-9400  

Walk-In Triage Center
A non-hospital, facility-based service affiliated with each of the Crisis Stabilization Units that offers 24-hour, seven-days-a-week behavioral health treatment to adults 18 years of age and older by providing assessment and evaluation, early intervention, prevention, stabilization, referral, and follow-up services for individuals seeking assistance in obtaining appropriate behavioral health services or linkage of services to achieve and/or improve his or her prior level of functioning following a crisis situation.

Medically Monitored Crisis Detoxification (MMCD) Unit

A medically monitored crisis detoxification (MMCD) service (ASAM Level 111.7D) is an organized substance-abuse detoxification service delivered by medical and nursing professionals that provide 24 hour medically supervised evaluation and withdrawal management in a residential treatment facility with inpatient/residential beds. Services are delivered under a defined set of physician-approved policies and physician-monitored procedures or clinical protocols. This level provides care to people whose withdrawal signs and symptoms are sufficiently severe as to require 24 hour residential care. It is the expectation that each of the five MMCD units be deeply embedded in the communities they serve, ensuring that referrals to each unit and referrals from each unit are closely linked with community treatment and recovery service providers. It is designed to provide brief stabilization, detoxification and evaluation so that an informed decision can be made regarding the individual's clinical needs.

Crisis Stabilization Services

Crisis stabilization services are short-term supervised care services that are accessed to prevent further increase in symptoms of a behavioral health illness or to prevent hospitalization. Crisis stabilization services are more intensive than regular crisis respite services in that they require more secure environments and highly trained staff and typically have longer stays. Crisis stabilization services should include availability and utilization of the following types of services on a short-term basis, as appropriate:

  • Individual and/or family counseling and support;
     
  • Medication management and administration;
     
  • Stress management counseling;
     
  • Individualized treatment plan development that empowers the consumer;
     
  • Mental illness/substance abuse awareness/education; and
     
  • Identification and development of natural support systems.

Follow-up Services

Follow-up services can be telephone calls or face-to-face assessments between crisis staff and the individual following crisis intervention, respite or stabilization to ensure the safety of the individual until treatment is scheduled or treatment begins and/or the crisis is alleviated and/or stabilized. Follow-up services can include crisis services staff contacting the individual only one time or can include several contacts per day for several days, as deemed appropriate by crisis staff.

For the Statewide Tennessee Crisis Services Link- Click Here

http://mentalhealth.samhsa.gov/publications/allpubs/sma-3720/crisis.asp

http:/www.tn.gov/mental/recovery/oca5.shtml

http://www.recoverywithinreach.org/treatment/consumerrights/mobilecrisis