Community crises can take many forms and fall into many categories. This call for assistance could initially appear to be a public safety incident, but upon closer inspection could be caused by issues of housing instability, behavioral health issues, substance use, domestic conflict, or lack of access to necessary services.
In addition to emergency services such as police, firefighters, and ambulances, a growing number of community crisis calls involve issues outside of typical public safety incidents. This is not to say that the typical public safety call for service is now incorporating issues outside of typical public safety incidents. In fact, quite the opposite. Many crisis calls are becoming more complex, involving, in addition to typical public safety issues, a host of other issues.
Also of value is a determination of whether or not the individual in crisis is going to need continued support after the crisis has been brought under control.
Why Some Community Incidents Require More Than an Immediate Response
These problems are not solved by emergency services providing an immediate response in a crisis. In many cases, the root causes of a crisis remain unsolved and give rise to new problems.
Many individuals who experience a behavioral health crisis are also dealing with issues of homelessness, poverty, and lack of access to care and treatment as well as substance use. Therefore, the immediate emergency situation is likely to recur unless the individual receives ongoing support.
Recurring incidents can be very problematic for individuals and organizations alike. The root cause of many incidents is a set of circumstances that have not been addressed, and as a result, there is an ongoing need for emergency responses, with subsequent use of resources to address essentially the same situation, without change.
The Expanding Role of Outreach and Advocacy Workers
Outreach and advocacy workers work with people in crisis to assess their needs. Workers can make referrals to people for a wide array of programs and services, including behavioral health services, housing services, benefits and services, and transportation. Outreach and advocacy workers can also accompany a person in crisis, and their family and friends, to appointments and visits to programs and services.
When someone is dealing with social services for issues of health, housing, and other areas of need, there can be many organizations involved. It can be difficult for the individual to know how to communicate with the various organizations and programs that are available to assist them. Outreach and advocacy workers can help coordinate communications and services with other organizations, such as healthcare providers and other social services.
How Co-Response and Mobile Teams Work in the Field
A mobile crisis team and co-response model can provide support to individuals in crisis in their own environment. Teams can consist of first responders such as police, paramedics/EMTs, mental health professionals, social workers, substance abuse counselors, nurses, case managers, outreach and advocacy workers, and other professionals and organizations.
Each crisis can demand several services: medical attention, a range of behavioral health services, housing assistance, and transportation to receive services and others. Thus, having people with a range of expertise in crisis response available to provide services in the field can ensure that all of the needs of a given crisis are being met and that the community is not responding to crises using the same approach and with the same results over and over again.
These types of services are critical for people in crisis, as they are often unable to access services due to reasons including lack of transportation, information, and/or ability to navigate complex systems of care.
Keeping Cases Connected After the Immediate Crisis
One of the most difficult parts of crisis response happens after the scene has been cleared.
Outreach teams may need to record interactions, track referrals, schedule follow-ups, document service connections, and coordinate with other organizations. When information is scattered across separate systems, spreadsheets, emails, or paper records, maintaining continuity becomes difficult.
Technology can support this work by giving teams a clearer view of each case. For example, public safety case management software can help organizations centralize case information, document field interactions, manage referrals, and track follow-up activity.
Track the services provided and follow up on actions completed. Information is provided to teams of first responders and outreach professionals as well as to advocates, case managers, and service providers from within the community.
Technology can facilitate and enhance the work of professionals in crisis intervention, but it cannot replace professional judgment and personal relationships.
Why Follow-Up Can Matter as Much as the Initial Response
Even the best crisis intervention does not necessarily avert the immediate crisis but rather sets into motion a host of long-term effects that will not be realized until some time after the intervention itself.
Someone with a behavioral health problem may need follow-up to ensure they have an appointment with a provider, while someone with housing instability needs multiple contacts until they can find and move into a temporary or permanent housing solution. Someone applying for benefits needs follow-up to collect and submit the required documents and determine eligibility.
By staying in contact with these organizations, we can find out whether an individual is accessing services and also seek further information about their needs and the amount of support they require. Follow-up contact helps us hold other organizations and individual professionals accountable for their actions in the crisis response system.
Improving Coordination Across Community Services
In addition to hospital, behavioral health, shelter, and other programs within organizations, there are also a multitude of non-profits, outreach programs, etc., and public safety and government agencies that are involved in crisis response for a particular individual.
When many organizations are involved in crisis response, each can have its own systems and processes for documentation, communication, and making referrals. Thus, a team of professionals may find it very difficult to work together effectively.
The processes and procedures for transferring cases between different organizations within a crisis response system are an important part of an effective response system. Documentation of contacts between emergency services and community services, as well as between other agencies and organizations involved in assisting the individual in crisis, can help ensure that all parties are aware of the individual’s situation and can provide the most appropriate assistance. Multidisciplinary case reviews of individuals who are repeatedly contacting emergency services and community services can assist in identifying the most effective course of action and developing a more appropriate plan of care for that individual.
Tracking cases through a Crisis Response Program does not require a multitude of administrative systems. Rather, a Crisis Response Program will facilitate tracking individuals in crisis to ensure they are not ‘lost’ in the system between agencies.
Measuring Whether a Crisis Response Program Is Actually Helping
The number of calls answered, or incidents resolved, only tells part of the story.
These data can also show the number of individuals and families who are treated, housed, etc. between crises (i.e., repeat users of crisis intervention services who are able to access and utilize needed services between crises). Measuring the amount of time that has passed between the crisis intervention and the next contact or intervention with that individual and family can also be useful.
Measuring the impact of a crisis response program is essential in determining whether it is helping. Documenting and tracking data from interactions with individuals in need can help establish a baseline measure of a program’s impact. Case documentation over time can highlight gaps in services and identify effective approaches in different situations. It can also facilitate better partnerships with other organizations and agencies to provide the best possible crisis response and ongoing support.
Building a More Connected Response System
For people with serious mental health issues and chronic substance abuse, a wide variety of help is often needed from time to time. As a result, a new kind of crisis intervention that draws on a large variety of experience is becoming more common than ever.
The initial crisis intervention is followed by a period of stabilization, then a referral to appropriate services, then a follow-up to determine whether those services were actually accessed and whether additional support is needed.
By establishing relationships, processes, and systems to enhance communication and information sharing, crisis response becomes a permanent part of the system, providing services and making effective use of community resources to achieve desired outcomes for individuals in need.
