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EMERGENCY SERVICES CRISIS CENTER
What is the mandate of the Emergency Services Crisis Center?
Our Emergency Services Crisis Center is a 24 hour a day program
providing comprehensive biopsychosocial assessments with a strong
focus on current mental status and risk assessment. All assessments
are completed by a Masters level clinician and reviewed with an
independently licensed administrator prior to disposition.
Psychiatry is available 24 hours a day, either on site or by pager
for consultation or to authorize part A of involuntary commitment
papers. Our program sees in excess of 3000 clients a year. We
complete evaluations both on site and off site to include local
hospital emergency rooms. The mandate of our program is to seek
the least restrictive level of care appropriate to each clinical
presentation.
How is the Crisis Center Staffed?
Our staffing pattern consists of up to six clinicians during the
major part of the week and a minimum of two clinicians on
over-nights. Administrator on call duties provide a back up
clinician at any given time if volume demands it. Our clinicians
have a variety of specialties including substance abuse, child
evaluations and working with the elderly. We have clinicians who are
fluent in both Spanish and Portuguese. All clinicians are encouraged
to attend regular trainings on a variety of mental health and
substance abuse topics as well as ethnic competency and cultural
diversity.
How are clients screened?
Our screening instrument offers a comprehensive picture of each
client's history, current symptomology, and degree of risk
associated with suicidal or homicidal ideation and or impaired
judgment. Our documentation process is evolving to include all
typewritten evaluations contained in a state of the art data base to
eliminate the problems of illegibility. Our data base will also
provide detailed data for continuous quality improvement and process
issues. Our data base provides instantaneous data on any clinicians
statistics, i.e. percent of clients who go inpatient to assure that
there is consistent and comprehensive over sight of appropriate
dispositions.
Our CQI (Continuous Quality Improvement) department regularly
profiles clinicians and reports are produced for supervisors and the
director to review.
Upon presentation, every effort is made to contact community
providers to assist in the process of information gathering. Efforts
are made in all cases to have clients sign releases of information
for discharge summaries if a client is to go inpatient.
As stated above our mandate is to pursue to the least restrictive
level of care appropriate to the presentation at hand. Our
criteria for placing a person inpatient is being a current and clear
danger to self or others associated with a psychiatric episode.
We have a good relationship with the courts and often access
them to deal with substance abuse issues that require issuance of a
Section 35. A section 35 mandates a client to 30 days of detainment
at a state facility.
Every effort is made to work with clients to deal with any current
episode and return them to the community. We are able to schedule a
client to come back in for a follow up in order to bridge the time a
client might have to wait for an our patent appointment. Follow Ups
are also helpful to process strategies associated with the acute
presentation of any given client. In cases where clients are in need
of a higher level of care but do not meet the criteria to go
inpatient we offer a nine bed Crisis
Stabilization Unit.
Our Crisis Stabilization Unit is an nine bed adult unit. Our
staffing pattern consists of 24 hour nursing availability, a full
time and a half time social worker on the unit Monday through Friday
and cross over social work availability from our Emergency Services
Program throughout all other hours of the day and week end. A mental
health assistant is on the unit from 7am to 11pm seven days a week.
Psychiatry is scheduled on the unit for three hours per day to
address the needs of our clients. A multi-disciplinary team meeting
occurs every week day to discuss issues related to each case on the
unit. All clients leave the unit with appointments for out patient
providers in the community.
All clients admitted to CSU are seen by a psychiatrist within 24
hours of admission. Clients meet with a social worker on a daily
basis seven days a week. Groups are provided to include,
psycho-education, symptom management, coping strategies, stress
relief etc. Contact is made with all existing providers and or
agencies/organizations involved in the treatment of any client.
Family or significant other meetings are often facilitated to assist
clients with a smooth transition back into the community. Our work
on the unit is short term problem focused to relieve the acute
symptomology present and return the client to the community as soon
as possible.
The average length of stay on our Crisis Stabilization Unit is three
to five days. The unit is not locked and requires that clients are
able to contract for safety on the unit. We accommodate clients who,
in the past, would have been put on an inpatient unit due to the
need for immediate medication evaluations or enhanced support to
deal with current stressors.
Contact Information
If you have any questions or need more information, contact the
Emergency Services Program (Crisis Center) located at Child & Family Services, Inc.
Emergency Services (Crisis Center)
Michael P. Page LICSW, Site Director
543 North Street,
New Bedford, Ma 02740
508-984-5566 ext.145
mpage@cfservices.org
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