After two years of rolling shutdowns, lockdowns, isolation, fear, sickness, grief, loss and uncertainty, youth are not alright.
They are in crisis, a state of being that can result in intense emotions, behavioral struggles and a lack of control. Depending on their situation, teens can experience everything from sadness to anger to thoughts of suicide.
1. Assessing the Acuity
A youth in crisis is defined as demonstrating impairment in mood, thought and/or behavior that substantially interferes with functioning at home, school and in the community. They may present with suicidal/assaultive/destructive ideas, threats, plans or actions that represent a risk to themselves or others.
In the MCI model, a robust Crisis System of Care is about expanding options for services that a youth and parent(s)/caregiver(s) might choose to help manage their situation. This includes not limiting or blocking access (when criteria are met) to hospitalization, law enforcement, and other out-of-home services.
MCI Family Partners work with systems partners to promote and support Crisis System of Care efforts. This involves empowering parents and caregivers to self-refer for CBHI services, sharing relevant information, and offering personal support and encouragement.
2. Engaging the Family/Caregiver(s)
Providing support to families/caregiver(s) of youth in crisis is important for their emotional and mental well-being as well as their ability to successfully cope with the stressors that often accompany crises. This is especially true for those who put their academics and personal health at risk by caring for ill, injured or disabled family members.
Many studies have identified family characteristics that predict engagement in treatment programs (e.g., single-parent status, socioeconomic disadvantage, parental psychopathology, ethnic minority status and living in a low-resource neighborhood). However, few studies have tested the effects of program, provider or system-level factors on family engagement or retention.
3. Providing Personalized Care
Personalized care is a whole system approach that connects different parts of the NHS, social care, public health and community sectors to deliver better outcomes. It improves people’s health and wellbeing, joins up care in local communities, reduces pressure on stretched NHS services and helps to build resilience and mental health.
Personalized care focuses on the individual patient and takes into account personal determinants of health, including personality, health beliefs, and healthcare perspectives. It allows medical professionals to look at a person’s entire health – not just their disease – and provides them with the tools they need to make informed decisions about their treatment.
4. Stabilizing the Youth
Crisis stabilization programs provide a short-term care setting that offers a place to stay for youth who have experienced an extremely difficult life situation. They also offer treatment and support while a young person is stabilized, treatment plans are assessed, and long-term placements are solidified.
In addition to mobile services, some communities offer in-home stabilization. This program is a short-term intervention that is delivered face-to-face in the home, or in the community, and it might last anywhere from 6 to 16 weeks.
According to national guidelines from SAMHSA, all children and youth in behavioral health crises should receive care in the least restrictive setting possible, and whenever possible, hospitalizations and justice system involvement should be safely reduced or prevented. These guidelines also emphasize that 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.
5. Supporting the Family/Caregiver(s)
Providing support to the family/caregiver(s) of a youth in crisis can have a profound effect on the youth and their family. Simple acts, like taking time to cook a meal or offer respite can be an important part of helping the family cope with the situation.
Across the United States, more than 5.4 million children under age 18 are caregivers for their parents or other family members. This has resulted in the need to address the unique needs of youth caregivers and to promote a holistic approach to supporting them.