Teenagers are more emotionally and psychically vulnerable than at any other time in recent memory. They are experiencing a growing number of psychiatric emergency room visits, suicidal thoughts and drug overdoses.
Youth are also facing significant economic challenges as they struggle to find jobs and keep them. In addition, they face social isolation, academic disruption and a decline in compassion in our culture.
Crisis Assessment
When someone experiences a crisis, their ability to problem-solve and regulate behavior can change dramatically. This can lead to a loss of mental balance and a potential relapse in substance use or other harmful behaviors.
The first step to effectively treating youth in crisis is assessment. This requires a thorough interview that helps professionals learn about a person’s past crises, current crisis status and their psychosocial needs.
Effective crisis intervention should also include crisis resolution planning and connection to community resources. This requires crisis clinicians to have the appropriate training and knowledge to help an individual develop a plan for responding to stressors, restoring previous baseline status and engaging with ongoing supports.
The first rule of clinical practice development is that every client in a crisis is welcome and treated with respect, gentleness, safety and hope. This includes not only the individual, but their families and collaterals as well. All crisis providers should be trained in family and collateral engagement practices.
Psychosocial Assessment
Youth in crisis have unique needs and challenges. These often involve a range of psychological, emotional, and social concerns. The ideal psychosocial assessment provides a comprehensive and thorough examination of these issues, allowing the health professional to develop a treatment plan that will address all aspects of the young person’s life.
Suitable psychosocial assessments can improve engagement between young people and health professionals, create spaces for disclosure and encourage engagement with treatment, and help to identify potential risks for suicide, substance abuse or other mental health problems. Several instruments have been developed to meet these needs.
The current systematic review aimed to identify and evaluate psychosocial assessment instruments for use in primary care and multidisciplinary contexts by clinicians working with the general population of young people. It was conducted using a database search that complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. 89 articles were identified and 31 different assessment instruments were evaluated.
Personalized Care
A growing body of evidence suggests that youth in crisis benefit from personalized care. This approach uses medical and genetic data, including DNA sequencing, to develop treatment plans that are uniquely tailored for each individual patient.
Personalized care is a major shift in the way physicians treat patients. It aims to optimize the effectiveness of treatments by taking into account an individual’s unique medical and behavioral history, as well as their values and circumstances.
This approach will help decrease patients’ stress, minimize their discomfort and side effects from rounds of testing and attempted treatments, and instill confidence in their clinician’s prescribed care plan. It also can save substantial costs by reducing avoidable outpatient and inpatient events.
Stabilization
Stabilization is an essential part of behavioral health treatment, especially for youth. It allows a client to step back from crisis and return to regular life. It can help reduce the likelihood of hospitalization or admission to jail.
When clients are in a crisis, they need to feel seen and heard. They also need to be empowered to make decisions about their care.
A key part of crisis services is de-escalating and providing safety planning to ensure clients stay safe. This can involve partnering with law enforcement or emergency medical staff, working directly with families and other community resources, and providing referrals to support networks.
In-home crisis stabilization is a viable alternative to jail or emergency room visits for young people, and can be more cost effective. “In home stabilization allows us to meet kids where they are,” says Rifkind.