Youth in crisis are often experiencing intense emotions such as fear, anger or hopelessness. They may engage in behaviors that are harmful to themselves or others or have destructive thoughts.
They can also be running away or engaging in sexual promiscuity. Biological factors like hormone changes, family and peer dynamics and strained relationships can all contribute to the crisis.
1. A safe place to be
Safe Place is a national outreach and prevention program that makes help readily available to youth who need it. A network of fast food restaurants, convenience stores, fire stations, libraries, public buses and other community locations display the yellow and black Safe Place sign indicating that a child can seek assistance there.
When a youth presents at a Safe Place location and asks for help, trained staff connect the child with the appropriate local youth shelter for assistance. Kids In Crisis provides temporary shelter for children and teens in need of a place to stay while receiving counseling, medical assessment (at the on site TLC Health Center), educational support, advocacy and a strengths-based perspective that builds resilience in each client.
Youth can also reach out for help using NSPN’s TXT 4 HELP, a nationwide 24-hour text-for-support service that gives youth the option to share their location, receive immediate local information and even connect with a counselor for more help. Parents or guardians aren’t notified unless the youth agrees to go to a shelter or youth agency, a practice that helps ensure the safety and well-being of the child.
2. Support for the family/caregiver(s)
Young people in crisis may experience a variety of issues including the loss of a friend or family member to suicide, a natural or large scale disaster, a breakup, emotional abuse, domestic violence, or financial struggles. Often these experiences can lead to depression or anxiety.
Pediatricians are uniquely positioned to de-stigmatize mental health care by helping families understand that it is normal to have ups and downs in life, and by supporting parents in connecting their children with the right resources. They also help to build long-term relationships with children, offering 12 well-child checkups and annual visits.
State programs like Kids in Crisis and DYCD’s Youth Crisis Services offer immediate crisis assistance to children and teens through mobile response and stabilization services (MRSS). These programs can be provided at home or at community locations such as schools. They are designed to be recovery oriented and least restrictive in setting, whenever possible. Moreover, they work with the individual to develop plans to prevent future crises.
3. Psychosocial assessment
With self-harm rates on the rise, particularly during the coronavirus pandemic, it’s crucial to identify risks and needs early. Psychosocial assessments explore a client’s background, education, employment, relationships, mental health, and coping skills. They may include tools like timelines or eco-maps that help clients visualize how experiences, emotions and events impact them over time.
Getting young people to volunteer information that impacts their health and wellbeing is a challenge for many legitimate reasons [5-7]. A systematic review of literature identified instruments that can be used in an initial assessment context to improve engagement between youth and healthcare professionals, and provide a more holistic understanding of risks, strengths, and needs for current and future health and well-being.
These include standard questionnaires that evaluate symptoms and stressors, genograms (family maps) of interpersonal patterns of trauma and maladaptive coping, and timelines of significant life experiences. Ideally, these tools are easy for nurses to use and can be completed quickly.
4. Personalized care
Depending on the severity of their situation, youth should leave a crisis facility with clear next steps for maintaining safety and with individualized resources. Ideally, they should also be given an appointment at a local mental health clinic that can influence their long-term treatment and recovery plan.
Youth Prevention Mentors (YPM) is one example of an organization that takes a personalized care approach to the youth mental health crisis. Their mobile crisis teams bring treatment directly to the homes of adolescents and teens in need.
Personalizing care builds on the work of social care in embedding a person-centered approach across services, enabling choice and control for people and recognizing the role of carers. It includes approaches like allowing a choice of therapies, building tailored clinical pathways and integrating with community-based support. It relies on research to develop tools for identifying person-specific needs and measuring the impact of personalizing interventions. It also requires new models of partnership between people and professionals.