National Guidelines for Child and Youth Behavioral Health Crisis Care Study Notes
National Guidelines for Child and Youth Behavioral Health Crisis Care
Acknowledgments
The document is produced for SAMHSA under contract number HHSS23820170000741/75S20319F42002.
Lora Fleetwood served as the contracting officer representative.
All material is public domain and can be reproduced freely, but not for a fee without SAMHSA's permission.
Citation of the source is encouraged.
Publication available for download at www.samhsa.gov or via SAMHSA’s Health Information Network at 1-877-SAMHSA-7.
Suggested Citation
Citation format: Substance Abuse and Mental Health Services Administration, Center for Mental Health Services. (2022, November). National Guidelines for Child and Youth Behavioral Health Crisis Care. Rockville, MD.
Contents
Forward
Executive Summary
Core Principles for Delivering Crisis Response to Children, Youth, and Families
Integrating Systems of Care Approach in Serving Children, Youth, and Families in Crisis
Special Populations and Settings
Introduction
About this Document
Language and Terminology
Youth Crisis in Context
Traditional Youth Crisis Response System
Core Youth Crisis Services
Expectations and Best Practices
Connecting to the System of Care
Conclusion
Appendix I: Summary of Implementation Strategies
Reference List
Forward
Dr. Miriam Delphin-Rittmon, Assistant Secretary for Mental Health, emphasizes the increasing emotional and behavioral health needs among youth, leading to adverse outcomes such as unnecessary hospitalizations and justice system involvement.
The guidelines aim to establish a robust crisis response system, ensuring equity in service provision, particularly for historically underserved populations.
The launch of the 988 Crisis Lifeline is highlighted as a significant opportunity for improving crisis care across all communities.
Executive Summary
The transition to 988 provides 24/7 behavioral health crisis response through text, chat, and voice calls, addressing an urgent need for youth-specific services.
Many existing systems lack the capacity to engage youth, leading to potential hospitalization instead of community-based support.
SAMHSA’s guidelines outline best practices and strategies for developing effective systems to meet the needs of youth in crisis and their families.
Core Principles for Delivering Crisis Response to Children, Youth, and Families
Keeping Youth at Home - Prioritization of in-home services to maintain family integrity and avoid out-of-home placements.
Developmentally Appropriate Services - Services should be tailored for the developmental age of youth.
Family and Peer Support - Involvement of family and peer supporters in service planning and implementation.
Culturally Appropriate Services - Ensuring services are equitable and culturally responsive.
Core Components of Child, Youth, and Family Crisis Response
Crisis Call Centers
Operate 24/7 providing assessment and de-escalation support.
Staff should have specialized training in youth and family crisis response.
Mobile Response Teams
Engage onsite in community settings to provide immediate support and safety planning.
Crisis Receiving and Stabilization Services
Include facilities offering trauma-informed care and short-term interventions.
Integrating Systems of Care Approach
The System of Care framework emphasizes family-driven, youth-guided, and culturally responsive crisis services.
Coordination among diverse services is vital for delivering individualized care to youth and families in crisis.
Special Populations and Settings
The guidelines recognize the unique needs of various populations, including:
Infants and young children
Transition-age youth
LGBTQI+ youth
Youth with intellectual and developmental disabilities (IDD)
Youth experiencing homelessness
Emphasis on recruiting diverse clinicians and ensuring multilingual support.
Introduction
Establishment of the 988 crisis line represents an unprecedented opportunity to enhance behavioral health services nationally.
Many communities lack adequate crisis response services, particularly in rural areas, necessitating focused improvements.
About this Document
Intended as a guide to best practices and practical advice for developing youth crisis systems.
Supplementary to other SAMHSA publications, enhancing prior guidance from expert panels.
Language and Terminology
Emphasis on using inclusive, recovery-oriented language that evolves with understanding of behavioral health.
Definitions adopt inclusive practices, recognizing the variations in identities within youth populations.
Youth Crisis in Context
Recent years have seen a marked rise in youth mental health issues exacerbated by factors such as the pandemic.
Statistics indicate considerable risks of behavioral health disorders among youth populations, particularly for marginalized groups.
Traditional Youth Crisis Response System
Acknowledgment of the harms caused by current response systems such as hospitalizations and police involvement.
Core Youth Crisis Services
Three essential services: someone to talk to (call centers), someone to respond (mobile teams), someone to go to (stabilization services).
Expectations and Best Practices
Recommendations for crisis call centers, mobile crisis teams, and stabilization services include operating 24/7, responding to youth needs effectively, and ensuring culturally responsive practices.
Connecting to the System of Care
Importance of building partnerships with various stakeholders including schools, juvenile justice, child welfare services, and primary care providers.
Conclusion
Highlights the collective effort needed to create equitable, responsive systems for youth experiencing crisis. Success involves understanding and acknowledging community needs.
Appendix I: Summary of Implementation Strategies
Provides a concise reference for strategies presented throughout the guidelines.
Reference List
Comprehensive list of sources and studies supporting SAMHSA's guidelines, reflecting research and evidence-based practice in behavioral health crisis care and services.