Teens in crisis often have trouble coping with their mental health conditions or self-harm. They may experience changes in sleep patterns, eating habits or socializing with friends.
Sometimes they may need help from a mental health professional to stabilize them and set them up for long term care and recovery. This requires close collaboration between behavioral health services, schools and children’s welfare agencies.
Helping Youth in Crisis
Many children and youth with behavioral health needs end up in emergency departments due to a lack of community-based options. These kids often bounce between hospitals, detention centers and community-based care without consistency or a plan of action. This can lead to a cycle of negative outcomes for both the youth and their family.
Fortunately, states are taking steps to create better crisis response services for youth. These programs are designed to provide the least restrictive care, ideally in the community or at home. They also focus on youth voice and ensuring that services reflect the diverse needs of these young people.
One example is a mobile crisis team that can be dispatched to the home or school of a youth who has experienced a mental health-related event. This approach has been shown to improve the safety and reduce the need for future ED visits. It has been adapted by a variety of organizations, including schools, child welfare and juvenile justice agencies, and even pediatricians and primary care medical providers.
Assessing the Situation
There are a variety of circumstances that can trigger a mental health crisis in youth, including a breakup or loss of a loved one, witnessing or experiencing a natural or large-scale disaster, bullying or school-related pressures, physical or sexual abuse, and living in communities affected by conflict. Additionally, systemic issues that can exacerbate these challenges include discrimination (such as stigma around being gay or transgender), violence against marginalized groups, and efforts to suppress self-expression.
To address this crisis, states are using a variety of strategies to ensure that youth have access to the right care and support. Many are expanding youth-specific crisis receiving and stabilization facilities, which provide immediate assessment and treatment for young people in a setting more comprehensive than 23-hour observation units or the Living Room Model but less restrictive than an inpatient psychiatric hospital. They are also developing innovative ways to provide intensive wraparound services after youth leave these settings. These efforts can help reduce the need for readmissions to crisis receiving and stabilization facilities and improve outcomes.
Stabilizing the Youth
Youths in crisis often face multiple issues. They might have a substance use issue and need to be detoxed, for example. They may also have a behavioral addiction, such as spending too much time on their phone or gaming, that could lead to dangerous situations. Some have behavioral problems that put them at risk, such as running away from home or engaging in sexual misconduct.
When a youth leaves a stabilization facility, they should be given a clear plan for maintaining safety and getting access to individualized resources. The plan should include post-crisis follow-up appointments at an outpatient clinic. The plan should also help the family and/or caregiver(s) to understand that if there is ever another crisis, they can call 988.
Some states are using a crisis-setting model that includes families and people with lived experience, such as Wisconsin, which requires a seat for families on its Advisory Council. Other states have implemented community-based, peer support programs that offer recovery coaching and other services to help youths stay on the path to wellness.
Supporting the Family
Children and youth live with their families, so any crisis services for them must include the family as well. This is why SAMHSA’s new guidelines specifically mention the need for services that support families of youth in crisis.
It’s important to consider that when a young person is in crisis, there are often two crises taking place: the youth’s personal struggle and the challenges their family members may face as they try to help them. Communication struggles, unhealthy coping skills, and strained relationships between family members can contribute to a youth’s vulnerability in times of crisis.
Families are often overwhelmed by their own challenges, including the stress of trying to manage a crisis situation while dealing with other pressing issues such as poverty, unemployment and homelessness. As such, they need a range of supports to help them stay stable and safe. This includes providing housing assistance, facilitating connections with employment and training programs, boosting job opportunities and assisting with small-business development.