Children’s Mental Health Crisis Services, Part 3

Last month our blog returned to the topic of children’s mental health crisis services.  This week’s blog will continue our focus on this important part of the continuum of mental health care for children, youth, and families.

Grant Funding Dedicated to Expanding Local Crisis Resources for Children and Families

Citing reports which called to attention a continuing problem of inappropriate and unnecessary use of hospital emergency rooms in California due to limited mental health services for individuals, children in particular, experiencing an acute psychiatric crisis, the Senate Budget Committee introduced a budget item designed to increase access to mental health services for children and families in crisis.

As a result of the Senate Budget Committee’s efforts, $30 million was included in the state’s final 2016-17 budget for a grant program designed to develop or expand children’s mental health crisis services and programs. This was an unexpected development late in the budget process – and is evidence of the impact of advocacy efforts by CMHACY and other organizations to shed light on the problem faced by youth and families in crisis. Section 20 of Senate Bill (SB) 833 (Statutes of 2016) implements this grant proposal. Similar to the provisions of SB 82 (Chapter 34, Statutes of 2013) which was developed to expand the capacity for adult mental health crisis services, SB833 authorizes the California Health Facilities Financing Authority Act (CHFFA) to adopt emergency regulations to provide grant awards to be used to expand local resources for the development, capital, equipment acquisition, and applicable program startup or expansion costs to increase capacity for mental health crisis services for children and youth 21 years of age under in the following areas:

(A)  Mobile crisis support teams: Mental health mobile crisis response teams are staffed with mental health professionals and individuals with lived experiences (ie: parent and youth mentors) who can effectively and appropriately intervene in a mental health crisis. Mobile crisis teams can meet a youth at home, school, work or wherever a crisis occurs. The teams meet face-to-face with the person in crisis to assess and de-escalate the situation. Additional services can include linkage to stabilization services (see below) for up to several days, rapid access to psychiatrists, health care navigators, and referrals to community mental health providers. Teams can also contact emergency services when necessary.

(B) Crisis intervention: “Crisis Intervention” means a service, lasting less than 24 hours, to or on behalf of a youth for a condition that requires a more immediately response than a regularly scheduled visit. Service activities include, but are not limited to, one or more of the following: assessment, collateral (working with the youth’s natural supporters) and therapy. Crisis intervention services may either be face-to-face or by telephone with the youth or significant support persons and may be provided anywhere in the community.

(C) Crisis stabilization: “Crisis Stabilization” is similar to crisis intervention, however, crisis stabilization has specific requirements pertaining to the staffing and facility in which it is “housed”.  All youth receiving Crisis Stabilization services receive an assessment of their physical and mental health.  If ongoing services and supports are needed, a referral that corresponds with the youth’s need shall be made.

(D) Children’s Crisis residential treatment: “Crisis Residential Treatment Service” means therapeutic or restorative services provided in a non-institutional residential setting which provides a structured program as an alternative to hospitalization for children or youth experiencing an acute psychiatric episode or crisis. The service includes a range of activities and services that support youth in their efforts to restore, maintain, and apply interpersonal and independent living skills, and to access community support systems. The service is available 24hours a day, seven days a week. Service activities may include but are not limited to assessment, safety plan development, individual and family therapy, rehabilitation, collateral, and crisis intervention.

(E) Family respite care: Respite care services provides temporary, planned routine care to maintain a child with serious mental health needs at home with the child’s family or long-term primary caretaker. This type of care can also be used on an emergency or crisis basis. This program gives families and caregivers a much needed break while offering a safe environment for their children. Respite care can be provided in a family’s home, foster home or other appropriate community location and gives families a chance to reenergize and refocus.

SB833 authorizes the California Health Facilities Financing Authority (CHFFA) to adopt emergency regulations to provide grant awards to be used to expand local resources for the development and applicable program startup or expansion costs to increase capacity for crisis services and supports specific to the unique needs of youth under the age of 21, as well as their family members.

CHFFA has been developing the emergency regulations to provide framework for grant process since the budget was passed in June, 2016.  They anticipate that the funding will be available in the upcoming months.  You can sign up for CHFFA Investment in Mental Wellness Act email updates at:  http://www.treasurer.ca.gov/chffa/imhwa/ CMHACY will also send out an update when specific dates are announced by CHFFA.

How You Can Help

Ensure that your county mental health plan and mental health advisory board are aware that this funding will soon be available.  Encourage your county to engage stakeholders in a planning process which includes a detailed assessment of the local strengths and needs related to the children’s mental health crisis continuum of care.