Nevada’s Crisis Response System Webinar Series · Crisis Call Center Hubs Minimum Standards 4 • Operate every moment of every day. • Be ... (via tele-med, mobile app, or ...

Rural RegionValerie Cauhape, RBHC

Kim Hopkinson, Social Entrepreneurs, Inc.

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Questions and Answers

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Please put all questions and comments in the Chat.

ContextValerie Cauhape, RBHC

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Crisis Call Center HubsMinimum Standards

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• Operate every moment of every day.• Be staffed with clinicians overseeing

clinical triage and other trained team members to respond to all calls received.

• Answer every call or coordinate overflow coverage with a resource that also meets all of the minimum crisis call center expectations defined in this toolkit.

• Assess risk of suicide in a manner that meets National Suicide Prevention Lifeline standards and danger to others within each call.

• Coordinate connections to crisis mobile team services in the region.

• Connect individuals to facility-based care through warm hand-offs and coordination of transportation as needed.

Crisis Call Center Hubs

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Criteria Met:• Minimal

• Call Center Exists• 24/7 Call Center in Place to Receive BH

Crisis Calls• Answer Calls Within 30 Seconds• Cold Referral to Community Resources or

Better Connection to Care• Meets National Suicide Prevention Lifeline

Standards and Participates in National Network

• Basic• Meets Level 1 Criteria• Staff Trained in Zero Suicide/Suicide Safer

Care and Behavioral Health Services• Priority Focus on Safety/Security

Minimal8/42

Crisis Call Center Hubs

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5/5

3/8

0/8 0/10 0/110%

50%

100%

Rural

Minimal Basic Progressing Close Full

Crisis Call Center Hubs: Assets• CSSNV• Vitality Unlimited

• Contracts with CSSNV to provide call coverage after hours

• NAMI Warmline• Safe Voice Nevada for youth• Crisis Text Line

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Crisis Call Center Hubs: Gaps• Connections to resources or

referrals• Training inconsistencies between

multiple crisis lines• No process for consistent warm

hand-offs • No formal communication

protocols between any of the current crisis lines and local or statewide providers

• MOUs are not currently in place between CSSNV and other providers in the area

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Polling

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Please check all statements that you agree with.

Polling

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What are the top two gaps from the Crisis Now Scoring Tool for Crisis Call Center Hubs in the Rural Region?

Mobile Crisis TeamsMinimum Standards

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• Include a licensed and/or credentialed clinician capable of assessing the needs of individuals within the region of operation.

• Respond where the person is (home, work, park, etc.) and not restrict services to select locations within the region or particular days/times.

• Connect individuals to facility-based care as needed through warm hand-offs and coordinating transportation when and only if situations warrant transition to other locations.

Mobile Crisis Teams

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Below Minimal

6/37


• Mobile Teams are in Place for Part of the Region

• Mobile Teams are Operating at Least 8 hours Per Day in at least part of the region

• Mobile Teams Complete Community-Based Assessments

• Mobile Teams Connect to Additional Crisis Services as Needed

• Basic• Staff Trained in Zero Suicide/Suicide

Safer Care and BH Services• Priority Focus on Safety/Security

Mobile Crisis Teams

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4/5

2/7

0/7 0/8 0/100%

50%

100%

RuralMinimal Basic Progressing Close Full

Mobile Crisis Teams: Assets• Vitality Unlimited has capacity to

provide a mobile response • CARE Team to virtually respond

(via tele-med, mobile app, or telephone)

• Mobile Crisis Response Team (MCRT) established by Rural Clinics

• The Family Support Center (FSC) has informal agreements in place with local law enforcement in Winnemucca that allows a physical response to persons in crisis, as staffing allows

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Mobile Crisis Teams: Gaps• No 24/7, GPS-enabled

mobile crisis response team available to the entire region

• Challenges with staffing and funding availability

• Delays in physical response to crisis

• Example: MCRT is dispatched from Reno or Las Vegas

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Polling

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Polling

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What are the top two gaps from the Crisis Now Scoring Tool for Mobile Crisis Teams in the Rural Region?

Crisis Stabilization FacilitiesMinimum Standards

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• Accept all referrals• Not require medical clearance prior to admission

but rather assessment and support for medical stability while in the program

• Design services to address mental health and substance use crisis issues

• Employ the capacity to assess physical health needs and deliver care with an identified pathway to transfer to more medically staffed services

• Staffed at all times with a multidisciplinary team to meet the needs of individuals experiencing all levels of crisis

• Offer walk-in and first responder drop-off options• Structure that offers capacity to accept all referrals

at least 90% of the time with a no rejection policyfor first responders

• Screen for suicide risk and complete comprehensive suicide risk assessments and planning

• Screen for violence risk and complete comprehensive violence risk assessments and planning

Crisis Stabilization Facilities

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Below Minimal

3/38


• Have 24/7 Access to Psychiatrists or Master’s Level Clinicians

• In Counties with Sub-Acute Stabilization, at Least 1 Bed/Chair per 100,000 Census

• Basic• Priority Focus on

Safety/Security

Crisis Stabilization Facilities

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2/3

1/6

0/8 0/10 0/110%

50%

100%


Crisis Stabilization Facilities: Assets• Vitality Unlimited provides psychiatric

and substance abuse treatment, outpatient treatment for mental illness, and co-occurring disorders

• The Family Support Center (FSC) works with various agencies across the region to provide outpatient and group therapeutic services post-crisis

• Regional hospitals offer tele-mental health services and a social worker or social work team

• Psychiatric Advanced Practice Registered Nurses working with community agencies related to substance abuse

• Stakeholders are looking into the possibility of setting up crisis facilities in local hospitals

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Crisis Stabilization Facilities: Gaps• No sub-acute crisis stabilization facility • Individuals in crisis that need stabilization

services are placed in emergency departments of local hospitals or transported out of the region

• Transportation:• Extended transportation times/distances by law

enforcement or ambulance• Medical flight evacuation• Strain on local medical resources, public safety

issue, financial burden to individual and community• Example: MedX in Elko

• There is no clearly defined process for law enforcement drop-offs to local hospitals

• Limited funding and capacity to develop facilities

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Polling

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Polling

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What are the top two gaps from the Crisis Now Scoring Tool for Crisis Stabilization Facilities in the Rural Region?

Essential Principles and PracticesMinimum Standards

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• Addressing recovery needs

• Significant role for peers• Zero Suicide/Suicide Safer

Care• Trauma-informed care• Safety/Security for staff

and people in crisis• Crisis Response

Partnerships with Law Enforcement, Dispatch and Emergency Medical Services (EMS)

Essential Principles and Practices

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Below Minimal

1/10


• Some Implementation of at Least 2 Crisis Now Modern Principles

Essential Principles and Practices

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1/2

0/2 0/2 0/2 0/20%

50%

100%


Essential Principles and Practices: Assets

• Vitality Unlimited and Family Support Center reported that all staff had received trainingrelevant to the essential principles and practices

• Regional Mobile Crisis Teams have been trained in trauma-informed care and will be trained on Zero Suicide

• All regional hospitals are planning to be trained on Zero Suicide

• Northeastern Nevada Regional Hospital has implemented SafeTALK training

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Essential Principles and Practices: Gaps

• Lack of uniformity and clarity on evidence-based practicesutilization and implementation across the region

• Stakeholders identified the need for:

• Internal audits of staff training • Quality assurance checks

• The region is motivated to ensure all staff are trained in crisis response best practices

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Polling

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What are the top two gaps from the Crisis Now Scoring Tool for the Essential Principles and Practices in the Rural Region?

Polling

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What component would you prioritize first for the Rural Region?

Discussion

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Please use the Chat to identify specific barriers to implementation in your region.

Discussion

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What things could be maximized that are not currently being used in your region to improve crisis response?

Thank you! • Please return from the

break at 11:00 AM using the link provided for the afternoon portion of the Summit.

• Up Next:• Debrief

• Regional and Statewide Gaps and Priorities

• Q & A

• Closing

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Nevada’s Crisis Response System Webinar Series · Crisis Call Center Hubs Minimum Standards 4 • Operate every moment of every day. • Be ... (via tele-med, mobile app, or ...

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