	Crisis Response and Information Services: Crisis Intervention; Crisis Hotline Services; Information and Referral Services

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

CRI 2: Screening and Assessment

The organization screens and assesses individuals promptly and responsively to efficiently determine urgency of need.

CRI 2.01

Individuals are screened and informed about how well their request matches the organization’s services.

NA Another organization is responsible for screening.

CRI 2.02

Prompt, responsive screening practices ensure equitable treatment and support timely initiation of services.

Research Note: Research suggests that cultural awareness is essential to effective engagement and crisis intervention treatment. Screening and assessment practices should identify and respond to cultural differences in the perception or interpretation of different crisis situations to minimize this possible barrier to service delivery.

CRI 2.03

An ongoing, rapid risk assessment is conducted in a culturally responsive manner to determine:

if the client is in imminent danger;
potential lethality including harm to one’s self or others;
the client’s emotional status and imminent psychosocial needs;
client strengths and available coping mechanisms;
resources that can increase service participation and success; and
the most appropriate and least restrictive service alternative for the client.

Interpretation: Culturally responsive assessments can include attention to geographic location, language of choice, and the person’s religious, racial, ethnic, and cultural background. Other important factors that contribute to a responsive assessment include attention to age, sexual orientation, and developmental level.

Interpretation: Some crisis intervention services, such as mobile crisis units, will require a more thorough psychosocial assessment. This is likely to occur when the treatment provided is much more extensive including the prescribing of medication by a physician.

Note: Refer to the Assessment Matrix for additional Screening/Intake Assessment criteria. The elements of the matrix can be tailored according to the needs of specific individuals or service design.

Research Note: Studies have shown that suicidal desire in combination with capability or intent are indicators of imminent suicide risk and should be included as part of a suicide risk assessment. Indicators of suicidal desire include: suicidal ideation, psychological pain, hopelessness, helplessness, perceived burden on others, feeling trapped and feeling intolerably alone. Indicators of suicidal capability include: a history of suicide attempts, exposure to someone else’s death by suicide, history of/current violence to others, available means of killing self/others, current intoxication, substance abuse, acute symptoms of mental illness and extreme agitation/rage. Indicators of suicidal intent include: an attempt in progress, plan to kill self/others, preparatory behaviors and an expressed intent to die. The National Suicide Prevention Lifeline Suicide Risk Assessment Standards recognize a fourth assessment factor called “buffers against suicidality.” Buffers against suicidality refer to social connections and engagements that can offset the risk of a suicide attempt. Buffers against suicidality can include factors such as: immediate supports, social supports, planning for the future, engagement with the helper, ambivalence for living/dying, core values/beliefs and a sense of purpose.

Research Note: For telephone crisis interventions, a risk assessment conducted at the start of the call helps establish rapport, can reduce the caller’s anxiety and despair, and initiates the development of an Action Plan for callers to address their concerns following the conclusion of the call.

CRI 2.04

Individuals who cannot be served, or cannot be served promptly, are referred or connected to appropriate resources.

NA The agency: (1) accepts all clients, or (2) only receives clients by referral, and is required by contract to accept all referrals.

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	PURPOSE: Crisis Response and Information Services operate as part of the community's crisis response system to provide immediate, dependable responses and reliable information to promote safety and stability for the individual in crisis.

RELATED FILES


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	COMMUNITY A specific group of people living in the same locality and who may share a common culture, values, and norms. Communities can also be defined by race, religion, ethnicity, age, occupation, political status, tribal affiliation, interest in particular problems or outcomes, or other common bonds. The term "community" encompasses worksites, schools, tribes, residential neighborhoods, business districts, recreational areas, and health and human service sites.


	SCREEN A preliminary test administered to a client to determine whether he/she meets eligibility criteria for the services offered by an organization.


	PRACTICE Established actions or ways of proceeding in the regular performance of organizational duties. Policies and procedures often guide practice.


	RESEARCH For purposes of COA accreditation, all forms of internal or external research involving persons served except internal program evaluation and outcomes research, or educational projects performed by students and interns that are part of their professional training.


	CRISIS INTERVENTION The immediate response to the acute needs of a person in crisis including referral to appropriate community resources, advocacy, support, or direct assistance.


	ASSESSMENT An evaluation, which utilizes professional expertise and skills in the collection and analysis of data to understand and describe the nature of service needs of an individual, family, or group. Assessment, as in needs assessment, is also used to determine priorities of program planning and service development for the organization as a whole. See also DIAGNOSIS.


	PSYCHOSOCIAL ASSESSMENT A type of professional assessment that describes the summary judgment derived from a multidimensional evaluation of psychological, sociocultural, and environmental factors that are components of a presenting problem. It includes results of tests and evaluations, brief expressive descriptions of the problem, an inventory of actual and potential assets and resources, the prognosis, and analysis of what is needed or planned to resolve the problem. A psychosocial assessment is also called a psychosocial diagnosis


	MEDICATION A prescribed or over-the-counter drug that is injected, taken orally, applied topically, or otherwise administered.


	INDICATOR A described activity, event, outcome, or benchmark used for measurement in monitoring the quality and outcome(s) of service.


	CLIENT See service recipient.


	SUBSTANCE ABUSE The misuse of a chemical substance in a manner that is detrimental to an individual's physical or mental health.


	PREVENTION Actions taken to minimize and/or eliminate social, psychological, or other conditions. Prevention can occur at the individual, group, community, and societal levels and enhances opportunities to achieve positive fulfillment.


	PLANNING The process of specifying objectives, evaluating the means for their achievement, and exercising deliberate decision making about appropriate courses of action.


	CONNECTED The means by which individuals access services that may or may not be provided by the organization itself. These terms are used interchangeably when individuals are connected to services either directly or by referral. See also LINKED.


	CONTRACT A formal written agreement between two or more parties that specifies the services, space, or products to be provided in exchange for some form of compensation. Also known as "purchase of service arrangement."


	REFERRALS Resource suggestions provided to consumers to address problems or needs that are beyond the scope of the organization's mission.