Focus on Preparing for Crisis

Focus on Preparing for Crisis

We can all relate to making it through a crisis saying “I made it through another one!” but oftentimes we have to make important decisions about our children’ care during these very stressful times. It is during non-crisis times that preparation can make the crisis less difficult. The following page offers some tools developed by families who have been through it for handling and preparing for a mental health crisis with your child. When your child is experiencing a serious mental health crisis, (s) he may be at serious risk of hurting themselves or others. At such a time, you may have to consider hospitalization and will have to seek assistance from professionals.

· Find out procedures for handling a crisis from your insurance carrier and who are the crisis team and admitting psychiatric hospital.
· Keep records with provider’s name, addresses, and phone numbers who you must contact when a crisis arises. Any special procedures you may have to follow during this time should be kept written down along with this information.
· Call the crisis team and admitting hospital and ask questions before an emergency occurs. Find out the terms they use and what kind of information they will need from you. Learning how to talk to the crisis team in specific terms will help them in their assessment of your child’s mental health crisis state.
· Visit the crisis facility and/ or admitting hospital before a crisis arises. Become familiar with the route and buildings and find parking, admitting entrances, and desk for when you arrive.

Before A Crisis, Ask Yourself Questions:

· Who will transport my child?
· What are my options?
· If I need an ambulance, will my insurance carrier require that they are contacted to make that determination?
· Who can I count on to help us? Family, friends, members of my church, a neighbor, our case manager, the police?
· How will I plan for my options in advance?
· Do I have a back up plan?
· Will I need someone to help me get my child safely from the car to the crisis team? If so, who can help?
· Will I need to arrange for care for other children? If so, who?
· How can my child’s brothers and sisters help during this time? How can I make them part of the team?

Asking for the help you need, and putting some plans in place, will help you fell you are not alone and can reassure you long before the crisis occurs that your child, your other family members, and you will safely make it through a crisis if it does arise.

Important Information

Keep information lists updated and handy! Make multiple copies and make sure you have the list with you when away from home. Remember this is an emotional and stressful time and crisis can happen anywhere. Anything written down is very helpful.

Your list should include:

· All pertinent information about your child including social security number and insurance carrier information
· All of your child’s care providers with their phone numbers including medical, mental health, and school
· Your child’s mental health diagnosis and other medical conditions
· Allergies, special diet needs, medication and dosages
· Previous hospitalizations with names of hospitals, dates of admissions, and discharge and reason for hospitalization
· A list of questions to ask the hospital.

Discharge Planning

· Discharge planning should begin the first night of admission! With a good discharge plan you may be able to get the services in place that were needed and not available to you before the crisis.
· Find out the name and number at the hospital responsible for discharge planning. Talk to this person as soon as possible about your child’s needs
· Get answers to key questions:
· Who will coordinate and notify all of my child’s outpatient services and school of the discharge plan?
· When will the discharge meeting occur?
· How much notification will I have, and which hospital staff will be there? Remember you can invite anyone you find will be helpful to the meeting and may need this information. This may be your child, other family members, a friend or advocate, outpatient therapist, special education teacher or your respite worker.
·Make sure the discharge team follows up with written discharge instructions to any of you child’s providers who are unable to attend the meeting.
· Remember you have the option as a parent to file an appeal of a decision made by your insurance carrier or the hospital if you feel an unsound clinical decision is being made. You may also file a grievance if you don’t agree with a treatment decision. Both must be filed in writing in order for a formal review to happen. There are a number of protection and advocacy organizations that can assist you with such a process.

If Your Child is Not Hospitalized

Make sure a qualified child clinician evaluates your child. If the crisis team finds your child is not in need of hospital care you should be given a plan for your child. Ask for it in writing. If a crisis reoccurs, no matter how short of a period after leaving the team, you can return for another evaluation. When evaluated, if your child signs any kind of safety contract (a plan for keeping themselves safe), and then is not willing or capable of following the plan bring your child back to the crisis team.

A plan should include:
· Action steps for the family to follow when/ if a crisis reoccurs
· Medical and psychiatric referrals
· Community resources like parent support groups
· Follow-up call from the clinician within three hours

This information was adapted from “Crisis Planning Guide for Parents”. The authors are Marian Butler, Carol Grimm, and Lisa Lambert. The project was funded by Central Massachusetts Department of Mental Health & Massachusetts Behavioral Health Partnership. © 1998