[NYAPRS Enews] MH Crisis Teams to Help Stabilize At-Risk Youth

Tue May 5 08:49:02 EDT 2015

NYAPRS Note: Mobile crisis teams for youth in Connecticut demonstrate how concerted efforts by policymakers to target early intervention and diverted hospitalizations and incarcerations can help to stabilize trauma and improve outcomes. This program is in its infancy, but is already a statewide approach that serves the most vulnerable young people. As NY explores the way forward for implementation of children's integrated managed care in Medicaid, this model may be useful to understand.

Mental Health Crisis Teams to Help Stabilize At-Risk Youth
Stamford Advocate; Magaly Olivero, 5/4/2015

The growing number of children and teens exposed to traumatic events in everyday life has forced the state's crisis intervention teams to respond to a broader range of behavioral and mental health issues, and those teams often serve as a bridge until at-risk youth find appropriate outpatient or inpatient services.
Sixty-four percent of Connecticut's youth who use Emergency Mobile Psychiatric Services<http://www.stamfordadvocate.com/search/?action=search&channel=local&inlineLink=1&searchindex=gsa&query=%22Emergency+Mobile+Psychiatric+Services%22>, the state's mobile crisis intervention team, have experienced one or more traumatic incidents, such as domestic violence, cyber-bullying, physical assaults or gang warfare, experts report.
Research shows childhood exposure to violence, physical or sexual abuse, and other traumatic events can cause chronic health and behavioral health problems, and such exposure is associated with increased involvement with the child welfare and criminal justice systems.
"We're seeing kids who require an intense level of services that might not be available right away. We're being called in to provide treatment in the interim so their situation does not escalate. Some children need a high level of care. But others can step down from the crisis," said Jessica Welt<http://www.stamfordadvocate.com/search/?action=search&channel=local&inlineLink=1&searchindex=gsa&query=%22Jessica+Welt%22>, director of crisis services at the Child Guidance Center of Southern Connecticut<http://www.stamfordadvocate.com/search/?action=search&channel=local&inlineLink=1&searchindex=gsa&query=%22Child+Guidance+Center+of+Southern+Connecticut%22> in Stamford, which lost three high school students to suicide in the 2013-14 school year.
The center is one of six agencies that provide crisis-intervention services from 15 satellite sites statewide.
EMPS is a crisis-intervention program with a statewide network of about 150 mobile mental-health professionals who assist children up to age 18 with behavioral or mental-health emergencies. When a call is placed to 2-1-1 from any Connecticut town, clinicians respond within 45 minutes, either by telephone or at a face-to-face crisis assessment and intervention at home, at school or in the community. They can remain involved for up to 45 days, creating care plans, coordinating services and following up.
Last fiscal year, EMPS provided 12,376 instances of care -- up 11.4 percent from the previous fiscal year -- and some worry that demand will soon exceed the program's capacity.
"The number of children who have been exposed to trauma is a significant concern. It's a common occurrence among young people," said Jeffrey Vanderploeg<http://www.stamfordadvocate.com/search/?action=search&channel=local&inlineLink=1&searchindex=gsa&query=%22Jeffrey+Vanderploeg%22>, vice president for mental health initiatives for the Child Health and Development Institute of Connecticut<http://www.stamfordadvocate.com/search/?action=search&channel=local&inlineLink=1&searchindex=gsa&query=%22Child+Health+and+Development+Institute+of+Connecticut%22>. He is director of the EMPS Performance Improvement Center<http://www.stamfordadvocate.com/search/?action=search&channel=local&inlineLink=1&searchindex=gsa&query=%22EMPS+Performance+Improvement+Center%22>, which is housed at CHDI.
In October, Gov. Dannel P. Malloy<http://www.stamfordadvocate.com/search/?action=search&channel=local&inlineLink=1&searchindex=gsa&query=%22Dannel+P.+Malloy%22> issued an "action plan" for children's behavioral health that called for using $160,000 to post a full-time EMPS crisis-intervention worker in the emergency department of Connecticut Children's Medical Center<http://www.stamfordadvocate.com/search/?action=search&channel=local&inlineLink=1&searchindex=gsa&query=%22department+of+Connecticut+Children%27s+Medical+Center%22> in Hartford and a part-time worker in another hospital. The plan said the governor was "considering" enhancing the EMPS network by increasing the hours of service from 11 hours a day to 18 hours a day, at an expected cost of $3 million. EMPS costs are about $10.5 million this year.
EMPS was created to assist children in their homes and communities, reduce emergency department visits, and divert youth from more restrictive and costly interventions, such as hospitalizations, residential-care settings or arrest. Funded by the state Department of Children and Families<http://www.stamfordadvocate.com/search/?action=search&channel=local&inlineLink=1&searchindex=gsa&query=%22Department+of+Children+and+Families%22> in partnership with United Way<http://www.stamfordadvocate.com/search/?action=search&channel=local&inlineLink=1&searchindex=gsa&query=%22United+Way%22> of Connecticut, the program serves all youth regardless of health-insurance status.
Heightened awareness about behavioral-health issues and the EMPS program accounts for some of the increased demand for services, experts said. But clinicians report an increase in the severity of cases, compounded by the shortage of outpatient and residential-treatment placements and the inability of many families to afford the behavioral-health care their children need.
But more Connecticut children and young people with mental-health problems are being hospitalized. Mental disorders surpassed respiratory problems and all other ailments as the leading cause of hospitalization in Connecticut in 2012 for children ages 5 to 14, teenagers and younger adults, according to a new state Department of Public Health<http://www.stamfordadvocate.com/search/?action=search&channel=local&inlineLink=1&searchindex=gsa&query=%22Department+of+Public+Health%22> report.
Latin American children traumatized by their journey to the United States and their experiences back home represent a growing portion of youth accessing crisis services, said Welt, of the Child Guidance Center. The agency -- which saw a 33 percent increase in crisis calls last fiscal year -- serves Stamford, New Canaan, Greenwich and Darien.
"Fairfield County has a large immigrant population. We're seeing an increasing number of children and young adolescents who have been exposed to horrific traumas en route to the United States or in their country of origin," she said. These include youths who have experienced or witnessed physical or sexual abuse, assault, homicides, separation from loved ones, gang violence and more.
This story was reported under a partnership with the Connecticut Health I-Team<http://www.stamfordadvocate.com/search/?action=search&channel=local&inlineLink=1&searchindex=gsa&query=%22Connecticut+Health+I-Team%22>: www.c-hit.org<http://www.c-hit.org/>
http://www.stamfordadvocate.com/local/article/Mental-health-crisis-teams-to-help-stabilize-6242073.php
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