Rights and Legal Issues

Persons Experiencing Psychiatric Crises: Information for Emergency Department Staff and Others Regarding Available Resources, Protocols, and Requirements

How Could A Crisis Worker Be Helpful to Emergency Department Staff When An Individual Comes to an ED in Psychiatric Crisis?

1.) Treatment Recommendations and Referrals

The crisis provider can assess the individual and make recommendations regarding the need for hospitalization and the appropriateness and availability of less restrictive alternatives to hospitalization; locate and arrange for needed services; and review crisis plans and advance directives.

The determination regarding hospitalization is the responsibility of the physician, licensed clinical psychologist, physician's assistant, nurse practitioner or certified psychiatric clinical nurse specialist who has examined the patient in the emergency department.  If the qualified professional determines that hospitalization is required, the crisis worker is responsible for assisting the Emergency Department in locating a bed.

If it is determined that the individual would be better served in a less restrictive environment the crisis worker can assist in identifying community based alternatives to hospitalization, including crisis stabilization units.

2.) Coordination and Access to Records

Crisis service staff can serve a coordinating role as well as assist in gathering pertinent information.

At any time of day or night a crisis worker can arrange for access to an individual's mental health records, including the person's Individualized Support Plan (ISP), crisis plan, health care advance directives, and name and contact information for the prescriber of psychiatric medications if the individual is receiving community support services. 

If the individual in psychiatric crisis is unable to provide information about his/her mental health provider, the crisis worker may know the individual and be able to provide that information.

The crisis worker is also responsible for coordinating with community mental health providers to ensure continuity of care.