COUN6323 Final draft

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Feb 20, 2024

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CRISIS RESPONSE 1 Crisis Response in Your Community: Interview Response Brittany Spann Department of Psychology, Houston Baptist University COUNS 6323: Crisis Response & Trauma Care Dr. Katherine Pang December 10, 2023

CRISIS RESPONSE 2 Crisis Response in Your Community: Interview Response According to NASMHPD, “over 55 million Americans suffer from mental health or substance use disorders in the United States and account for nearly 10 million hospitalizations annually (Pinals & Edwards, 2021).” There is a current systematic effort to reform the simplification of emergency mental health services being provided majority at emergency psychiatric hospitals and instead offered through local mental health providers who focus on immediate mental health services to minimize hospitalizations. Recently communities have implemented and begun utilizing a variety of community-based crisis services such as walk-in clinics, crisis hotlines, and mobile treatment centers. The local crisis center that provides services to my community is one such community center, providing the listed services at little to no cost to the client depending on the client’s financial stability and need. Interview For the interview process of assessing a community crisis resource I initially planned only to interview the Crisis departmental lead, Kristin Zajicek. I was able to gain information about the structure of the program the services offered, and logistical information but when I began asking about more counseling or direct contact questions, I was directed to speak with Carlos Sanchez LPC. Carlos is the Team Lead for the crisis response team and their Licensed Professional Counselor who provides trauma, grief, and addiction counseling to their clients. Central Counties Services is a network of mental health clinics that provides services to 5 counties in central Texas. Those counties include Bell, Milam, Coryell, Hamilton, and Lampasas Counties. Central Counties Services provides adult mental health, veteran mental health, crisis, youth mental health, children's mental health, and intellectual developmental disabilities services, as well as 1115 waiver services. The current crisis services that are supervised by Mrs.

CRISIS RESPONSE 3 Zajicek include behavioral services through the HCS adult IDD program, crisis respite through the adult IDD program, ABA services through youth and children mental health services and crisis hotline services which are provided 24 hours both through the crisis department and through a contract crisis line outside of regular business hours (K. Zajicek, personal communication, November 10, 2023). Program qualifications and duration of services All of the crisis programs are provided through private insurance, and Medicaid, or can be provided through private pay as needed. Each program has specific application processes that are completed during intake which is usually completed during the initial crisis response session. The initial assessment can be completed over the phone if the client chooses to utilize the crisis hotline, or in person should the client be in the hospital or walk into one of the clinics and request assistance. The programs do not have contacts with any specific companies and are generally offered to clients with limited financial resources. While private pay is offered, for many of the program services they can be offered to clients for free should the client meet the guidelines for merit services (K. Zajicek, personal communication, November 10, 2023). The initial crisis services are usually completed within 7-10 business days. This time period is intentionally limited to allow crisis response workers time to assess the clients for their needs and qualifications and move them into long-term, case-managed services. The initial crisis response team is made up of 15 members who work a rotating on-call schedule that covers the crisis hotline as well as a crisis request line for hospitals and law enforcement to make referrals. Once the initial assessment is complete the client is assigned a service coordinator who monitors the delivery of the services, gauges satisfaction, and makes additional referrals or facilitates mediation should the client be unsatisfied with a service. These service coordinators remain with

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CRISIS RESPONSE 4 the client for the duration of their treatment and occasionally act as immediate crisis responders should their client experience a new event during their treatment. There are currently 40 service coordinators that are spread among the different clinics in each county. These service coordinators have high caseloads, most well over 100 clients that they must see monthly to assess their client's physical well-being (C. Sanchez, personal communication, November 10, 2023). It is reported that the reason their caseloads are so high is because of the waitlist for many of the long-term mental health services. While all of the crisis services have a constant rotation of clients and a relatively small waitlist the long-term services such as psychiatry, counseling, employment, housing etc have long waitlists largely caused by limitations of state funding or limited-service providers that can work with Medicaid or clients with little to no financial resources. These programs do have grant funding that is provided every few years but that funding is limited and usually runs out fairly quickly (C. Sanchez, personal communication, November 10, 2023). Concerns about readiness Overall, I did not have major concerns about the readiness of the program to provide services as the program is currently operating and accepting clients. I found that there is no real way for the services to be individualized. Each assessment for services is structured in a simple questionnaire template to assess needs and qualifications and the guideline for the service provider is pretty straightforward as well. I also did not find much incorporation of culture into the treatment assessment or service outline for the programs. With Fort Cavasos being so near to the center the surrounding community has a diverse mixture of cultures that simply cannot be ignored when providing crisis services.

CRISIS RESPONSE 5 According to Ahmad (2019) culture can affect how a client perceives their crisis and their readiness for crisis intervention services. Along with a lack of cultural focus, there was also no focus on religion or spiritual-based services. With the variety of cultures in the area, there is of course the possibility that the crisis workers will face clients with conflicting religious backgrounds. There should be some focus on what to do or training for the service providers on how to continue to work effectively with patients from different cultures and religious backgrounds. Conclusion Based upon my interview I believe that the crisis services provided were what I was expecting. I think that overall the services offered are effective and while there is always room to incorporate new tools and techniques the services are quality services that foster healing and resolution of the immediate crisis for the client while making referrals to necessary longer-term services.

CRISIS RESPONSE 6 References Ahmad, N. S. (2018). Crisis Intervention: Issues and Challenges. Advances in Social Science, Education and Humanities Research , (304), 452-455. https://doi.org/10.2991/acpch- 18.2019.105 Gingrich, H.D.G. C. (2017). Treating Trauma in Christian Counseling. InterVarsity Press. https://bookshelf-activate.vitalsource.com/books/9780830889129 Miller, G. (2011). Fundamentals of Crisis Counseling. Wiley Professional, Reference & Trade (Wiley K&L). https://bookshelf-activate.vitalsource.com/books/9781118156346 Pinals, D. A., Edwards M. L. (2020). Crisis Services: Addressing Unique Needs of Diverse Populations. Technical Assistance Collaborative Paper No. 8. Alexandria, VA: National Association of State Mental Health Program Directors. Crisis Services: Addressing Unique Needs of Diverse Populations (nasmhpd.org)

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