crisis services€¦ · new placement. jail. other. total number of outcomes per fiscal year...
TRANSCRIPT
DBHDS Vision: A life of possibilities for all Virginians
Crisis Services
Division of Developmental Services
Heather Norton, Director
…both children and adults …persons with a developmental disability, including
an intellectual disability …who have a co-occurring mental health illness or
behavioral disorder ...who are at risk for a crisis event or are in the
midst of a crisis …the support system surrounding individuals
receiving services from REACH
To Educate
• Providers • Family • Health Care
staff • Schools • Mental Health
Professionals • Law
enforcement • Members of
the person’s natural circle of support
To Assess
• Crisis situations
• Mental health symptoms
• Behavioral function
• Environment • The support
system surrounding the Individual
• Medical issues impacting behavior
To Provide Crisis Services
• 24/7 crisis response
• Stabilization services
• Coaching and mentoring for the person’s system of support
• Making environmental changes that support the person
To Habilitate
• Teach effective coping skills
• To develop stress tolerance skills
• To teach functional skills for increased independence
• To identify individual interests and learn to access these
Slide 4
Adult Crisis
54
592
472 584
854
1369
0
200
400
600
800
1000
1200
1400
1600
FY12 FY13 FY14 FY15 FY16 FY17
Tota
l # o
f Ref
erra
ls
Fiscal Year
Total Number of Referrals by Fiscal Year
Slide 5
Child Crisis
384
999
0
200
400
600
800
1000
1200
FY16 FY17
Tota
l # o
f Ref
erra
ls
Total Number of Referrals by Fiscal Year
Slide 6
Outcome of Crisis Assessments (Adult)
480
193
11
130
28
501
256 260
10
100
13 4 0 7
710
255
580
29 116
36 0 3 17
0
100
200
300
400
500
600
700
800
Retain Setting Retain Settingw/REACH
PsychiatricHosp.
Medical CTH Admission Alternative CSU New Placement Jail Other
Tota
l Num
ber o
f Out
com
es p
er F
isca
l Yea
r
Outcome of Crisis Assessment by Fiscal Year
FY15
FY16
FY17
Slide 7
Outcome of Crisis Assessment (Child)
182
0
41
6 2 0 0
304
229 213
6 6 1 11
0
50
100
150
200
250
300
350
Tota
l Num
ber o
f Out
com
es p
er F
isca
l Yea
r
Outcome of Crisis Assessment by Fiscal Year
FY16
FY17
Slide 8
Mobile Support Outcome (Adult)
46
6
419
7 0 10 15 45
0
502
23 0 4
42 39
1
398
6 1 7 30
0
100
200
300
400
500
600
PsychiatricHospitalization
MedicalHospitalization
Retained Setting New ResidentialSetting
Jail Other CTH
Tota
l Num
ber o
f Dis
posi
tions
per
Set
ting
Disposition at Conclusion of Mobile Supports by Fiscal Year
FY15 FY16
FY17
Fiscal Year
Slide 9
Mobile Support Outcomes (Child)
6 0
148
5 0 0
66
1
550
6 18
3 0
100
200
300
400
500
600
PsychiatricHospitalization
MedicalHospitalization
Retained Setting New ResidentialSetting
Mobile SupportsActive
Other
Tota
l Num
ber o
f Dis
posi
tions
per
Set
ting
Disposition at Conclusion of Mobile Crisis by Fiscal Year
FY16
FY17
Slide 10
CTH Outcomes (Adults)
27 0
338
45
12 8 28
461
79
38 27 1
338
67
1 13
40
0
50
100
150
200
250
300
350
400
450
500
PsychiatricHospitalization
Medical Hospitalization Retained Setting New Residential Setting Jail Other CTH
Tota
l Num
ber p
er S
ettin
g
Disposition from CTH by Fiscal Year
FY15
FY16
FY17
Slide 11
Independent Reviewer Concerns
“The Commonwealth should study and determine the root causes of the significant increase in admissions of individuals with IDD to state operated psychiatric facilities. Studies found two related factors: an unexpected high rate of families refusing REACH services and not all CSB ES Teams informed REACH of individuals with IDD being screened for psychiatric admission.” • Emergency Services System • Psychiatric Hospitalizations
– Adult – Children
• Refusal of services
Slide 12
Next Steps Children’s Crisis • Hospital Data Review
– Reasons for increased admissions • Age of parent caregiver • Size of child (obesity and GMO) • Increase in survival rate of preemies • Fetal Alcohol/Drug impact • DSS/Foster Care • Single natural parent households • Abuse /Neglect and trauma • Bullying • Looking at CSA data – are more kids remaining in state in comparison
• Children’s Therapeutic Homes • Increase consistency
– Training – Documentation – Processes
Slide 13
Next Steps Adult Crisis
• Hospital Data Review – Vet data and theories
• Adult Transitional Homes • Increase consistency
– Training – Documentation – Processes
• Partnership with BH Acute Care Team – Hospitalizations
• Behavioral Provider Development