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Psychological Crisis Intervention: The SAFER-R Model is designed to provide the reader with a simple set of guidelines for the provision of psychological first aid (PFA). The model of psychological first aid (PFA) for individuals presented in this volume is the SAFER-R model developed by the authors. Arguably it is the most widely used tactical model of crisis intervention in the world with roughly 1 million individuals trained in its operational and derivative guidelines. This model of PFA is not a therapy model nor a substitute for therapy. Rather it is designed to help crisis interventionists stabile and mitigate acute crisis reactions in individuals, as opposed to groups. Guidelines for triage and referrals are also provided. Before plunging into the step-by-step guidelines, a brief history and terminological framework is provided. Lastly, recommendations for addressing specific psychological challenges (suicidal ideation, resistance to seeking professional psychological support, and depression) are provided.
This document reports on a descriptive study of mental health crisis response systems. It was sponsored by the Center for Mental Health Services as part of its continuing effort to support knowledge development & dissemination relevant to critical aspects of mental health service delivery for persons with long-term mental illness. Chapters: overview of mental health crisis services; telephone crisis services; walk-in crisis services; mobile outreach crisis services; residential crisis services; inpatient crisis services; selected references; & list of respondent communities & agencies by State. Seven exhibits & thirty tables.
Crisis resolution and home treatment teams respond rapidly to people experiencing mental health crises and offer an alternative to hospital admission. They are an increasingly important component of mental health care and are adopted by many health care systems around the world. This practical and pioneering book describes the evidence for the effectiveness of such teams, the principles underpinning them, how to set up and organise them, how patients should be assessed and what types of care the teams should offer. Other topics covered include integration of crisis teams with in-patient, community residential and day care services, the service users' experiences of crisis teams, and responding to diversity in home treatment. This book is essential reading for all policy makers, service managers and mental health workers interested in establishing or operating crisis resolution and home treatment services, as well as for researchers and students seeking to understand this model.
In the devastation that follows a major disaster, there is a need for multiple sectors to unite and devote new resources to support the rebuilding of infrastructure, the provision of health and social services, the restoration of care delivery systems, and other critical recovery needs. In some cases, billions of dollars from public, private and charitable sources are invested to help communities recover. National rhetoric often characterizes these efforts as a "return to normal." But for many American communities, pre-disaster conditions are far from optimal. Large segments of the U.S. population suffer from preventable health problems, experience inequitable access to services, and rely on overburdened health systems. A return to pre-event conditions in such cases may be short-sighted given the high costs - both economic and social - of poor health. Instead, it is important to understand that the disaster recovery process offers a series of unique and valuable opportunities to improve on the status quo. Capitalizing on these opportunities can advance the long-term health, resilience, and sustainability of communities - thereby better preparing them for future challenges. Healthy, Resilient, and Sustainable Communities After Disasters identifies and recommends recovery practices and novel programs most likely to impact overall community public health and contribute to resiliency for future incidents. This book makes the case that disaster recovery should be guided by a healthy community vision, where health considerations are integrated into all aspects of recovery planning before and after a disaster, and funding streams are leveraged in a coordinated manner and applied to health improvement priorities in order to meet human recovery needs and create healthy built and natural environments. The conceptual framework presented in Healthy, Resilient, and Sustainable Communities After Disasters lays the groundwork to achieve this goal and provides operational guidance for multiple sectors involved in community planning and disaster recovery. Healthy, Resilient, and Sustainable Communities After Disasters calls for actions at multiple levels to facilitate recovery strategies that optimize community health. With a shared healthy community vision, strategic planning that prioritizes health, and coordinated implementation, disaster recovery can result in a communities that are healthier, more livable places for current and future generations to grow and thrive - communities that are better prepared for future adversities.
This book describes a spectrum of possible solutions to providing comprehensive emergency psychiatric care. It discusses in detail all components of emergency psychiatric care, such as triage, security, management of suicide risk, violent patients, interdisciplinary treatment teams, administration, and telepsychiatry. It has been written by and is of interest to psychiatrists, emergency medicine physicians, nurses, social workers, administrators, the police and security staff.
Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. During such crises, hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies and beds could be in short supply; and alternate care facilities may need to be used. Planning for these situations is necessary to provide the best possible health care during a crisis and, if needed, equitably allocate scarce resources. Crisis Standards of Care: A Toolkit for Indicators and Triggers examines indicators and triggers that guide the implementation of crisis standards of care and provides a discussion toolkit to help stakeholders establish indicators and triggers for their own communities. Together, indicators and triggers help guide operational decision making about providing care during public health and medical emergencies and disasters. Indicators and triggers represent the information and actions taken at specific thresholds that guide incident recognition, response, and recovery. This report discusses indicators and triggers for both a slow onset scenario, such as pandemic influenza, and a no-notice scenario, such as an earthquake. Crisis Standards of Care features discussion toolkits customized to help various stakeholders develop indicators and triggers for their own organizations, agencies, and jurisdictions. The toolkit contains scenarios, key questions, and examples of indicators, triggers, and tactics to help promote discussion. In addition to common elements designed to facilitate integrated planning, the toolkit contains chapters specifically customized for emergency management, public health, emergency medical services, hospital and acute care, and out-of-hospital care.
When hospitals release seriously mentally ill patients too soon without outpatient follow-up, the patients can end up homeless, jailed, harming others, or even dead. When patients are deemed suitable for inpatient care, they can languish for weeks in hospital emergency departments before placements become available. Meanwhile, patients who fake the need for care are smoothly and swiftly moved to inpatient settings. Breakdown opens a dialogue with anyone interested in improving the system of care for the seriously mentally ill population. This book helps to answer questions such as: Is inpatient care too inaccessible to those who need it most? Do mental health professionals discriminate against mentally ill patients? Are more stringent measures needed to ensure that patients take their medication? Is borderline personality disorder too serious to be classified as just a personality disorder? Using vignettes based on real interactions with patients, their families, police officers, and other mental health providers, Lynn Nanos shares her passion for helping this population. With more than twenty years of professional experience in the mental health field, her deep interest in helping people who don’t know how to request help is evident to readers. A woman travels from Maine to Massachusetts because she was ordered by her voice, a spirit called "Crystal," to make the trip. A foul-smelling and oddly dressed man strolls barefooted into the office, unable to stop talking. A man delivers insects to his neighbors' homes to minimize the effects of poisonous toxins that he says exist in their homes. Breakdown uses objective and dramatic accounts from the psychiatric trenches to appeal for simple and common-sense solutions to reform our dysfunctional system. This book will benefit anyone interested in seeing a glimpse of the broken mental health system way beyond the classroom. It can guide legislative officials, family members, mental health professionals, and law enforcement officers toward a better understanding of the system.
Mental health and psychosocial support (MHPSS) is a term used to describe a wide range of actions that address social, psychological and psychiatric problems that are either pre-existing or emergency-induced. These actions are carried out in highly different contexts by organizations and people with different professional backgrounds, in different sectors and with different types of resources. All these different actors--and their donors--need practical assessments leading to recommendations that can be used immediately to improve people's mental health and well-being. Although a range of assessment tools exist, what has been missing is an overall approach that clarifies when to use which tool for what purpose. This document offers an approach to assessment that should help you review information that is already available and only collect new data that will be of practical use, depending on your capacity and the phase of the humanitarian crisis. This document is rooted in two policy documents, the IASC Reference Group s (2010) "Mental Health and Psychosocial Support in Humanitarian Emergencies: What Should Humanitarian Health Actors Know?" and the "Sphere Handbook's Standard on Mental Health" (Sphere Project, 2011). It is written primarily for public health actors. As the social determinants of mental health and psychosocial problems occur across sectors, half of the tools in the accompanying toolkit cover MHPSS assessment issues relevant to other sectors as well as the health sector.