Standards for public agencies

2020 Edition

Crisis Response and Information Services (PA-CRI) 4: Crisis Intervention Services

The agency responds immediately and appropriately to individuals in crisis situations.
2020 Edition

Currently viewing: CRISIS RESPONSE AND INFORMATION SERVICES (PA-CRI)

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Purpose

Crisis Response and Information Services operate as part of the community's crisis response system to provide immediate, dependable responses and reliable information to promote safety and stability for the individual in crisis.
1
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
2
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
3

Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  

  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.  
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.  
  • Service quality or agency functioning may be compromised.  
  • Capacity is at a basic level.
4
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Action planning procedures
  • Safety planning procedures
  • Treatment and referral procedures
  • Supervisory review procedures
  • Community resource and referral list
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

PA-CRI 4.01

Crisis intervention personnel respond immediately and:
  1. provide intervention and stabilization;
  2. work with the person to develop an action plan;
  3. work with the person to develop a safety plan, as needed, once it has been determined that no immediate emergency intervention is required;
  4. never utilize “no suicide contracts” or “no-harm contracts;"
  5. refer or connect individuals with appropriate resources; and
  6. follow up with each person within 24 hours, when appropriate.

Interpretation

A safety plan includes a prioritized written list of coping strategies and sources of support that individuals who have been deemed to be at high risk for suicide can use. Individuals can implement these strategies before or during a suicidal crisis in order to prevent a suicide attempt or possibly death. Components of a safety plan can include: recognition of warning signs, internal coping strategies, socialization strategies for distraction and support, family and social contacts for assistance, professional and agency contacts, and lethal means restriction.

Interpretation

No-suicide contracts are based on a verbal or written agreement by the service recipient to not engage in self-harm or suicidal acts during a specific timeframe. Research does not support this practice or show that these agreements are effective at preventing suicides, nor have they been found to provide protection against malpractice lawsuits.

Interpretation

In cases of individuals at risk for suicide, every effort should be made to follow up within 24 hours after the initial contact.
Examples: Follow-up can be by telephone, non-identifiable postcards, emails, or text messages. Contacts can be brief, tailored to the individual’s needs, and focused on continued assessment of risk.

Fundamental Practice

PA-CRI 4.02

Written procedures address the provision of treatment and referral when individuals are at risk of imminent harm, including situations involving victims of violence, individuals at risk for suicide, medical crises, and other emergencies.

Interpretation

When an individual calling a crisis hotline is considered to be at imminent risk for suicide, staff should have a written procedure directing them to: (1) practice “active engagement” to promote the caller’s collaboration in securing his/her own safety, (2) use the least invasive intervention and consider involuntary emergency interventions as a last resort, and (3) initiate “active rescue” (i.e., immediately dispatching emergency rescue interventions with or without the callers consent) if the caller remains unwilling and/or unable to take action on their own behalf. 

PA-CRI 4.03

Supervisory personnel review service interventions within 24 hours.