Psychiatric Crisis Services at Milwaukee County BHD Presented

Psychiatric Crisis Services at Milwaukee County BHD Presented by Emily Kenney, Crisis Services Coordinator

What is Crisis Services? Crisis Services aims to serve the “before” and “after” hospitalization. Hopefully before- our services try to be preventive. We have 10 different programs. We serve 10, 000 people in PCS; 33, 000 people on our crisis line. Distinct from CARS and Acute Inpatient

PCS/OBS PCS (Psychiatric Crisis Services) is open 24/7/365 for mental health emergencies. It is an emergency room. What happens when you walk in the door: Greeted by a security guard and a nurse to triage you and ensure you don’t have anything dangerous Meet with our fiscal office Meet with a nurse Meet with a doctor Who is inappropriate: Delirium Dementia or other physical problems AODA Overdoses or other needs for medical clearance Needing medications (non-emergency)

PCS/OBS Who is appropriate? Acute mental health emergency (suicidal ideation, mania, psychosis) Treatable What happens? Meds given, crisis resolved, then discharged Sent to Observation Sent to inpatient What is OBS? Short-term stay (2 -3 days) We think the issue will be resolved quickly We want further assessment Person with Family Care who we don’t want to lose benefits

How to Refer To bring a client to PCS, come to 9455 W Watertown Plank Rd Drive to Circle Drive Walk in and go to the 2 nd floor Call ahead if you want to give a nurse information ahead of time: 414 -2577260 You cannot refer directly to OBS, that is a medical determination

Crisis Line The Crisis Line serves a number of functions Front door to other services Someone to talk to in times of crisis Answers 1 -800 -SUICIDE calls Answered 24/7/365 414 -257 -7222

Crisis Mobile Team Crisis Mobile can be dispatched through the Crisis Line if the client/family needs in-person services A team of 2 clinicians comes to assess the client They make recommendations for next steps They act as the “eyes and ears” of PCS off-site Determine if emergency detentions should stay or be dropped Coverage is 8 am-midnight every day and 24 hours Sunday-Thursday Just over 20 staff in total- but they cover all service areas 414 -257 -7222

Crisis Mobile Team- Specialties One geriatric nurse who specifically responds to “gero mobiles” 8 am-4: 30 pm Monday-Friday Sees folks over 60 years old Has the ability for some follow-through CART (Crisis Assessment Response Team) Partnership with MPD: each team has a clinician and an officer Respond mostly to police dispatch w/ mental health involved Can be dispatched by crisis mobile if law enforcement might be needed 11 am-midnight Monday-Friday To refer to either of these, call the Crisis Line and they will decide if either one of these is more appropriate than general mobile

Community Consultation Team We call this our “DD mobile”: a mobile response team for individuals with intellectual/developmental disabilities 3 legs of the team Crisis response: just like crisis mobile, CCT can help triage a situation over the phone or can respond in teams of 2 to a crisis situation to do an in-person assessment Consultation: the team can do a professional consultation to try to prevent crises from occurring; they also work with our patients in OBS Professional Education: CCT is working on 12 curricula for professionals working with this population to teach strategies for handling crisis on their own Call 414 -257 -7797 to refer 8 am-9 pm Monday-Friday; 8 am-5 pm on weekends and holidays

Access Clinic is an outpatient mental health clinic for Milwaukee County residents who don’t have insurance Provide access to medication therapy and psychotherapy 2 Locations!!! 9455 W Watertown Plank Rd, Room 2000 (2 nd floor); call 414 -257 -7665 Hours: Monday-Friday, 8 am-4 pm 804 W Greenfield Avenue, rear entrance; call 414 -316 -4156 Hours: Monday & Wednesday, 9 am-3 pm; Tuesday, Thursday, & Friday, 10 am-2 pm

Access Clinic: How It Works Walk in during business hours You’ll go through a financial assessment and intake process to our clinic You’ll meet with a clinician who will do a clinical assessment Based on that assessment, you’ll be recommended for a psychiatrist, a therapist, or both Access has psychiatrists on-site. If you need a psychiatrist, you’ll be referred to our psychiatrist first. After 1 -2 sessions, you’ll be referred to one of 2 outpatient providers. We contract with therapy providers. You’ll choose from a list of providers if therapy is recommended for you. Have a client who doesn’t fit the criteria? Exceptions go through Emily.

Crisis Stabilization Houses 3 Stabilization Houses Clients can stay for 2 weeks (except for the 1 long-term stabilization house) The goal is to help clients prevent a crisis or step down from hospitalization back to the community The houses are run by contracted agencies and have paraprofessionals on-site 24/7 Clients see a mobile team clinician daily To refer, call 414 -257 -7222 Be prepared to discuss the clinical reason for the referral The client must be voluntary and able to self-care, including taking medications The client must have 2 weeks’ worth of medications for admission CSH is not housing; the client needs to have a housing plan

Crisis Resource Centers Shorter-term than CSH; the goal is for clients to stay for only 3 -5 days Goal is to prevent psychiatric crisis Holistic approach for the client’s needs to stabilize Integrate peer support and clinical staff Contracted to TLS; call them to refer directly Crisis Resource Center South 2057 S. 14 th St. Milwaukee, WI 53204 Phone: 414 -643 -8778 Crisis Resource Center North 5409 W. Villard Ave. Milwaukee, WI 53218 Phone: 414 -539 -4024

Crisis Staffings are meant to help bring all the players in a case to the table to discuss a complex case 3 times per month Geared toward high-utilizers To refer, fill out the crisis staffings form and fax to Sylvia Cortez

Need Help? Always feel free to call or email: Emily Kenney 414 -257 -7750 414 -308 -5323 (cell) emily. kenney@milwaukeecountywi. gov