The term crisis means different things to different people, but it is always a time of intense difficulty.  Often there is trouble or danger, and someone may be experiencing a distressing disturbance in emotions, thoughts or behavior.  In mental health, crises often include acute and severe anxiety or depression, suicidal gestures, and substance abuse problems.  It is not uncommon for individuals who have experienced trauma to have moments of crisis requiring immediate assistance.  Failing to address these issues quickly may result in further emotional or physical harm.  There are a number of well-known services available for dealing with non-medical crises, for example 24-hour call centers.  There is, however, a lesser known service:  mobile crisis centers.

Mobile crisis centers are unique in that, although the service is initiated by a phone call, as it would be with a call center, mobile crisis workers can travel to the person in need. The location of the meeting spot is usually a hospital, a mutually agreed upon location in the community, or the client’s home.  The face-to-face visit allows for a more thorough risk assessment and recommendations for additional services.  Follow-up visits are usually conducted within 24 to 48 hours of the original call and then a few weeks later, and are performed by mobile crisis workers.  Some units only operate during regular business hours whereas others are running 24 hours a day, 7 days a week.

To illustrate how such a unit works, take for example the situation where someone is having thoughts of suicide.  In this case, one of the first things the worker will do over the phone is find out if the person is in need of emergency medical attention and, if so, will immediately contact these services.  Otherwise, the worker will assess the level of suicide risk, usually rated as low, medium or high, by asking a series of questions.  Questions include whether or not the individual has a clear plan, has decided on the means with which to carry out the plan, and whether or not the person can talk about the event that triggered the crisis.  Depending on the size of and available resources to the mobile crisis unit, the workers may respond by going out to the client within thirty minutes.  Smaller units may use a triage system, going to those at the greatest risk of harm first.  In regard to risk of suicide, if a person is at low risk, then a crisis worker may not make a visit at all, or would visit that individual after seeing others in more urgent need.  If the person is at medium or high risk for suicide, the mobile crisis unit would likely go out and perform a more in-depth assessment.

When such visits occur, the mobile crisis worker determines the needs of the individual in distress, develops a safety plan, and makes referrals for immediate or future services.  In the case of suicidal ideation, the safety plan may include having a friend or family member stay with the person for a period of time, or if necessary, hospitalization.  The visit may also include a referral to a psychiatrist, or other mental health professionals for longer term treatment, a plan for the individual to follow if they have another occurrence of suicidal thinking, and times and dates for future follow-up visits, which help ensure that the individual is accessing the referrals originally provided.  Follow-up visits may also be an opportunity to assess if there have been any further thoughts of suicide or suicide attempts, and adherence to medication regimes.

Although the example above refers to suicidal thinking, there are other types of common crises, such as the mother who is overwhelmed caring for her child, the intoxicated individual whose spouse left because of substance-related relapse, or the person experiencing acute symptoms of Posttraumatic Stress Disorder (PTSD).

The services are readily accessible across Canada and the United States.  Mobile crisis units in different regions or cities can be contacted directly; they can also be located by dialing 911 and in some cases your local hospital.  Listed below are numbers for mobile crisis units in the Greater Toronto Area in addition to a link for crisis centers across Canada.

• St.Elizabeth Mobile Crisis for Etobicoke and North York :         416-498-0043

• New Dimensions in Community Living Mobile Crisis Service:   416-929-5200

• Peel Region Crisis Services:                                                    416-289-2434

• Durham Region Crisis Services:                                              1-800-742-1890

• York Region Crisis Services:                                                    905-310-2673

For a complete list of crisis services, including all mobile crisis services across Canada cut and paste the following link into your webpage browser:

www.pmhl.ca/webpages/reports/CANADIAN%20CRISIS%20RESPONSE.pdf

–Crystal Slanzi, Contributing Writer