Western Highlands Network

Friday E-Mail Newsletter

Number 64
08/11/2006

The Friday E-Mail is a weekly update for providers by the Services Management Department of Western Highlands Network. Please distribute to all your staff.

Western Highlands Network Provides Additional Clarification on Community Support and
Mobile Crisis Team Services

WHN has received a variety of questions regarding the use of Community Support (and/or Community Support Team for adults) versus when Mobile Crisis should be used. The following is an attempt to clarify the differences between these services.

In all situations, clinical judgment, along with supervisory consultation, should be used in determining the level of intervention. Neither Community Support nor Mobile Crisis is appropriate if weapons are present and cannot be secured.

Standard
Community Support
Mobile Crisis
First Responder
 Yes- 24/7/365
 No, must be secondary intervention
Location of Service
 In office or onsite Must be in the least restrictive community environment (home, work or school )

Psychiatric Involvement

 As listed on the consumer's PCP

Must be available for face to face or phone consultation with
Type of intervention
 Includes office, onsite, and/or telephonic interventions
 Primarily face to face
Intensity of situation
  • Crisis can be resolved telephonically, or with face to face contact with CS provider.
  • CS worker can reasonably and safely intervene at consumer's home without the need of a second person.
  • Consumer's family or natural supports are agreeable with onsite visit and will participate in crisis resolution strategies.
  • Substance abuse is minimal and without need for Detox.
  • Co-occurring Physical health issues are minimal and do not require onsite medical personnel.
  • On call MD is comfortable with giving stat order for oral medication.
  • CS has made a face to face assessment, followed the crisis plan, has tried and failed to resolve crisis. (The CS worker must be able to communicate what was tried and why that intervention failed.
  • Situation involves intoxicated or a consumer in an active psychotic state or with possible impulse control issues.
  • Family members may be resistant to onsite intervention, unable or unwilling to participate in crisis resolution strategies.
  • Consumer needs assessment for onsite medication change including possible injection.
  • Consumer has multiple or serious co-occurring medical issues that require RN or MD assessment.
  • It is anticipated that more than one staff member may be required onsite to ensure the efficacy and safety of the intervention.

Charlie Schoenheit
Director of Services Management
Western Highlands Network
356 Biltmore Avenue
Asheville, NC 28801
Telephone: (828)258-3511 x2219
FAX: (828) 225-2779
E-Mail: Charlie@westernhighlands.org
Website: westernhighlands.org