Mobile Crisis, or Mobile Crisis Rapid Response Team (MCRRT), is a mental health service in the United States and Canada (typically operated by hospital or community mental health agency) which services the community by providing immediate response emergency mental health evaluations. Evaluations are often requested by hospital emergency rooms, but can also be requested by ICUs, CCUs, jails, nursing homes, police, or EMS. These services are often available on a 24-hour basis.
Mental health is the level of psychological well-being or an absence of mental illness. It is the state of someone who is "functioning at a satisfactory level of emotional and behavioural adjustment". From the perspectives of positive psychology or of holism, mental health may include an individual's ability to enjoy life, and to create a balance between life activities and efforts to achieve psychological resilience. According to the World Health Organization (WHO), mental health includes "subjective well-being, perceived self-efficacy, autonomy, competence, inter-generational dependence, and self-actualization of one's intellectual and emotional potential, among others." The WHO further states that the well-being of an individual is encompassed in the realization of their abilities, coping with normal stresses of life, productive work and contribution to their community. Cultural differences, subjective assessments, and competing professional theories all affect how one defines "mental health".
The United States of America (USA), commonly known as the United States or America, is a country comprising 50 states, a federal district, five major self-governing territories, and various possessions. At 3.8 million square miles, the United States is the world's third or fourth largest country by total area and is slightly smaller than the entire continent of Europe's 3.9 million square miles. With a population of over 327 million people, the U.S. is the third most populous country. The capital is Washington, D.C., and the most populous city is New York City. Most of the country is located contiguously in North America between Canada and Mexico.
Canada is a country in the northern part of North America. Its ten provinces and three territories extend from the Atlantic to the Pacific and northward into the Arctic Ocean, covering 9.98 million square kilometres, making it the world's second-largest country by total area. Its southern border with the United States, stretching some 8,891 kilometres (5,525 mi), is the world's longest bi-national land border. Canada's capital is Ottawa, and its three largest metropolitan areas are Toronto, Montreal, and Vancouver.
Mobile Crisis evaluations are typically requested due to a reasonable expectation of self-inflicted harm to the client, but can also be requested due to a reasonable expectation of the client's intent to harm another person. In addition to Suicidal/Homicidal Ideation or gestures, an assessment may be requested due to a person exhibiting signs of psychosis, grave alien, or altered mental status believed not to have an organic etiology. Criteria for requesting a Mobile Crisis assessment varies depending upon individual mental health agencies and entities that regulate mental health services, as well as statues created via legislative assemblies. An assessment may be requested for situations involving alcohol and drugs (where there is not a mental health component), or "routine" evaluations requested where there is not a reasonable expectation of harm to the client or another individual, as long as psychopathology is not otherwise ruled out.
Alcohol, also known by its chemical name ethanol, is a psychoactive drug that is the active ingredient in drinks such as beer, wine, and distilled spirits. It is one of the oldest and most common recreational substances, causing the characteristic effects of alcohol intoxication ("drunkenness"). Among other effects, alcohol produces a mood lift and euphoria, decreased anxiety, increased sociability, sedation, impairment of cognitive, memory, motor, and sensory function, and generalized depression of central nervous system function. Ethanol is a type of chemical compound known as an alcohol, and is the only type of alcohol that is found in alcoholic beverages or is commonly used for recreational purposes; other alcohols such as methanol and isopropyl alcohol are toxic.
The Mobile Crisis clinician has typically obtained her/his Master's degree in a mental health-related field (such as social work, mental health counseling, or counseling psychology). The clinician performs the evaluation based on standard models of mental status examination (alert and oriented, mood, thought process, affect, etc.), and assigns a DSM-5 (Diagnostic and Statistical Manual of the American Psychiatric Association, Fifth Edition) diagnosis if this falls within their scope of practice. After completing the evaluation, the clinician makes a disposition, or placement, decision for the client. Placements can include involuntary in-patient hospitalization, voluntary in-patient hospitalization, or discharge to home with out-patient referrals. Following disposition, the Mobile Crisis unit can be expected to follow up with the client within a few days.
A master's degree is an academic degree awarded by universities or colleges upon completion of a course of study demonstrating mastery or a high-order overview of a specific field of study or area of professional practice. A master's degree normally requires previous study at the bachelor's level, either as a separate degree or as part of an integrated course. Within the area studied, master's graduates are expected to possess advanced knowledge of a specialized body of theoretical and applied topics; high order skills in analysis, critical evaluation, or professional application; and the ability to solve complex problems and think rigorously and independently.
Social work is an academic discipline and profession that concerns itself with individuals, families, groups and communities in an effort to enhance social functioning and overall well-being. Social functioning is the way in which people perform their social roles, and the structural institutions that are provided to sustain them. Social work applies social sciences, such as sociology, psychology, political science, public health, community development, law, and economics, to engage with client systems, conduct assessments, and develop interventions to solve social and personal problems; and to bring about social change.
Counseling psychology is a psychological specialty that encompasses research and applied work in several broad domains: counseling process and outcome; supervision and training; career development and counseling; and prevention and health. Some unifying themes among counseling psychologists include a focus on assets and strengths, person–environment interactions, educational and career development, brief interactions, and a focus on intact personalities.
Psychiatric hospitals, also known as mental hospitals, mental health units, mental asylums or simply asylums, are hospitals or wards specializing in the treatment of serious mental disorders, such as major depressive disorder, schizophrenia and bipolar disorder. Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialize only in short term or outpatient therapy for low-risk patients. Others may specialize in the temporary or permanent care of residents who, as a result of a psychological disorder, require routine assistance, treatment, or a specialized and controlled environment. Patients are often admitted on a voluntary basis, but people whom psychiatrists believe may pose a significant danger to themselves or others may be subject to involuntary commitment. Psychiatric hospitals may also be referred to as psychiatric wards or units when they are a subunit of a regular hospital.
The Lanterman–Petris–Short (LPS) Act regulates involuntary civil commitment to a mental health institution in the state of California. The act set the precedent for modern mental health commitment procedures in the United States. The bipartisan bill was co-authored by California State Assemblyman Frank D. Lanterman (R) and California State Senators Nicholas C. Petris (D) and Alan Short (D), and signed into law in 1967 by Governor Ronald Reagan. The Act went into full effect on July 1, 1972. It cited seven articles of intent:
Telenursing refers to the use of information technology in the provision of nursing services whenever physical distance exists between patient and nurse, or between any number of nurses. As a field, it is part of telemedicine, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, and telemonitoring. The field, however, is still being developed as the information on telenursing isn't comprehensive enough.
A methadone clinic, or substance use disorder services clinic (SUDS) is a clinic which has been established for the dispensing of methadone, naltrexone, and suboxone. Medically assisted drug therapy treatment is indicated in patients who are opioid dependent or have a history of opioid dependence. Methadone is a schedule II (USA) opioid analgesic, that is also prescribed for pain management. It is a long-acting opioid that can delay the opioid withdrawal symptoms that patients experience from taking short-acting opioids, like heroin, and allow time for detoxification. In the United States, by law, patients must receive methadone under the supervision of a physician, and dispensed through an opioid treatment program certified by Substance Abuse and Mental Health Services Administration and registered with the Drug Enforcement Agency.
Nursing assessment is the gathering of information about a patient's physiological, psychological, sociological, and spiritual status by a licensed Registered Nurse. Nursing assessment is the first step in the nursing process. A section of the nursing assessment may be delegated to certified nurses aides. Vitals and EKG's may be delegated to certified nurses aides or nursing techs. It differs from a medical diagnosis. In some instances, the nursing assessment is very broad in scope and in other cases it may focus on one body system or mental health. Nursing assessment is used to identify current and future patient care needs. It incorporates the recognition of normal versus abnormal body physiology. Prompt recognition of pertinent changes along with the skill of critical thinking allows the nurse to identify and prioritize appropriate interventions. An assessment format may already be in place to be used at specific facilities and in specific circumstances.
Emergency psychiatry is the clinical application of psychiatry in emergency settings. Conditions requiring psychiatric interventions may include attempted suicide, substance abuse, depression, psychosis, violence or other rapid changes in behavior. Psychiatric emergency services are rendered by professionals in the fields of medicine, nursing, psychology and social work. The demand for emergency psychiatric services has rapidly increased throughout the world since the 1960s, especially in urban areas. Care for patients in situations involving emergency psychiatry is complex.
Liaison psychiatry, also known as consultative psychiatry or consultation-liaison psychiatry is the branch of psychiatry that specialises in the interface between general medicine and psychiatry, usually taking place in a hospital or medical setting. The role of the consultation-liaison psychiatrist is to see patients with comorbid medical conditions at the request of the treating medical or surgical consultant or team. Liaison psychiatry has areas of overlap with other disciplines including psychosomatic medicine, health psychology and neuropsychiatry.
Telepsychiatry is the application of telemedicine to the specialty field of psychiatry. The term typically describes the delivery of psychiatric assessment and care through telecommunications technology, usually videoconferencing. Telepsychiatry services can be offered through intermediary companies that partner with facilities to increase care capacities, or by individual providers or provider groups. Most commonly, telepsychiatry encounters take place at medical facilities under the supervision of onsite staff, though at-home models are becoming accepted as long as they are in compliance with HIPAA standards.
Licensed clinical professional counselor (LCPC) is a professional who has been qualified to provide psychotherapy and other counselling services. LCPCs are trained to work with individuals, families, and groups to treat mental, behavioural and emotional problems and disorders. The main goal of LCPCs is to use counselling strategies to help people live a more satisfying life, which typically involves identifying a goal and finding potential solutions.
Crisis intervention is an immediate and short-term psychological care aimed at assisting individuals in a crisis situation in order to restore equilibrium to their bio-psycho-social functioning and to minimize the potential of long-term psychological trauma.
Mental health triage is a clinical function conducted at point of entry to health services which aims to assess and categorise the urgency of mental health related problems. The mental health triage service may be located in the Emergency Department, Community Mental Health Services, Call Centre, or co-located with other specialist mental health services such as the Crisis Assessment and Treatment Team. Emergency Services such as police and ambulance may also have a co-located mental health triage service. There is considerable variation in the clinical settings in which mental health triage services may be operating, therefore service delivery models vary, however, the essential function is to determine the nature and severity of the mental health problem, determine which service response would best meet the needs of the patient, and how urgently the response is required. A core function of mental health triage is to conduct risk assessment that aims to determine whether the patient is a risk of harming self or others as a result of their mental state, and to assess other risks related to mental illness As with other triage models, the mental health triage clinician must assign a category of urgency to the case, which is recorded using verbal indicators of risk such as 'extreme risk' through to 'low risk', or by using numerical categories 1 (immediate) to 5, as per the 5-point Australasian Triage Scale.
A psychiatric assessment, or psychological screening, is the process of gathering information about a person within a psychiatric service, with the purpose of making a diagnosis. The assessment is usually the first stage of a treatment process, but psychiatric assessments may also be used for various legal purposes. The assessment includes social and biographical information, direct observations, and data from specific psychological tests. It is typically carried out by a psychiatrist, but it can be a multi-disciplinary process involving nurses, psychologists, occupational therapist, social workers, and licensed professional counselors.
Psychiatry is the medical specialty devoted to diagnosing, preventing, and treating mental disorders. These include various maladaptations related to mood, behavior, cognition, and perceptions. See glossary of psychiatry.
Behavioral health outcome management (BHOM) involves the use of behavioral health outcome measurement data to help guide and inform the treatment of each individual patient. Like blood pressure, cholesterol and other routine lab work that helps to guide and inform general medical practice, the use of routine measurement in behavioral health is proving to be invaluable in assisting therapists to deliver better quality care.
The Global Appraisal of Individual Needs (GAIN) is a family of evidence-based instruments used to assist clinicians with diagnosis, placement, and treatment planning. The GAIN is used with both adolescents and adults in all kinds of treatment programs, including outpatient, intensive outpatient, partial hospitalization, methadone, short-term residential, long-term residential, therapeutic community, and correctional programs.
The management of domestic violence deals with the treatment of victims of domestic violence and preventing repetitions of such violence. The response to domestic violence in Western countries is typically a combined effort between law enforcement, social services and health care. The role of each has evolved as domestic violence has been brought more into public view.
Goal attainment scaling (GAS) is a therapeutic method that refers to the development of a written follow-up guide between the client and the counselor used for monitoring client progress. GAS was first developed by Thomas Kiresuk and Robert Sherman in response to the wide variety of evaluation models regarding mental illness and treatment. With the advent of GAS, Kiresuk and Sherman sought to create an evaluation program that could measure effectiveness across several different modalities and justify economic and labor resources based on effectiveness. Evaluation practices are important for justification and support for services, especially in mental health. The existing evaluation procedures had problems in definition and measurement, and each mental health center used its own definitions and measurements to evaluate. This created unspecified and informal evaluations. The variety of evaluation methods also made comparisons impossible. Thus, evaluation reform was needed.
Psychotherapy discontinuation, also known as unilateral termination, patient dropout, and premature termination, is a patient's decision to stop mental health treatment before they have received an adequate number of sessions or before they have adequately reduced their symptoms. In the United States, the prevalence of patient dropout is estimated to be between 40–60% over the course of treatment however the overwhelming majority of patients will drop after two sessions. An exhaustive meta-analysis of 146 studies in Western countries showed that the mean dropout rate is 34.8% with a wide range of 10.3% to 81.0%. The studies from the US had a dropout rate of 37.9%.
Involuntary commitment or civil commitment is a legal process through which an individual with symptoms of severe mental illness is court-ordered into treatment in a hospital (inpatient) or in the community (outpatient).
Correctional nursing, sometimes called forensic nursing, is a specialized field of nursing that involves caring for the medical and mental health needs of detainees and inmates. These nurses work in a variety of settings such as jails, prisons, and juvenile detention centers. In these correctional settings, nurses are the primary healthcare providers.