Changing Child Crisis Services in California

December 8, 2015

Providing Home-type Settings for Youth in Crisis 

Mandy*, a teenaged girl who had felt her life was not worth living, is thankful to be alive today in part due to the quick thinking actions of her parents and to Edgewood’s Crisis Stabilization Unit.

(* Individual pictured is a model used for illustrative purposes only. name changed for teen's privacy.)

In 2014, Edgewood Center for Children and Families, in collaboration with San Francisco Department of Public Health, opened a Child Crisis Stabilization Unit (CSU) on its campus – the first of its kind in San Francisco County. The goal of the CSU is to provide children and youth experiencing a psychiatric crisis a safe and supportive place for assessment and stabilization of the crisis in order to avoid unnecessary hospitalization. 

While this pilot program has taken off successfully, helping 450 youth like Mandy in the first 16 months alone and diverting 88 percent from unnecessary hospitalization, there are many challenges ahead when it comes to providing comprehensive crisis services for children in California.

That is why in September the Mental Health Services Oversight and Accountability Commission (MHSOAC) put together an advisory board of experts, including those from Edgewood, to document the current state of crisis services for children and youth throughout the state and to develop recommendations and strategies for improving delivery of those services.

“The advisory board is guiding and informing the larger commission (MHSOAC) who will be making recommendations to the governor and state officials,” explained Jill Anderson, MHSOAC Advisory Board Member and Behavioral Health Director at Edgewood. “I have been impressed with the level of commitment from the commission to research this important topic and to develop a plan that will holistically address the needs of children and families in crisis.”

Community-based crisis programs, like Edgewood’s crisis residential programs and CSU, provide home-type settings that equally, if not more, effectively address the needs of youth experiencing a mental health crisis and are less expensive than psychiatric hospitalizations or emergency room services. Edgewood continues to optimize its short-term residential programs into a forever family permanency model, which means less disruption due to moving from one family or foster care environment to another, keeping children near their community, and providing alternatives to the pre-existing emergency room and inpatient services.

In California, unnecessary hospitalization of youth with mental health issues continues due to fragmentation of treatment resources. In many counties, serious gaps in mental health care needlessly force children into further traumatizing situations and, in effect, worsen the current crisis even though their conditions could be de-escalated with more access to appropriate care.

San Francisco County is one of the few counties in California that has a continuum of crisis services and the ability to provide crisis services in child and family friendly settings. San Francisco County’s Comprehensive Crisis Services are able to provide assessment in a variety of locations including schools and homes. Edgewood’s contribution to the continuum of care includes the Crisis Stabilization Unit, Crisis Residential Program and the new Mobile Treatment Team all of which focus on keeping children near their community and providing alternatives to the preexisting emergency room and inpatient services. 

For these reasons, the commission visited San Francisco and Edgewood to learn more about the innovative services being provided. The visit included meetings with parents whose children have needed support from crisis services, a presentation by Edgewood leadership on the structure and continued need for this important reform, as well as additional meetings with county officials regarding program feasibility and components.  

In January, the advisory board will submit a formal summary and action-oriented policy to the commission.

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