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

2. 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

3. 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)

4. 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

5. 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: 414-257- 7260  You cannot refer directly to OBS, that is a medical determination

6. 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

7. 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 8am-midnight every day and 24 hours Sunday-Thursday  Just over 20 staff in total- but they cover all service areas  414-257-7222

8. Crisis Mobile Team- Specialties  One geriatric nurse who specifically responds to “gero mobiles”  8am-4:30pm 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  11am-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

9. 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 8am-9pm Monday-Friday; 8am-5pm on weekends and holidays

10. Access Clinic  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, 8am-4pm  804 W Greenfield Avenue, rear entrance; call 414-316-4156  Hours: Monday & Wednesday, 9am-3pm; Tuesday, Thursday, & Friday, 10am-2pm

11. 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.

12. 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

13. 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. 14th St. Milwaukee, WI 53204 Phone: 414-643-8778 Crisis Resource Center North 5409 W. Villard Ave. Milwaukee, WI 53218 Phone: 414-539-4024

14. Crisis Staffings  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

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