Referrals come to COAST via the COAST crisis line (1800-263-4944) or a “COAST Alert” from an agency
The crisis line is 24/7 and other social and mental health agencies as well as the ER’s have been educated on how to utilize a COAST Alert.
Alerts are sent to COAST to provide collateral information
Alerts provide COAST staff with information about the crisis and the recommended intervention (i.e. mobile visit, telephone support or as and FYI)
Initial data is collected to determine the nature of the call or Alert, location, who is calling and a brief history of the event is explored It is determined if the crisis is imminent
If imminent COAST or the person calling is advised to call 911 or take the individual to the nearest emergency
If it is not imminent and it is a mental health or addiction issue the
COAST staff will explore the nature of the presenting problem and collect additional data related to risk, the crisis intervention depends on the presenting issue
Often the crisis intervention can be managed over the telephone building a crisis plan and providing additional support as indicated
Referrals may be made to other services
Mobile intervention is often necessary and this can be provided in the community depending on COAST resources, at that time.
Once assessed a plan and disposition is determined.
This may mean hospitalization at a Schedule 1 facility if hospitalization is required for mental health inpatient treatment.
Or a referral back to the referral source, or a referral to another appropriate service or the crisis is resolved
If a crisis plan is on file the COAST staff will utilize the crisis plan to facilitate crisis intervention
Once the mental health assessment is completed a copy of the report can be sent to the referring agency, GP etc. with the clients consent
The follow-up depends on the outcome of the assessment
COAST may follow-up by providing telephone support post crisis for a couple of days or request the client or service provider to check in with COAST post intervention to determine the stability post crisis
COAST does not provide ongoing support, if this is required COAST will refer client to another agency.
3. Post Crisis:
a. Developmental, Addiction and Mental Health Services agencies will complete a
statistical information report (Crisis Response Follow-Up Forms) in each situation where individuals utilize emergency services and provide notification to the Facilitator of the Southern Network of Specialized Care of the situation without providing identifying information.
b. The Facilitator for the Southern Network of Specialized Carewill use the above information to create statistical information regarding the usage of Emergency Services and the effectiveness of the Crisis Plans and Protocol.
c. Should there be a need for services from the Developmental Sector for the individual; COAST or Community Crisis Care will call Developmental Services Ontario (DSO). With consent, Community Crisis Care is able to initiate the referral to the DSO where this is the preferred option. The DSO is the single access point agency for Ministry of
Community and Social Services funded services for children and adults with
developmental disabilities. Adults (18+years) requesting developmental services must have a confirmed developmental disability. Following the intake process and need prioritization and with appropriate consent, DSO staff will make the required referrals. The local case resolution table is responsible for the Resolution Process.
Should there be a need for ongoing services from the mental health sector for the
individual; Community Crisis Care will call the appropriate service provider to make the referral, with consent.
d. If there are issues with the effectiveness of the Crisis Plan, these issues should be addressed with the case manager who will reconvene the individual’s support team to revise the Crisis Plan as needed.
e. Gaps in service will be brought to the attention of the Local Service Dual Diagnosis Network or the NSDN.
f. Where situations were not resolved to the satisfaction of any party who is part of this protocol, they should address their concerns directly to the proper agency and/or follow the complaint mechanisms of their agency.
4. Review
a. Southern Network of Specialized Care
The Facilitator for the Southern Network of Specialized Care will collect all reviewed Crisis Response Follow up Forms, on behal of the NSDN, and provide annual statistical reports to the Niagara Service Delivery Network, the Mental Health and Addiction Network and the Developmental Service System Tables, as necessary.
b. Agencies will be asked to review the protocol each year and re-commit to participation for the coming year.
c. Any signatory to the protocol may request that the protocol be reviewed and/or amended at any time. Should this request be made, the Niagara Service Delivery Network will meet to review and amend this protocol.
Please Note: Agencies that sign this agreement are committing to following this guideline as written.
Print Name Signature Position Agency/
CRISIS PLAN
Niagara Community Crisis Protocol
Date: DOB:
Name: Emergency Contact/Substitute Decision
Maker/Guardian: (name and number below)
Address:
Client Tel #: Contact #:
Psychiatrist: Contact #:
Family Physician: Contact #:
Lead agency/Case manager Contact #: Known Diagnoses (medical and
psychiatric):
List Stressors or Triggers:
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ What would you NOT find helpful during a crisis?
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
LEVEL 1 (BEGINNING ESCALATION PHASE or STRESS PHASE/Early Warning Signs)
What do you feel when you are stressed?