The NIRS Report: CRSS

Tuesday, February 20, 2018

Institutionalization prevented for Kansans

February 20, 2018

Through a crisis intervention program for persons with intellectual disabilities and mental illness, institutionalization was prevented for 24 individuals in 33 crisis situations over the course of the 12-month period July 1, 2016 – June 30, 2017. In the past 5 years, the program has served 128 individuals. This is one person’s story.

Patti BlakeThree years ago, Patti Blake, coordinator of the Coordinated Resource Support Services (CRSS) program, met a boy who had a history of trouble. It was an unusual case because this boy seemed to understand the expectations, the rules, the boundaries set by the adults in his life. However, when one listened carefully it became apparent that this boy had better expressive than receptive language skills. He seemed to understand but he didn’t and these crossed signals caused a lot of misunderstandings in his life and a whole lot of trouble. When Patti met him, he had already “aged out” of the foster care system with no place to go and no family “safety net”. He was living in a homeless shelter with no income and unable to meet the job seeking activity requirement for all shelter residents, to fill out five job applications per day. A task that he might have been glad to do but he didn’t have the skills and thus no way to succeed. He was asked to leave. With no income and no prospects, he was once again homeless. His luck changed when Patti found him. She contacted his father; no help there. She tapped into her network of colleagues and found him emergency shelter with a mental health center in southeast Kansas. This young person was unprepared by the adults in his life to make his own way after school ended. He was not transitioned from school to work, and with his poor behavior and his lack of communication skills, his needs often were unmet. He suffered frostbite during his homeless time outside, everything he had was stolen, and he was left with nothing. With the help of CRSS and Patti Blake, the future looks bright for a boy who could not tie his own shoes and now receives day services through a local agency, lives in his own apartment, and is employed.

Sometimes a crisis happens because someone is being asked to do something they don’t want to do and have no choice in the matter and that simple lack of choice may be a behavioral trigger. Some people have more than one crisis a year. Other times the phone call is about someone who has been abandoned at a mental health center with nowhere to go and no means to get there. More recently, homelessness is more apt to be the most immediate issue; a tragic situation for persons without mental health issues, and one can only imagine what it’s like for someone with intellectual or developmental disabilities and mental illness. When the crisis has been resolved it is really the start of a support relationship with the CRSS team and doesn’t mean that services have stopped.

Patti talks about the job and says, “The main duties, as I see them, are to help individuals with intellectual disabilities/ developmental disabilities and who may have mental illness when they are in crisis situations and develop a plan that fits each individual to help them through a problem time. We have a great team to work with and I have met many service-oriented staff that I can rely on for assistance, for which I am very appreciative.”

Follow-up with individuals who have received CRSS services occurs regularly, sometimes it is just a drop-in visit, maybe just to get a coke, or have a chat. Patti visits the area CDDOs and mental health centers so that individuals are familiar with her. Then when she’s called in to assist with a crisis, that familiarity alleviates some of the stress and many times it helps, sometimes they remember her voice and that can de-escalate behavior.

Opportunities for choice, even if it’s only when to get up, what to wear, what to eat, where to go, etc., give some quality of life control to the individual with disabilities or mental health challenges. Budget constraints often mean less staff offering fewer choices and the results are more stress and predictably more problematic behaviors that keep Patti and her team busy. CRSS is the only organization like it in the state and offers 9 counties in southeast Kansas 24/7 crisis services. What that means is that there is always someone waiting for a call, even in the middle of the night, to offer the experience and skills necessary to help de-escalate a person in crisis. And Patti will go anywhere to help, even if it means spending the night in jail to help an individual cope because she says, “They become a part of you.” She feels safe “most of the time” and she has learned to ask the right questions when she gets that phone call asking for help. Sometimes she takes another person with her as she heads out to help an individual in crisis and her team has learned to “go with the flow.”

Some of her successes include the establishment of a Crisis House where she and/or members of her team can take an individual to calm down in a quiet, nonthreatening environment alleviating danger for all concerned. And she has a big goal: to ensure law enforcement personnel in each of the 9 counties become skilled in recognizing behavioral triggers and learning more ways to reduce the stress in a crisis situation with someone who has intellectual disabilities as well as a mental health diagnosis. She’s been the face, the voice, and the heart of the CRSS Crisis Team for exactly 7 years and the 9-county area is lucky she’s here.

More about the project: CRSS is designed to stabilize an individual who is in crisis with the goal of preventing the need for hospitalization or institutionalization. Additional outcomes include limiting the person’s contact with law enforcement or removal/eviction from their living situation. Following the initial crisis intervention, this program focuses on the development of recommendations related to the environmental, behavioral, psychological, and or systemic issues that may be contributing to the person’s difficulties.

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