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Top 30 Quality Measures

Availability of Crisis Response System Overall Rank: 16
A crisis response system (CRS) is available in each district and includes a plan for 24 hours, 7 days per week services.
Domain : Emergency Services
A hospital room or mobile crisis response unit equipped for the reception and treatment of persons requiring immediate medical care.
Additional Domain(s) : Accessibility, Patients with Acute Conditions
Rationale
The capacity to provide a crisis and emergency response is an integral part of a mental health services continuum of care.
A Crisis Response Service (CRS) links children, youth and adults in acute crises with the appropriate community resources and/or establishes an immediate communication link and supportive intervention for children, youth and adults experiencing critical or emergency mental health problems. This service provides appropriate, timely, and well coordinated responses to those persons in crisis. With their specialized training and experience, CRS personnel provide the necessary support and interventions to individuals and/or their significant others, and consultation to community providers, mental health staff, family practitioners, police, etc.
Within the mental health environment, crises manifest themselves in many ways, ranging from an acute occurrence of mental illnesses to the emotional consequences of the loss of housing and support networks. A crisis occurs when an individuals usual coping strategies are suddenly overwhelmed and the individual requires an immediate response.
Not all crises result in mental health emergencies. However, when an individuals coping strategies are so overwhelmed and there is potential for harm to self or others, or the individuals well-being is drastically threatened, an immediate emergency response is required. A CRS must have skilled professional staff who are able to differentiate between true emergencies which must be seen immediately in order to be treated and stabilized, and those crises which may be appropriately handled in other ways. The availability of experienced professional staff to respond to the first telephone or walk-in contacts made to the service is crucial to effective management and control of
the crisis. Critical information is gathered and important questions are asked which assists in the initial triage. It is also an opportunity for the CRS staff to inform referring agents about the individuals clinical presentation and about the services recommendations.
According to Best practices in Mental Health reform (1997), the range of functions provided by a CRS includes:
1) Stabilizing individuals in crisis in order to assist them to return to their pre-crisis level of functioning;
2) Assisting individuals and members of their natural support systems to resolve
situations that may have precipitated or contributed to the crisis; and,
3) Linking individuals with services and supports in the community in order to meet their ongoing community support needs.
4) Linking individuals to appropriate follow-up mental health care.
Primary Reference
Standards for Mental Health Services in Nova Scotia. (Feb 2003) Retrieved on July 31, 2006 from: http://www.gov.ns.ca/heal/downloads/Standards.pdf
Level of Evidence
III: Preliminary research evidence only or evidence based on consensus opinion only.

Summarized CommentsAdd Comment
  • The crisis response system should include mobile capability. This is not under the control of primary care.
Variation in Results
Ratings-based Rank
Relevance 4
Actionability 47
Overall Importance 4
 
Stakeholder Rank
Academics 10
Clinicians 18
Consumers 25
Decision Makers 13
 
Special Group Rank
First Nations 30
Rural Areas 6
Federal Stakeholders 13
Regional Rank
BC AB SK MB ON QC NB NS PE NL YT NT NU
30 4 70 3 15 11 27 9 98 41 62 11 16
 
Overall Rank

      

16


SA18b (H219)

 
Distribution of Survey Respondent Ratings
Relevance
100
90
80
70
60
50
40
30
20
10
0
0.54 0 0.72 0.86 0 0.71 2.75 23.68 70.74
1 2 3 4 5 6 7 8 9
Low High
Actionability
100
90
80
70
60
50
40
30
20
10
0
1.26 2.12 3.84 2.41 2.72 7.36 12.95 27.37 39.98
1 2 3 4 5 6 7 8 9
Low High
Overall Importance
100
90
80
70
60
50
40
30
20
10
0
0.78 6.48 92.74
3 2 1

3 = can live without
2 = nice to have
1 = indispensable

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The views expressed herein do not necessarily represent the official policies of Health Canada