Ensuring Access to Crisis Services During COVID-19

Abstract

This article discusses the access to crisis services during COVID-19 Behavioral health crisis services provide an effective alternative to emergency departments (EDs), hospitals, and jails for patients with mental health and substance use emergencies This alternative is especially important during a pandemic, when EDs are overwhelmed Connections Health Solutions operates crisis centers in Arizona and is recognized as a national model Many patients arrive via law enforcement Common presentations include danger to self or other, psychosis, agitation, and intoxication or withdrawal Patients who might otherwise be arrested or board in EDs are instead stabilized in the 23-hour observation units With rapid assessment, early intervention, and proactive discharge planning, most patients return to the community without hospitalization The crisis setting poses unique challenges not addressed by existing COVID-19 guidelines The observation units are open spaces that facilitate line-of-sight visualization and social interactions rather than isolation and quarantine Impaired patients have difficulty adhering to masking and social distancing protocols Contact tracing suggests staff-to-staff or community transmission Staff infection rates have been similar to those in the general population in Arizona This approach identifies infected asymptomatic staff who would not otherwise be isolated and provides peace of mind to symptomatic staff or staff exposed to the virus who turned out to be uninfected (PsycInfo Database Record (c) 2021 APA, all rights reserved)