Crisis Intervention
 In Marion County, the Marion Area Counseling Center, through a contract with the Crawford-Marion Board of Alcohol, Drug Addiction and Mental Health Services (ADAMH Board), provides emergency evaluations for psychiatric conditions that present as imminently dangerous to residents or persons within the county. The same services are provided in Crawford County by Community Counseling Services. In this context, crisis intervention means an evaluation of a person exhibiting acute psychiatric symptoms or suicidality. Trained masters degree therapists are on call to respond in emergency situations 24-hours per day. After regular office hours, on weekends and holidays all persons requiring face to face crisis evaluation will be assessed at Marion General Hospital Emergency Room.
A crisis situation is one in which the individual presents as, or is suspected of being in crisis. An imminent danger indicates that there is both a plan and a means to implement the intended plan, with an intention to follow through with the plan in the immediate future. Crisis workers are trained to evaluate an individual's commitment to do harm and will intervene as required. The mental health system is dedicated to the philosophy that persons are best served in the community where they live, rather than placed in an institutionalized environment.
This means that hospitalization, which is the most restrictive form of treatment, is used on a very limited basis. Some persons exhibit symptoms or are having difficulty related to cognitive problems other than mental illness. A variety of conditions would not be appropriate for psychiatric hospitalization. Persons under the influence of drugs and/or alcohol may not have symptoms upon clearing from the influence.
In addition, mental health units will not accept individuals under the influence of drugs and/or alcohol because, once they are no longer under the influence, their emotional and mental status changes significantly. In the vast majority of these cases, the person no longer demonstrates dangerous thoughts and behavior. Confusion from Alzheimer's Disease or behavioral problems with a teenager is often inappropriate also. Crisis workers will make effort at the time of intervention to make alternative referrals in such situations.
Often times, the mental health professional will begin the assessment by reviewing the case with the doctor on call, as well as looking at the patients chart. After meeting with the patient, the assessment begins. The process of assessment includes completion of an assessment form that is uniformly used within the county as well as many other areas in the State of Ohio. This includes:
Presenting problem
Mental status examination
Past attempts to harm self or others
Current risk of harm to self
Current risk of harm to others
Current medications
Mental health treatment history
Alcohol and drug history
Alcohol and other drug treatment history
Clients strengths/support system
Much of the assessment is dependent upon the client/patient being forthcoming with information about their current situation and history. If the patient has private health insurance, the on call therapist must work through the insurance carrier with regard to the disposition of the case.
If the therapist believes the patient is appropriate for hospitalization and the doctor on call agrees, they then begin the process of looking for an available bed. Access to psychiatric beds in the Central Ohio area has decreased by 35% in the past three years. If the patient does not meet the specific criteria for hospitalization, the mental health professional will work with them on an action plan with specific follow up for treatment.
At times, involuntary hospitalization becomes necessary. In Ohio, the laws governing involuntary hospitalization fall under Ohio Revised Code 5122.01. This requires meeting the following criteria:
Represents a substantial risk of physical harm to him/her self as manifested by evidence of threats of, or attempts at, suicide or serious self-inflicted bodily harm;
Represents a substantial risk of physical harm to others as manifested by evidence of recent homicidal or other violent behavior, evidence of present dangerousness;
Represents a substantial and immediate risk of serious physical impairment or injury to himself as manifested by evidence that he/she is unable to provide for and is not providing for his basic physical needs because of his/her mental illness and that appropriate provision of such needs cannot be made immediately available in the community or;
Would benefit from treatment in a hospital for his/her mental illness and is in need of such treatment as manifested by evidence of behavior that creates a grave and imminent risk to substantial rights of others or him/her self.
For the courts to take the serious step of depriving someone of his civil liberties, there must be clear and convincing evidence of the above criteria. This can be frustrating to family members or professionals working with the client in that a person may really be in need of treatment but be unable to meet all legal criteria for commitment. The Ohio Revised Code protects the basic liberties and freedom of all citizens, and thus the courts have made the grounds for involuntary hospitalization as narrow and strict as possible.
Families can initiate the process for probate of a person deemed to be mentally ill by filing an affidavit with the local Probate Court. If the court finds there is probable cause, they will issue a Temporary Order of Detention, ordering a member of law enforcement to take the person into custody and transport them to a hospital or the mental health agency for an assessment.
Once the affidavit is filed with the probate court, an attorney will be assigned to represent the individual alleged to have a serious brain disorder and in need of hospitalization. The court will then notify all parties of a hearing in connection with the affidavit. At the hearing, the results of an independent psychiatric evaluation are admitted into court and testimony will be provided by individuals, including family members and mental health professionals, with first hand knowledge. The court will make the decision to either continue the commitment at a treatment facility not to exceed 90 days or immediately discharge the patient.
|
|
 Marion/Crawford ADAMH Annual Report
Our Mission Statement
The mission of the Crawford-Marion ADAMH Board, under local leadership, is to assure the availability
of high quality alcohol, drug addiction, and mental health services to all residents through planning
(assessing needs and resources, and determining priorities); purchasing cost effective services
to the extent resources are available; coordinating services; and evaluating
these services.
Vision Statement
We envision communities where recovery is possible, resiliency is innate, communities are supportive,
stigma is eliminated and resources are plentiful.
Our Purpose
Giving hope. Providing treatment. Teaching independence. Gaining peace of mind.
That's the driving force behind the Crawford-Marion Board of Alcohol, Drug Addiction & Mental
Health Services (ADAMH), responsible for monitoring, evaluating and planning all publicly funded
mental health and substance abuse treatment needs for Crawford and Marion County residents.
Clients range in age from pre-schoolers and teens to older adults. Many rely on some form of
public assistance, while others are steadily employed. Some are suffering from a neuro-biological
disorder (formerly referred to as a "mental illness"), while others suffer from dependence on
alcohol or other drugs.
Our network of critical support services strives to provide a unified system of treatment and
follow-up care so those served don't "fall through the cracks." It is our goal to actively protect
and maintain the dignity and individual liberty of those we serve, while helping them become
healthy, active members in our community.
The Crawford-Marion ADAMH Board encourages the development of comprehensive, yet cost-effective,
mental health and substance abuse services in our area, and works to ensure that these services
meet the highest standards of care. |
|
