Our Crisis Resolution Intensive Support Service (CRISS) launched in March 2019.
It supports adults (usually aged 18-65) experiencing a mental health crisis with intensive home-based treatment as a genuine alternative to hospital admission.
It also supports older people in crisis outside of normal working hours. CRISS operates 24 hours a day, 7 days a week, 365 days a year.
The aims of CRISS are to:
To prevent where possible, admissions and readmissions to inpatient care
To support urgent assessments and intensive support for adults (aged 18-65) over a 24 hour working period, and overnight only for older people usually aged over 65 years.
Provide initial contact with a person within four hours of referral and assess them face-to-face within 24 hours
Provide a service for people with complex, acute mental health needs, who may be in crisis and can be safely supported in the community. The service will be sensitive to diversity and respond to service user and carers considering their disability, gender, sexuality, ethnicity and cultural background.
Focus on supporting people’s recovery helping to improve personal independence.
Work closely with health and social care partners and third sector agencies, ensuring people’s needs are planned for in a coordinated way.
Follow the principles outlined in the Care Programme Approach (CPA), including joint working between community and inpatient mental health teams and provision of enhanced support and interventions.
Provide urgent advice to service users, carers, families and professionals across the whole system which may involve signposting and liaison.
If you are experiencing a mental health crisis we will identify a key professional for you.
If you are already receiving support from our Community Mental Health Service, we will provide additional intensive support alongside your care coordinator to ensure we plan and deliver effective joined up care.
Our clinicians will aim to see everyone who requires an urgent assessment within 24 hours, unless the person chooses otherwise. The assessment team will be two qualified staff with one being a senior practitioner. Following the completion of the initial assessment, CRISS clinicians will put together an immediate care plan.
We’ll provide documented service information including how to get feedback and contact details to all service users and carers involved in the initial assessment.
For service users with a specific communication need, we’ll provide support using language interpreters, either in person or through phone or video conference. For these service users, we’ll provide a written treatment plan in their primary language, identifying which therapies will be provided within three days.
CRISS health workers may arrange a joint assessment with other partners who are already involved in a person’s care.
Care planning and formulation
Formulation means bringing together lots of different types of information about a person and their situation to understand problems and develop a care plan. It is a useful way of developing a shared understanding of what people are struggling with, and helps us put plans in place for the most appropriate types of care and therapy for a person at that time.
Formulation will begin when we first assess somebody. It is a fluid process which is intended to be reviewed and developed as more information is obtained during the assessment phase.
Once initial assessment is completed, we’ll work out what we think is causing problems and what plans, therapies and other interventions we think will work best.
As people in crisis often have complex needs and may be experiencing chaotic situations, it’s not always possible to obtain all the information at once.
Our interventions – what kinds of things we can do to help
Here are a few examples of the things we can do to help people experiencing a mental health crisis:
Practical help with issues which have either triggered the crisis, or are impacting on the person’s illness, such as help with benefits, housing and meaningful day time activities
Support for carers and family members to relieve stress
Medical assessment, treatment, education and monitoring – which could include working with a person’s GP and reviewing medication
Specific psychological therapies can be provided that fit within a short time frame; such as anxiety management and mindfulness
Supporting self-management, independence and coping strategies, whilst promoting choice and self-determination
Relapse prevention, including recognising symptoms and managing early warning signs of relapse
Health education and promotion, including support with alcohol and illicit substance misuse via harm reduction workers
Reducing social isolation by helping people access local community support
Assessment of risk and development of risk management and safety plans
If your health professional has given you a direct contact in times of crisis, please continue to use that contact.
We recommend the following places where you can find helpful and reliable information with links to further help and support.
MindWell is the single ‘go to’ website for information about mental health in Leeds. It includes advice on practical help with things like housing, benefits or money problems.
MindMate website for younger people
MindMate is a Leeds-based website for younger people, their families and the professionals who support them. It covers emotional wellbeing and mental health issues and offers information about where support is available.
The Leeds Crisis Card: “Feel like you’ve had enough?”
The national NHS website (formerly known as NHS Choices) is the official website of the National Health Service in England. It provides a comprehensive health information service helping you to make the best choices about your health and lifestyle, but also about making the most of NHS and social care services in England.
NHS 111 service
You can call the NHS 111 service 24 hours a day, 365 days a year, if:
you need medical help fast but it’s not a 999 emergency
you think you need to go to A&E or need another NHS urgent care service
you don’t know who to call or you don’t have a GP to call
you need health information or reassurance about what to do next
For less urgent health needs, you should contact your GP or a local pharmacist in the usual way. For immediate, life-threatening emergencies, always call 999.
Please note this is not comprehensive list of services but a few suggestions of how to get started finding help and information.
External access will tend to come from GPs, Aspire, Yorkshire Ambulance Service, Adult Social Care (especially AMHP provision), third sector organisations and self or carer referral.
For LYPFT services this will include locality CMHTs, ALPS, Assertive Outreach Team, LYPFT Specialist services, Inpatient services and Primary Care Mental Health Liaison Practitioners.
Access to the intensive support element will come through CRISS.
Appropriate referrals / criteria
Appropriate referrals include:
Service users with acute mental health need who require a period of intensive support in the community, aiming to prevent hospital admission or facilitate timely transfer from a hospital setting.
Service users who fit the referral criteria for the OPS service outside of IHTT operational hours.
The service user’s mental health needs can safely and effectively managed within a community setting.
The service user is usually registered with a Leeds GP or resident in Leeds, however if there is a request to accept a service-user outside of this, it must be discussed with a CTM or senior medical colleague.
Access will be provided according to need, vulnerability and risk.
Service users who may be under a neighbouring mental health team but are living in LYPFT catchment areas and may be more suitable for our services to provide home based treatment.
Return to Referrer of inappropriate referrals or signposting to other services
If following a crisis assessment a referral does not require ongoing CRISS support this will be communicated to the service user and the referrer via letter, and recorded on the Trust’s electronic patient record system.
Access to CRISS for service users and carers currently under secondary mental health services
There are instances when a service-user or carer may contact CRISS which include:
Service users previously known to LYPFT services that may not require a full assessment, but may benefit from a ‘one off intervention’ as indicated in their safety plan. Following this contact it is likely they can be signposted to alternatives for crisis support or existing support as part of their care package.
Service users currently under LYPFT services and receiving care from the Intensive Support Service or CMHT for additional support out of working hours. During operational hours these service-users and carers will be directed straight to their CMHT or Intensive Support Service and CRISS will highlight this contact to the relevant teams.