Director of crisis respite services at Elmcrest Children’s Center talks about a new program for children in crisis
By Mary Beth Roach
Q: Is this new initiative a respite program or a center?
A: We refer to it in a couple of different ways. We currently operate two six-bed crisis respite programs. All of the crisis programs that we operate currently and will operate in the future will sort of be considered a part of a crisis respite center. It started actually before my current time at Elmcrest. My history with the agency is that I worked here from 2013 to 2015 in a long-term residential program, worked elsewhere, and came back last July specifically to do this. But my understanding is that this conversation was in the talks for months and perhaps years before I returned in the summer of 2022.
In terms of opening our doors, that was on March 28 of 2023, but we began program development and construction probably last summer.
Q: What prompted the creation of the center?
A: We were seeing this real gap in care and level of care between what could be provided with families in their home and in community-based settings and what would prompt an admission to one of our local hospitals. There’s a really wide gap. Anecdotally, as a supervising therapist over the last few years, I had been consulted with on a number of occasions about a child who was in a crisis and my recommendation would have to be to the therapist that they should direct the family to the hospital, but that the child would, in all likelihood, not be admitted to the hospital because only the most severe situations and circumstances prompt hospital admission. That is the level of strain that is on the local emergency departments, particularly those that serve psychiatric needs in youth.
Q: Can you briefly explain how this center operates?
A: We operate with a short-term focus on meeting the mental health needs of young people aged 5 to 18. They can come and stay with us for up to 21 days and during the length of their stay, they are provided with an array of mental health services on site with our therapist, with our contract psychiatrists, with the rest of our paraprofessional team that oversees their safety and mental health treatment while they’re here. And we try to maintain as much connection to the home community as we can. We bring kids to their regular school. We ensure that if they have an existing therapist or doctor’s appointment that we get them to those appointments as well. They do not have to stop seeing any of their existing providers when they come to stay with us. We actually really want those relationships to continue. We also transport kids to extracurricular and recreation activities that they already have set up in the community. It’s a really important part of their treatment and not disrupting any more of their life than is absolutely necessary. If a teenager has a job, we can bring them to and from work. They’re essentially living here. They’re getting their meals here, they’re sleeping here, they’re having recreation and homework time here. They’re basically living at Elmcrest for 21 days at a time.
Q: How many youth can you serve at a time?
A: We have 12 beds currently, but we are hoping to expand because we are already seeing that the need in the community far exceeds what we can provide. We’re seeing that we need more, and we’re already hard at work preparing for that next stage for our crisis respite center development.
Q: What kind of crisis or crises might bring a child to the center?
A: It’s really a wide range. Just about any kind of mental health-related crisis or mental health area that you can think of — anxiety, depression, panic attacks, aggression, self-harm, eating disorders, trauma or even something that would not have a diagnosis to it, but a challenging life experience that’s happening. Perhaps the child has moved to the area recently and they’re really struggling with the adjustment. Or perhaps the parents have just shared that they’re going to be separating and the child is really having a hard time with that life change. We can also be helpful in those types of situations, too.
Q: How do you — or will you — measure the success of your programs?
A: We have a range of clinical tools that we use. We administer those three, six, nine and 12 months after somebody has completed their stay with us. Now, because of the recentness of our opening date compared to our interview date, we don’t have any of those completed yet, but we are also going to be using patient satisfaction surveys, as well, to try to get the impressions of the youth and the family who we’ve served. One of the most important markers for success is ‘Did that young person need to utilize the area hospitals in the immediate aftermath of their stay at the crisis respite?’ Our hope is to disrupt the cycle of hospitalization that can occur for young people experiencing a psychological crisis.
Q: How does the referral process work?
A: All of the information can be found on elmcrest.org. But there’re two avenues to being referred. Anyone can complete the referral process. It can be a therapist or a doctor, a teacher, a coach, the parent.
Q: You referred to your plans for future expansion? Do you have anything concrete or is it still in the talking stages?
A: I’ve got a couple of different ideas for expansion of you know this is all planning stage. A lot can change, but I know we’re hoping to expand the number of beds that are on Elmcrest’s campus in Syracuse for crisis respite programming. We’re also recognizing already that there’s a need in some different geographic areas. We’ve already had youth come and stay with us from Oswego County, Cortland County, Oneida County. Those seem like logical next steps as far as other locations where a program like this might be needed.
Q: Is there anything you’d like to add?
A: The only thing that I would add is that it is paid for through the young person’s health insurance coverage, whether that be Medicaid or private insurance. In that way, we have an open door to just about anybody, but we do encourage the adults to check in with the insurance provider about what out-of-pocket costs might be before the stay begins.