Did you know that the Joint Commission has standards that support the provision of high-quality crisis services in both Hospital and Behavioral Health settings? In fact, the Joint Commission has had these standards for years. However, these standards have never been as important as they are now and here is why.

The 988 Suicide and Crisis Lifeline

In times of crisis, access to immediate and effective support can be a matter of life and death. The 988 suicide and crisis lifeline is a three-digit number that individuals can call to reach a trained crisis counselor 24/7. It is the national emergency number for mental health and suicide prevention.

By dialing 988, individuals will be connected to their local crisis call center where they will either receive:

• Immediate support, or
• Get redirected to the crisis services continuum of care

The continuum of care encompasses a range of interventions and supports available to individuals experiencing mental health crises. With the advent of the 988 crisis line, this continuum of care is becoming more seamless and effective.

The Joint Commission Supports High Quality Crisis Services

The crisis services continuum of care encompasses a range of interventions and supports available to individuals experiencing mental health crises. The Joint Commission has standards in both the Hospitals and Behavioral Health Care Manuals. These standards provide a framework for high quality crisis services throughout the continuum of care including care, treatment and services provided in:

• Crisis Call Centers
• Mobile Crisis Teams
• Crisis Stabilization Center
• Inpatient and Outpatient Crisis Centers
• Peer Support Networks

Joint Commission Standards for Crisis Services

The Joint Commission Care, Treatment, and Services (CTS) standards emphasize the importance of conducting a comprehensive assessment of individuals in crisis, including a thorough evaluation of their mental health needs, risks, and strengths. Next, organizations must develop and implement an individualized crisis treatment plan based on the assessment findings. The standards emphasize the need for coordinated and integrated care, considering the unique needs of each person. Further, the CTS standards highlight the importance of providing evidence-based interventions and services that are appropriate for crisis situations; emphasizing the use of best practices and the integration of research findings into clinical practice.

Environment of Care Standards

The TJC Environment of Care (EC) Standards focus on ensuring a safe and therapeutic environment for individuals in crisis; addressing important safety measures for the individuals served and the crisis staff such as environmental risk assessments, security protocols, and response to aggressive or violent behavior. Infection Prevention and Control (IC) standards address actions necessary to reduce the risk of infection, while Rights and Responsibilities (RC) standards ensure the protection of patient privacy.

Human Resources Standards

The Joint Commission’s Human Resources (HR) Standards focus on the qualifications and competence of staff providing crisis services; emphasizing the importance of appropriate training, education, and experience for crisis counselors, mental health professionals, and other staff involved in crisis response. Further, Human Resource (HR) standards address the need for a staffing plan that ensures adequate coverage and availability of trained personnel to respond to crisis situations promptly. They also emphasize the importance of ongoing staff education and training.

Joint Commission Performance Improvement Standards

Finally, TJC Performance Improvement (PI) standards focus on the establishment of a performance improvement program that monitors, evaluates, and improves the quality and safety of crisis services. These standards emphasize the need for data collection, analysis, and action plans to drive continuous improvement. But that is not all, PI standards highlight the importance of using performance data to identify opportunities for improvement in crisis services. They encourage organizations to use data-driven decision-making to enhance patient outcomes and optimize the delivery of care.

These Joint Commission standards, among others, help guide healthcare organizations providing crisis services in delivering high-quality, safe, and effective care. Adhering to these standards ensures that crisis services are evidence-based, patient-centered, and continuously monitored and improved to meet the needs of individuals in crisis.

Additional Crisis Services Resources

The Substance Abuse and Mental Health Services Administration (SAMHSA) has crisis care standards. Additionally, Mental Health First Aid (MHFA) provides education and training resources. Also, the Crisis Intervention Team (CIT) and the Assisting Individuals in Crisis (AIC) are crisis intervention models.

Crisis Hotline Services like the National Suicide Prevention Lifeline (1-800-273-TALK) and Crisis Text Line (text HOME to 741741) provide guidance, training materials, and opportunities for partnership or consultation. Professional organizations such as the American Association of Suicidology (AAS) and the International Critical Incident Stress Foundation (ICISF) offer conferences, webinars, publications, and networking opportunities.

In addition, explore technology and digital solutions such as telepsychiatry platforms, mobile apps or digital platforms for remote crisis counseling. Finally, do not forget to incorporate your patient perspectives to improve the delivery and responsiveness of crisis care.

Implications for your Joint Commission Survey

Prepare materials to orient the Joint Commission survey team to your continuum of crisis services. Provide marketing materials, patient handbooks, policies and procedures, admission eligibility criteria, and other relevant information that will highlight the crisis services you provide. Be ready for individual tracer activities that will follow the course of crisis care experienced by the individuals you serve. This includes observing your:

• Crisis care access services
• Mobile crisis team
• Inpatient and outpatient crisis stabilization services
• Coordination and integration of care with your healthcare partners
• Transitioning individuals within your continuum of care and to outside providers

Further, crisis services will be incorporated into the System Tracers including the:

• Environment of Care
• Information Management
• Medication Management
• Infection Prevention and Control
• Data Management and Use
• Human Resources including Competence Assessment

In addition, do not forget the importance of the Record of Care, Performance Improvement, National Patient Safety Goals, and Rights and Responsibilities standards in the evaluation of crisis services.

Barrins & Associates Consultation

We’ve incorporated the crisis services continuum of care into our Mock Survey and Continuous Readiness Consultations. We continue to be your partner in achieving and sustaining Joint Commission Accreditation and regulatory compliance.