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DHS COVID-19 PROVIDER GUIDANCE // ODP

ODP Announcement 20-035:
Guidance for Preventing and Responding
to Behavioral Crises

Issued: April 2, 2020

Audience

Behavioral Specialists, Supports Coordination Organizations (SCOs), and other providers

Purpose

During this time of uncertainty that can be challenging for individuals and supporters, we are providing guidance to Behavioral Specialists, Supports Coordination Organizations (SCOs), and other providers about diverting and responding to potential crisis situations. Here are some strategies that can be implemented, but remember, the key to effective supports during this time is flexibility in meeting the individual needs of the people we support. 

The guidance is broken down into two sections. The first is for Behavioral Specialists. The second is for non-Behavioral Specialist Providers and SCOs.

Discussion

Guidance to Behavioral Specialists 

    1. Review Plans: Given that many individual's schedules and routines have changed, it is important to review Behavioral Support Plans (BSP) and Crisis Intervention Plans (CIP) or crisis strategies to ensure that the plans are capturing the individual's most recent situations and circumstances. For example, are there additional strategies that need to be considered to proactively assist the individual to navigate their day (e.g., visual schedule, exposure to new at home activities)? Please update the plans, as appropriate. Also, since our current situation is unprecedented, a temporary plan may supersede the current BSP and CIP in an effort to prioritize health and safety to get through this pandemic.
    2. Capitalize on Natural Supports: It is a good time to reassess who is currently in the individual's life who can provide a source of mental, emotional, and physical support, as needed. Once identified, it would be helpful to reach out to these persons to review the BSP and CIP to ensure they are versed in the supports, strategies and interventions identified as helpful. Training and connecting with natural supports and supporters is an essential part of your job during this time. 
    3. Proactive Outreach: It would be helpful to identify individuals that have a tendency for a heightened response to change, transitions, not being able to engage in preferred activities, etc. Providing periodic wellness check-ins with these individuals in an effort to proactively assess and identify needs for additional on site or remote supports is important. Also, check-ins with supporters is important to ensure that they feel confident and competent in providing the day to day support. These check-ins can be done via technologies like Skype, FaceTime, and Google Duo. Note that the Substance Abuse and Mental Health Services Administration (SAMHSA) has outlined typical reactions that we all may face during times like these. It is important to remind each other that, no matter our mental health status, anxiety, worry and fear are normal reactions to this emergency. Many of the individuals we support may need some help understanding when they need to reach out for help to deal with these responses. The attached SAMHSA documents help to explain typical reactions as well as when and how to reach out for help and may be a helpful resource to assess someone’s needs.
    4. Communicate and Manage On Call Supports: There is the potential for crisis during this time for anyone. Providing a means for supporters to reach out to receive assistance, particularly during times of crisis, is important. It is important to remind supporters that reaching out when an individual is in the midst of crisis is not as productive or helpful. This emphasizes the importance of identifying the behaviors that are typical for an individual during periods of escalation as this is the point in which supporters should reach out to BS for additional support, if needed. It is equally important to communicate with supporters to reach out to the BS after a crisis (when the individual has de-escalated) to debrief on what worked and did not work during the crisis, for future reference. 

If you have any questions related to this email or requests for additional resources, please email us
at RA-basprovidersupprt@pa.gov