As leaders in the behavioral health crisis care space, we often are asked, “What defines a crisis?”. At Connections, we believe a behavioral health crisis is determined by the individual. We describe it as an emergent situation where an individual finds themselves unable to cope with their thoughts, emotions, or circumstances. A failure to resolve such a situation could potentially endanger oneself or others. Common indicators of a crisis include struggling with suicidal thoughts, substance misuse, anxiety, psychosis, or social issues.

Although there is no widely accepted definition of a behavioral health crisis, the modern trend is to accept that it is a highly subjective experience and may manifest differently from person to person. Definitions that focus on risk of harm or other objective factors could potentially exclude individuals whose crisis may not meet defined criteria.

According to Connections quality and clinical innovation officer, Dr. Margie Balfour, “the term ‘crisis’ itself possibly perpetuates the stigma and disparities attached to mental health. Why use separate terminology to distinguish mental health and substance use emergencies from other types of health emergencies? Does this distinction make it easier to accept a lesser standard of care for behavioral health emergencies?”

By using behavioral health crisis interchangeably with behavioral health emergency, and inclusive of both mental health and substance use-related emergencies, we can instead focus on the solution for crises, which is crisis care services.

Because crisis services are typically funded and regulated at the state or local level, there is substantial regional variation in terms of program definitions, financing, licensure, accessibility, and quality. Variation can result in unnecessary utilization of costly resources (hospitals EDs or jails) or a misalignment of the individual's needs to the available treatment intensity.

Comprehensive national standards are needed to ensure access, quality, and consistency of care for individuals in crisis, regardless of their geographic location. With efforts like the implementation of 988 and wide acceptance of the Crisis Roadmap underway, progress is being made which will ultimately result in better outcomes for all.