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Key Accomplishments of the Crisis Stabilization Unit

 

Description of the Crisis Stabilization Program:

The Edgewood Crisis Stabilization Unit (CSU) is a 24 hour unlocked, mental health specialty service designed to assess and stabilize youth ages 5-17 experiencing acute psychiatric symptoms or a mental health crisis.  The CSU also functions as the San Francisco Receiving Center (Welfare and Institutions Code 5151) for youth who are placed on a WIC 5150/5585 hold in San Francisco County.  A centralized WIC 5150/5585 Receiving Center and CSU ensures that youth with mental health disorders and experiencing mental health crisis are not unnecessarily hospitalized and that they will receive services in the least restrictive level of care to prevent and mitigate long-term disability. If, after assessment, the youth’s WIC 5585 is upheld the client is transferred to a 72 hour LPS (Lanternman Petris Short) facility for further evaluation and treatment.  If the WIC 5585 is not upheld, the client is diverted from hospitalization and connected to community resources. 

Edgewood’s CSU’s primary focus:

  • Crisis intervention
  • Ongoing assessment, up to 23 hours
  • Crisis Stabilization
  • Safety Planning
  • Aftercare and Discharge Planning

Upon discharge, youth and their caregivers are referred to their health network providers and/or other appropriate specialized community providers for follow-up services. If during assessment and after thorough discussion with the CSU clinical team it is apparent that the client could benefit from a higher level of care, a referral could then be made to Edgewood’s Acute Intensive Services (AIS).  Because Edgewood’s AIS are located on the same campus as the CSU, the clients in need benefit from minimal disruption in continued stabilization and a seamless continuum of care. 

Each CSU team is comprised of clinicians, counselors, nurses, a parent partner and clinical administrators, with an available psychiatrist 24 hours a day. 

CSU services include:

  • Comprehensive mental health evaluation and risk assessment
  • Medical screening
  • Collaborative treatment planning with an individualized strength-based focus
  • Meeting with family to gather collateral information
  • Crisis Stabilization and prevention
  • Discharge planning including linkage with community supports and services
  • Connection with youth’s school to support re-entry process
  • Providing therapeutic interventions and activities
  • Building coping skills and safety planning
  • Parent and guardian support and education together with a Parent Partner

Demographics Served:

  • Over 2,090 youth were assessed by our Crisis Stabilization Unit (CSU) since 2014.
  • The Edgewood CSU is serving culturally diverse populations in San Francisco including Latino/a (28%), African American (17%), and Asian/ Pacific Islander (17%) clients.

    In comparison to the 2010 census data for San Francisco, the CSU is serving the Latino/a population close to more than twice as much as their representation in the census data (15%) and close to thrice as much for African Americans (6%).

Hospitalization Decrease

Prior to the Edgewood CSU opening, SF DPH Child Crisis hospitalization rate was 27.48%.  Since the CSU has opened, that rate has decreased to only 12% of youth requiring hospitalization, meaning that 88% of the clients that have come to the CSU have stabilized and have not had to go to inpatient hospitalization.

  • Overall, since 2014 when the Edgewood CSU opened, there has been a decrease in the inpatient hospitalization rate for the youth in the San Francisco community by well over 50%.

Connection to Acute Intensive Services (AIS) and other city wide services:

Aside from the thorough assessment work that is done with the youth while on the unit, the CSU team takes great care to connect the youth and family to much needed resources that may be needed upon discharge.  If the youth is already connected to services, the team will connect with those providers, etc and do whatever is necessary to make sure they are fully updated and support the continued expedited care. If the youth is not yet connected to services, the team will make efforts to connect the youth and family to needed services. Our Parent Partner has even been able to work with families after discharge to ensure that the support continues.  As mentioned prior, if during assessment and after thorough discussion with the CSU clinical team it is apparent that the client could benefit from a higher level of care, a referral could then be made to Edgewood’s Acute Intensive Services (AIS).  A few key points about the CSU’s connection with Edgewood’s AIS:

  • Roughly 36% of the 472 clients served by CSU last year were referred and admitted to our Acute Intensive Services programs.
  • More than half (55%) of the 864 youth treated in our Acute Intensive Services last year were assessed by the CSU.
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