Adult Mental Health Crisis Response in Ambulatory Settings: A Quality Improvement Project

BACKGROUND: Six non-psychiatric ambulatory practice sites in Centre County, Pennsylvania were experiencing an increased number of patients presenting in mental health crisis. Providers and staff were unaware of available services and current processes; they verbalized a lack of confidence in the management and disposition of such patients. Delays in the county crisis response contributed to the inappropriate and undermanaged assessment, intervention, and disposition of this population. Leadership sought to improve the adult-specific mental health crisis response through the sustainable integration of existing ambulatory resources. INTERVENTION: A Mental Health First Aid (MHFA) program was implemented guided by Kolb’s Experiential Learning Theory (ELT). Components included 1) the formation of a crisis resolution team (CRT) comprised of volunteer interprofessional staff participants from six sites; and 2) education using simulation activities. Participants were surveyed using the Simulation Effectiveness Tool-Modified (SET-M), which measures confidence and knowledge post-simulation. A CRT was created across the six practice sites. RESULTS: A total of 12 participants completed the MHFA course and 11 completed simulation and SET-M surveys. The majority of participants reported an increase in their crisis management confidence and knowledge. A CRT was created, and the new formalized mental health crisis response was implemented. CONCLUSIONS: The MHFA program, simulation activities, and the development of a CRT are effective methods to increase staff and provider confidence and knowledge; and increase the capacity for mental health response.



Work Title Adult Mental Health Crisis Response in Ambulatory Settings: A Quality Improvement Project
Penn State
  1. Michelle Stroud
  1. mental health crisis
License CC BY-NC-SA 4.0 (Attribution-NonCommercial-ShareAlike)
Work Type Project
  1. Kristen Bransby, D.N.P., CRNP, CPNP-PC, PMHS
  2. Kelly Wolgast, D.N.P., RN, FACHE, FAAN
  3. Sheri Matter, Ph.D., RN, NEA-BC
  4. Marie Boltz, Ph.D., RN, GNP-BC, FGSA, FAAN
Publication Date February 23, 2021
DOI doi:10.26207/e7mw-gv27
Deposited April 07, 2020




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Version 2

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    Publication Date
    • 04/07/2020
    • 02/23/2021
  • Updated Publication Date Show Changes
    Publication Date
    • 02/23/2021
    • 2021-02-23
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