Psychosis is an illness affecting the structures and chemicals of the brain that enable us to experience emotions, make judgments, and perceive the world around us. The three most common problems associated with this illness are hallucinations (seeing or hearing things that are not there), delusions (beliefs that are odd or untrue), and disorganization (becoming confused and fragmented when attempting to think or speak). Other symptoms include fearfulness, difficulty making decisions, strong sensitivity to light and noise, problems paying attention, and emotional distress.
Psychotic experiences are actually fairly common. About 10-25% of youth and young adults report having at least one such experience in their lifetime, but in most cases these are mild and do not last very long. For 1 out of 50 youth, these experiences become sufficiently intense, frequent or long-lasting and interfere with daily routines and well-being.
Problematic psychosis tends to appear between the ages of 12 to 25. These are the ages when youth grow from being dependent on adults to assuming responsibility for making life decisions, taking care of one’s self and, eventually, taking care of others. Supporting a young person with psychosis is particularly challenging because the illness sometimes requires that he or she be heavily dependent on family and friends. Meanwhile, the people providing the support have to balance that individual’s need for support with his and her developmental need for independence. Sometimes it can be hard to know what to do.
What is Delaware CORE?
One aspect of treatment for psychosis that is reliably linked to better outcomes is the period of time that symptoms are left untreated, or as it is commonly referred to: “the duration of untreated psychosis” or just DUP. Researchers have long agreed that the more one waits to get treatment the greater the potential for harm. People who engage early on improve their chances for avoiding (or mitigating) episodes and maintaining a more meaningful quality of life.
Over the past two years, a program entitled Community Outreach and Early Intervention (CORE) has been working in Delaware for the purpose of shortening DUP by engaging young people (ages 12-25) who are experiencing their very first signs or symptoms of psychosis. With start-up funding from the Substance Abuse and Mental Health Services Administration (SAMHSA), Delaware CORE has been implementing a program that was developed by the Maine Medical Center nearly a decade ago.
That parent program, called the Portland Identification and Early Referral (or PIER) program, has been effectively improving the quality of life for youth or young adults with early psychosis for nearly a decade. The program’s developers attribute program success to the combined insight of a diverse professional team (e.g., prescribers, occupational therapist, educational specialist, social workers) and careful tracking of an individualized treatment plan for each enrollee. PIER philosophically rejects medicine as a stand-alone intervention and promotes stress reduction and practical problem solving as essential parts of the recovery process. Team members also maintain an aggressive outreach program to help raise public awareness and reduce stigma.
Back in July of 2015, Delaware CORE convened its first two teams (i.e., eight clinicians). Those teams now serve the entire state. The program offers a broad array of services including psychiatric consultation, occupational evaluation and therapy, supportive services for school or work, and inter-family group meetings to promote networking and support. Over sixty individuals and their families have enrolled.
Preliminary outcomes – based on the first 46 enrollees in CORE – are promising.
To learn more about Delaware CORE or arrange to have a team member come speak to you or your organization, call (888) 284-6030 or go to www.delawarecore.com
Our Medical Director, Richard Margolis MD, helps us make sense of new information in psychiatry, addiction, and behavioral health. This article summaries a New England Journal of Medicine review of current literature on neonatal abstinence syndrome, including clinical characteristics, prevention, identification, and treatment.
The incidence of the neonatal abstinence syndrome has increased substantially in the past decade.
The increase in cases of the neonatal abstinence syndrome corresponds with the reported rise in opioid use during pregnancy, which is attributed to the more liberal use of prescribed opioids for pain control in pregnant women, illicit use of opioids such as oxycodone and heroin, and a dramatic increase in opioid-substitution programs for the treatment of opioid addiction. The pattern of opioid use has also shifted from an inner-city, low-income population to a more socioeconomically and demographically diverse population that includes pregnant women. The causes of the neonatal abstinence syndrome are similarly diverse, including in utero exposure to prescribed or illicit opioids and to agents used for the treatment of maternal opioid addiction.
Illicit opioid use is often complicated by a chaotic lifestyle that includes drug-supporting and drug-seeking behaviors. This lifestyle may hinder access or commitment to medical and social services, leading to substantial risks of illness and death. These risks can be mitigated with opioid-substitution treatment, which has benefits for both health and social outcomes. Methadone is currently the most commonly prescribed treatment for opioid addiction during pregnancy, although the evidence suggests that buprenorphine may be associated with less severe neonatal withdrawal than methadone.
The neonatal abstinence syndrome refers to a postnatal opioid withdrawal syndrome that can occur in 55 to 94% of newborns whose mothers were addicted to or treated with opioids while pregnant. Other terms have also been used to describe the syndrome, including the neonatal withdrawal syndrome, the neonatal drug withdrawal syndrome, and neonatal withdrawal. Although the neonatal abstinence syndrome is the term used most frequently in the literature, neonatal withdrawal is probably a more accurate description of the syndrome.
The neonatal abstinence syndrome has been described as a complex disorder that primarily involves the central and autonomic nervous systems and the gastrointestinal system. The clinical manifestations of the syndrome vary ranging from mild tremors and irritability to fever, excessive weight loss, and seizures. Clinical signs typically develop within the first few days after birth, although the timing of their onset, as well as their severity, can vary. This variation is poorly understood and is believed to be multi-factorial. In particular, the type of opioid and the dose and timing of exposure may alter the risk of withdrawal. Clinical manifestations may develop later in infants who have been exposed to opioids with a longer half-life (e.g., methadone and buprenorphine) than in infants exposed to short-acting opioids.
Primary-prevention strategies are needed to address the epidemic of opioid use and the associated development of the neonatal abstinence syndrome. Ongoing surveillance is essential to inform public health–related efforts aimed at prevention. Evidence suggests that in the United States, states with the highest rates of prescription opioid use also have the highest rates of the neonatal abstinence syndrome. Therefore, targeted initiatives to address prescribing practices may help to reduce opioid use in women of childbearing age and prevent the subsequent development of the neonatal abstinence syndrome. Efforts are under way to address the over-prescribing of opioids, such as the introduction of programs to monitor opioid-drug prescribing practices, regulation of pain-management clinics, and establishment of opioid dosage thresholds. Health care providers are encouraged to practice safe and judicious prescribing of opioids to women of childbearing age.
The increased incidence of the neonatal abstinence syndrome and soaring increases in associated health care costs warrant a consistent and comprehensive approach to mitigating the negative outcomes for affected infants, their mothers, and the health care system. Recent innovations in management include standardized protocols for treatment, which have positive effects on important outcomes such as the duration of opioid treatment, the length of the hospital stay, and the use of adjunctive drugs. In addition, evidence from pharmacokinetic models supports the development of empirically based dosing protocols. Breast-feeding and rooming-in are promising non-pharmacologic strategies that may also improve outcomes for infants and mothers, including maternal satisfaction with and involvement in the care of the newborn.
Our Medical Director, Richard Margolis MD, helps us make sense of new information in psychiatry, addiction, and behavioral health. This blog post is a follow up to last week’s post on the Surgeon General’s Report on Alcohol, Drugs, and Health.
This article includes information from reports by the Washington Post-Kaiser Family Foundation, the Center for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA). The article highlights how addicting prescription medications are, the rise in deaths attributable to opioids, including prescription pain relievers, and demographic information on vulnerable populations including Medicaid recipients and women.
A Washington Post-Kaiser Family Foundation survey published in the Washington Post’s December 9 Health & Science section reported that, “One-third of Americans who have taken prescription opioids for at least two months say they became addicted to, or physically dependent on, the powerful painkillers.”
The article added that “Virtually all long-term users surveyed said that they were introduced to the drugs by a doctor’s prescription, not by friends or through illicit means. But more than 6 in 10 said doctors offered no advice on how or when to stop taking the drugs. And 1 in 5 said doctors provided insufficient information about the risk of side effects, including addiction.”
The Center for Disease Control and Prevention (CDC) reported in March 2016, “More people died from drug overdoses in 2014 than in any year on record. The majority of drug overdose deaths (more than six out of ten) involve an opioid. And since 1999, the number of overdose deaths involving opioids (including prescription opioid pain relievers and heroin) nearly quadrupled. From 2000 to 2014 nearly half a million people died from drug overdoses. 78 Americans die every day from an opioid overdose.”
The CDC report added “We now know that overdoses from prescription opioid pain relievers are a driving factor in the 15-year increase in opioid overdose deaths. Since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled, yet there has not been an overall change in the amount of pain that Americans report. Deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have also quadrupled since 1999.”
The Substance Abuse and Mental Health Services Administration (SAMHSA) published in August 2016, A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders: Practice and Policy Considerations for Child Welfare and Collaborating Service Providers.
The section titled Opioid Use Trends reported “Opioid use and related consequences also vary by several key demographics. For example, the Medicaid patient population is more likely to receive prescriptions for opioid pain medications and to have opioids prescribed at higher doses and for longer periods of time than the non-Medicaid patient population. Opioid medication overdose deaths are also more common among Medicaid-eligible populations.”
The demographic section described the increase in opioid use among women. “The overall rate of first time heroin use increased among all women, from 0.06 percent in 2002–2004 to 0.10 percent in 2009–2011, estimated to be an increase from 43,000 women to 77,000 women (SAMHSA, 2013). Among women, the number of overdose deaths due to the use of prescription opioid pain medications has increased significantly since 2007, surpassing deaths from motor vehicle-related injuries. Overdose deaths due to opioid medication increased among women more than 5-fold between 1999 and 2010, totaling 47,935 during that period (CDC, 2013).”
There has been a similar increase in opioid use among pregnant women leading to a rise in the Neonatal Abstinence Syndrome. This syndrome and its consequences will be addressed in a future article.
Our Medical Director, Richard Margolis MD, helps us make sense of new information in psychiatry, addiction, and behavioral health. This article summarizes the Facing Addiction in America, a report on alcohol, drugs, and health issued by the Surgeon General.
Facing Addiction in America, the Surgeon General’s Report on Alcohol, Drugs, and Health was published last fall. This report provides an extremely thorough and definitive public health report on substance use in America.
The report is organized into 7 chapters that present an overview, a description of the neurobiology of substance use, prevention programs and policies, early intervention/treatment/management, recovery, health care systems, and a vision for the future.
In Chapter 3, Prevention Programs and Policies, risk factors and protective factors are defined. Risk factors are “factors that increase the likelihood of beginning substance use, of regular and harmful use, and of other behavioral health problems associated with use.” Protective factors are “factors that directly decrease the likelihood of substance use and behavioral health problems or reduce the impact of risk factors on behavioral health problems.”
The report explains, “Although there are exceptions, most risk and protective factors associated with substance use also predict other problems affecting youth, including delinquency, psychiatric conditions, violence, and school dropout. Therefore, programs and policies addressing those common or overlapping predictors of problems have the potential to simultaneously prevent substance misuse as well as other undesired outcomes.”
Table 3.1: Risk Factors for Adolescent and Young Adult Substance Use lists individual/peer, family and community risks which are summarized below.
o Early initiation of substance use defined as engaging in alcohol or drug use at a young age.
o Early and persistent problem behavior defined as emotional distress, aggressiveness, and “difficult” temperaments in adolescents.
o Rebelliousness defined as high tolerance for deviance and rebellious activities.
o Favorable attitudes toward substance use defined as positive feelings towards alcohol or drug use, low perception of risk.
o Peer substance use defined as friends and peers who engage in alcohol or drug use.
o Genetic predictors defined as genetic susceptibility to alcohol or drug use.
o Family management problems defined as poor management practices, including parents’ failure to set clear expectations for children’s behavior, failure to supervise and monitor children, and excessively severe, harsh, or inconsistent punishment.
o Family conflict defined as conflict between parents or between parents and children, including abuse or neglect.
o Favorable parental attitudes defined as parental attitudes that are favorable to drug use and parental approval of drinking and drug use.
o Family history of substance misuse defined as persistent, progressive, and generalized substance use, misuse, and use disorders by family members.
o Academic failure beginning in late elementary school defined as poor grades in school.
o Lack of commitment to school defined as when a young person no longer considers the role of the student as meaningful and rewarding, or lacks investment or commitment to school.
o Low cost of alcohol defined as low alcohol sales tax, happy hour specials, and other price discounting.
o High availability of substances defined as high number of alcohol outlets in a defined geographical area or per a sector of the population.
o Community laws and norms favorable to substance use defined as community reinforcement of norms suggesting alcohol and drug use is acceptable for youth, including low tax rates on alcohol or tobacco or community beer tasting events.
o Media portrayal of alcohol use defined as exposure to actors using alcohol in movies or television.
o Low neighborhood attachment defined as low level of bonding to the neighborhood.
o Community disorganization defined as living in neighborhoods with high population density, lack of natural surveillance of public places, physical deterioration, and high rates of adult crime.
o Low socioeconomic status defined as a parent’s low socioeconomic status, as measured through a combination of education, income, and occupation.
o Transitions and mobility defined as communities with high rates of mobility within or between communities.
An understanding and identification of risk factors and protective factors can help guide our prevention, direct care and care management services.
You can review the full report, and additional materials on the Surgeon General website, by visiting https://addiction.surgeongeneral.gov/
Raising children is a major, and often challenging, responsibility for every parent and guardian. When childhood mental illness is added to the mix, it can become even more demanding. It is important for every Delaware parent and guardian, regardless of their circumstance, to know that help is available.
One evening every month families gather in each county for a free casual dinner and support. Each Family Partner gathering begins with adults and children sharing a meal and a question: “What’s the best thing that happened to you this week?”
The adults share their experiences in a relaxed, informal and non-judgmental environment with a facilitator. It’s a peer-to-peer kind of support group where parents and guardians can speak openly about their situations, ask questions and discuss ideas on ways to improve whatever circumstances they’re dealing with at any given time. It’s a safe space where families with lived-in experience lift each other up and connect.
The children move to another space for fun activities, which might include games, puzzles, arts and craft projects, etc. The children are doing more than playing though. Just like the adults, they are making connections with their peers. For example, some children who had shared experiences in residential and day treatment at common facilities talk among themselves about their treatment, goals, friends they made, how they were treated, their diagnosis, the medicine they were prescribed and their experiences.
We all need a helping hand sometimes and Family Partners can be an empowering experience for adults and children. Family Partners is a free event open to all parents and guardians statewide. The atmosphere is welcoming; the food is delicious; and the support is exceptional!
To learn more about times and locations for Family Partners in your area contact Anne Marie Gromis, 302-212-7444 or ChachiMom123@aol.com. You can also review the upcoming meeting schedule here: Family Partners Meetings Jul-Dec 2017
The Delaware Department of Services for Children, Youth, and their Families (DSCYF), is sponsoring several events the first week in August. These events are sure to fill August with fun and excitement for Delaware’s young people.
The Delaware Independent Living Program invites current and former foster youth aged 14 years and older to attend the 15th Annual Youth Advisory Council Conference on Wednesday, August 2, 2017. The conference will be held at Delaware State University (Martin Luther King, Jr. Student Center), in Dover. There is no cost to attend.
Workshops will focus on communication, anger management, conflict resolution, building self-esteem, team building and much more. It will be a fun day!
For more information, please visit: http://kids.delaware.gov/fs/il-yac-conference.shtml
The popular Delaware Teen Idol competition returns to downtown Wilmington’s Playhouse on Rodney Square on Friday, August 4, 2017. Youth from all over the state will sing and dance their hearts out as they perform original songs, poetry, rap, dance, and spoken word. All performances at this family friendly event will encourage youth to engage in healthy lifestyle behaviors, and to stay away from drugs, violence and criminal behavior. This year’s special guest judge is Delaware’s own Nadjah Nicole, who was a contestant on NBC’s The Voice. For tickets and more information, please visit http://aidsdelaware.org/events/delaware-teen-idol-august-4-2017/
The Delaware Prevention Coalition will present Teen Summit – Hollywood Invades Delaware on Saturday, August 5, 2017, 8:30am to 4:00pm at the Chase Center on the Riverfront in Wilmington. The Summit is free for youth to attend, and is geared toward ages 13-17 for a day of workshops, fun, and celebrities. Youth attendees will participate in work groups to discuss contemporary issues affecting today’s adolescents. Workshops will focus on bully prevention, building self-esteem, gun violence, and a variety of additional hot-button issues. Please visit http://www.delawarepreventioncoalition.org/ for more information.
The week wraps up Saturday night, August 5, 2017 with the Duffy’s Hope 15th Annual Celebrity Basketball Game. Held this year at the University of Delaware’s Bob Carpenter Center in Newark, the annual game promotes the importance of adult involvement in the lives of youth and the need for continual financial support of youth based programs.
Over the years, the star-studded event has featured celebrity guests including singer/actress Brandi; teen sports star Mo’Ne Davis; actress/singer Zendaya; singer LeToya Luckett; actor Wesley Jonathan; media personality Quincy Harris; actress Raven Simone; actress Nia Long; actor Lance Gross; and actor/author Hill Harper. For tickets please visit http://duffyshopeinc.org/. Tip off is at 5:00pm.
We hope you join us, and our community-based partners, for one or more of these exciting events!
You may hear the term Evidence-Based Practice, or EBP, to describe a skills-development or treatment program and wonder what that really means. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines Evidence-Based Practice as a practice that based on rigorous research that has demonstrated effectiveness in achieving the outcomes it is designed to achieve.
In practical terms, this means a treatment or program is provided to children and families in a way that was successful for other people with similar needs. When agencies implement a program as designed, children and families are more likely to see positive results. Many evidence-based practice programs can help children and families learn skills and strategies that help them manage challenges their family faces and improve communication.
Program models need time before they can become an evidence-based practice. Researchers review information reported during program participation, including outcome data. They also consider how long changes last after the program ends. Improvements and change must match the goals of the program. If a practice does not achieve the intended goals, changes may be made to the model. When others provide the same program, the results should be similar to show that the program model does what it says it does.
Delaware has been increasing use of evidence-based practices in the child and adult serving systems. There is a lot of research about prevention, early intervention, treatment, and skills development programming. This information helps agencies, like ours, and community-based providers choose effective programs that will be helpful to Delawareans.
The Division of Prevention and Behavioral Health Services offers a number of evidence-based practices. We are working to improve our ability to deliver evidence-based services and add new research-proven methods into our system.
You can learn more about our treatment services here: http://kids.delaware.gov/pbhs/services-offered.shtml and our prevention programs here: http://kids.delaware.gov/pdfs/pbh-guide-to-programs-and-services.pdf
To learn more about evidence-based practices, visit the following web-based resources:
Our Medical Director, Richard Margolis MD, helps us make sense of new information in psychiatry, addiction, and behavioral health. This article provides Alcohol Facts and Statistics across a range of areas that impact functioning and mortality.
According to the National Institute of Health’s National Institute on Alcohol Abuse and Alcoholism an estimated 88,000 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually. This sobering statistic makes alcohol the fourth leading preventable cause of death in the United States.
In 2014, alcohol-impaired driving fatalities accounted for 9,967 deaths (31 percent of overall driving fatalities).
• More than 10 percent of U.S. children live with a parent with alcohol problems, according to a 2012 study.
Prevalence of Underage Drinking
• According to the 2015 National Survey on Drug Use and Health (NSDUH), 33.1 percent of 15-year-olds report that they have had at least 1 drink in their lives.
• About 7.7 million people ages 12–20 (20.3 percent of this age group) reported drinking alcohol in the past month (19.8 percent of males and 20.8 percent of females).
Prevalence of Underage Binge Drinking
• According to the 2015 NSDUH, approximately 5.1 million people (about 13.4 percent) ages 12–20 (13.4 percent of males and 13.3 percent of females) reported binge drinking in the past month.
Prevalence of Underage Heavy Alcohol Use
• According to the 2015 NSDUH, approximately 1.3 million people (about 3.3 percent) ages 12–20 (3.6 percent of males and 3.0 percent of females) reported heavy alcohol use in the past month.
Consequences of Underage Alcohol Use
• Research indicates that alcohol use during the teenage years could interfere with normal adolescent brain development and increase the risk of developing Alcohol Use Disorders.
• In addition, underage drinking contributes to a range of acute consequences, including injuries, sexual assaults, and even deaths—including those from car crashes.
Alcohol and College Students
• According to the 2015 NSDUH, 58.0 percent of full-time college students ages 18–22 drank alcohol in the past month compared with 48.2 percent of other persons of the same age.
Prevalence of Binge Drinking among College Students
• According to the 2015 NSDUH, 37.9 percent of college students ages 18–22 reported binge drinking in the past month compared with 32.6 percent of other persons of the same age.
Prevalence of Heavy Alcohol Use among College Students
• According to the 2015 NSDUH, 12.5 percent of college students ages 18–22 reported heavy alcohol use in the past month compared with 8.5 percent of other persons of the same age.
Consequences of Alcohol Use among College Students
• Researchers estimate that each year 1,825 college students between the ages of 18 and 24 die from alcohol-related unintentional injuries, including motor-vehicle crashes.
• 696,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking.
• 97,000 students between the ages of 18 and 24 report experiencing alcohol-related sexual assault or date rape.
• Roughly 20 percent of college students meet the criteria for Alcohol Use Disorder
• About 1 in 4 college students report academic consequences from drinking, including missing class, falling behind in class, doing poorly on exams or papers, and receiving lower grades overall.
Alcohol and Pregnancy
• The prevalence of Fetal Alcohol Syndrome (FAS) in the United States was estimated by the Institute of Medicine in 1996 to be between 0.5 and 3.0 cases per 1,000.
• More recent reports from specific U.S. sites report the prevalence of FAS to be 2 to 7 cases per 1,000, and the prevalence of Fetal Alcohol Spectrum Disorders (FASD) to be as high as 20 to 50 cases per 1,000.
Alcohol and the Human Body
• In 2013, of the 72,559 liver disease deaths among individuals ages 12 and older, 45.8 percent involved alcohol. Among males, 48.5 percent of the 46,568 liver disease deaths involved alcohol. Among females, 41.8 percent of the 25,991 liver disease deaths involved alcohol.
• Among all cirrhosis deaths in 2013, 47.9 percent were alcohol related. The proportion of alcohol-related cirrhosis was highest (76.5 percent) among deaths of persons ages 25–34, followed by deaths of persons ages 35–44, at 70.0 percent.
• In 2009, alcohol-related liver disease was the primary cause of almost 1 in 3 liver transplants in the United States.
• Drinking alcohol increases the risk of cancers of the mouth, esophagus, pharynx, larynx, liver, and breast.
The State of Delaware’s Department of Services for Children, Youth and their Families (DSCYF) issued a Request for Proposals (RFP) for licensed medical practitioners to provide psychiatric services to children served in the following settings:
• two residential mental health treatment centers (RTCs), which also provide outpatient day treatment,
• staff-secure and secure care juvenile justice settings (two detention centers, one secure rehabilitative treatment facility, and three staff-secure cottage programs), and
• outpatient Bridge Psychiatric Services.*
The deadline to submit proposals for this solicitation is August 8, 2017 at 2:00 pm. You can view the bid information and status details here: CYF17005-PSYCHIATRY
This solicitation is open to any qualified provider of psychiatric services, including:
• sole proprietors,
• partnerships, corporations,
• limited liability corporations,
• either for-profit or not‐for‐profit.
Regardless of the type of contractor, direct treatment services under this RFP may be provided by a Delaware-licensed psychiatrist experienced with children and adolescents, or Psychiatric-Mental Health Nurse Practitioner-Board Certified (PMHNP-BC) with active prescriptive authority.
To sign up to receive notification about solicitation opportunities and to review this solicitation, visit the State of Delaware Bid Solicitation Directory: http://www.bids.delaware.gov/.
If you would like more information about our Request for Proposal and contracting processes, please visit the following webpages:
The Children’s Department wants all interested parties to have an opportunity to submit proposals in response to this RFP. Please share this information with agencies and practitioners you know who might be interested in providing psychiatric services to children served by DSCYF.
*Bridge Psychiatric Service, for purposes of this RFP, is defined as transitional psychiatric care needed when a DPBHS client temporarily has no current provider relationship, e.g., after leaving inpatient hospital care but before a first appointment with a new outpatient practitioner, in order to continue medications.
When a family is in the midst of an emotionally charged situation involving a child who is struggling emotionally or behaviorally, it can be hard to decide what to do and how to calm things down. Our Mobile Response and Stabilization Services (MRSS) are here to help. MRSS is available to address the needs of children through age 17 and their families anytime, day or night, including weekends and holidays. Family members and other concerned people can access MRSS by calling 1-800-969-HELP.
We expanded how we define a crisis to meet the needs of young Delawareans and their families. This approach will make it easier for children and families to get help when they need it to defuse situations that affect family functioning. MRSS provides timely assistance that assesses risk/safety and works collaboratively with children and families to identify their needs, strengthen their support network, and make connections to community resources.
The goals of our Mobile Response and Stabilization Services are to
• determine if emergency services, such as ambulance or police, are needed
• assess risk and plan for safety
• defuse emotionally charged crisis situations
• connect young people and their families with helpful resources
• help families develop plans to safely maintain children in their homes, schools, and community
• refer children and families to treatment services based on risk and needs ranging from outpatient treatment to hospitalization for psychiatric or crisis stabilization needs
DPBHS has contracted with two provider agencies to deliver this new service throughout the State. Legacy Treatment Services maintains the statewide call center and provides mobile response services in Kent and New Castle Counties. Delaware Guidance provides mobile response services in Sussex County.
You can learn more about our Mobile Stabilization and Response Services by attending an upcoming community meeting:
Sussex County on July 12, 2017 from 4:00 – 6:00 pm
Delaware Technical and Community College Owens Campus
Theater in the Arts and Science Center
21179 College Drive
Georgetown, DE 19947
New Castle County on July 20, 2017 from 4:00 – 6:00 pm
100 Rockford Drive
Newark, DE 19713
Kent County on July 27, 2017 from 4:00 – 6:00 pm
Dover Behavioral Health
725 Horsepond Road
Dover, DE 19901
If your child is injured, has a medical emergency, or there is immediate threat of harm to themselves or someone else; call 911 before calling the MRSS hotline.
For mental health or substance use emergencies involving people who are 18 years of age or older, contact the Delaware Division of Substance Abuse and Mental Health (DSAMH) Crisis Intervention Services as follows:
In Northern Delaware: 800-652-2929
In Southern Delaware: 800-345-6785