Crisis Stabilization & Therapeutic Respite (Acute Intervention)

Pipeline 05C

When risk spikes, speed matters. Short, therapeutic placements and rapid MH/SUD linkage can prevent unnecessary detention or revocation.

Overview

We document entry criteria, duration, staffing, clinical handoffs, and how youth return to community supervision with calibrated responses.

Overview

Crisis stabilization and short-term therapeutic respite provide rapid, safe de-escalation for acute situations, then bridge youth back to community supervision with calibrated supports. This page tracks entry criteria, stabilization windows, staffing/clinical practices, safety monitoring, and the warm handoffs that keep care continuous after discharge.

What We Track

Entry Criteria

Screening vs. assessment documented (tool name & version)
- Suicide/self-harm risk, acute MH/SUD symptoms
- Violence risk, runaway risk, family/placement crisis
Safety thresholds that trigger admission (and exclusion rules)
Consent & notification (youth/caregiver informed, rights explained)

Stabilization Window

Typical length of stay (LOS) (mean/median, IQR)
Discharge readiness criteria (symptom resolution, safety plan complete)
24/48/72-hour checkpoints completed (MD/clinician reviews)

Care Pathways

MH/SUD linkage (assessment, meds, therapy initiation)
ER diversion / telehealth utilization and outcomes
Follow-through to community providers (first-appointment date)

Staffing & Clinical Practice

Minimum staffing ratios met (RN/LCSW/peer roles)
Safety checks cadence (1:1, 15-min, or video-monitored)
Family/caregiver contact schedule documented

Return to Supervision

Adjusted dosage of supervision/contacts post-discharge
Graduated responses tailored to clinical needs (not punitive)
Aftercare plan shared across probation, provider, and school

Equity & Safety

Incidents: restraints/seclusion, injuries, AWOL — rate per 100 bed-days; de-escalation used
Safety & grievance logs; quality flags; parent/youth complaints & resolutions
Access & outcomes by race/ethnicity, gender, rurality; small-n safeguards; mark series breaks on policy/tool changes

Typical Flow

Identify & triage acute risk; screen and determine eligibility
- Apply crisis screen; confirm safety thresholds & exclusions
- Notify caregiver; document consent and rights in preferred language
Stabilize in therapeutic setting (short-term respite)
- Initiate safety checks; begin clinical assessment and brief treatment
- Set preliminary discharge criteria with youth/caregiver
Link to ongoing care and finalize aftercare plan
- Schedule first community appointment; transmit records per consent
- Coordinate with school/probation; address transport and coverage
Resume supervision with calibrated supports
- Increase contact intensity initially; use supportive responses over sanctions
- Set review interval (7/14/30 days) to taper as stability holds
Review outcomes at 30/90 days
- Track re-referrals, ED visits, school attendance, and engagement
- Log incidents/complaints and equity differentials; adjust practice

Fields

Field	Type	Required	Codeset	Description
pipeline_place_id	uuid	✅	—	Unique identifier for this pipeline place row.
pipeline_stage_id	enum	✅	stages.yml#stage_key(8) intake detention adjudication disposition supervision commitment_and_placement reentry closure	One of the 8 canonical stages.
pipeline_place_key	enum	✅	pipeline_places.yml#place_key(45) intake pre_petition_diversion_and_deflection diversion youth_assessment_tools prosecutorial_screening status_offenses adjudication case_planning family_engagement case_timeliness language_access restorative_justice detention_screening community_atds electronic_monitoring court_appearance_and_fta initial_hearing pretrial_supervision probation intensive_supervision …and 25 more	Canonical key for this place (maps to route/slug).
youth_id	string	✅	—	Salted/hashed or state UID. No plaintext PII.
staff_id	string		—	Primary supervising or referring officer/clinician.
occurred_datetime	datetime	✅	—	Timestamp when the crisis episode was opened/authorized/referral made.
jurisdiction_code	string	✅	—	County/parish/circuit or standardized local code.
legal_case_id	string		—	Case/docket identifier if applicable.
source_system	string	✅	—	Origin system name.
source_file	string		—	Source batch/file id if flatfile.
extract_run_id	string		—	ETL run id for lineage.
series_break_flag	boolean		—	Comparability break applies to this row.
series_break_reason	enum		series_breaks.yml#reason(4) definition_change vendor_change coverage_change policy_change	Reason for break when flagged.
screening_tool_key	enum	✅	assessment_tools.yml#tool(5) yasi pcra-youth pux craft state_local_other	Name/key of the crisis screening/assessment tool.
screening_tool_version	string	✅	—	Version string/number of the tool.
administration_context_code	enum	✅	admin_contexts.yml#context(5) intake_triage detention_screen case_planning reentry_review violation_review	Context of administration (e.g., crisis_screen, intake_triage).
screen_result_code	enum		screen_results.yml#result(4) positive negative inconclusive not_done	Result category (e.g., admit_recommended, safety_plan_only, no_admit).
entry_reason_codes	array<string>	✅	crisis_entry_reasons.yml#reason(7) suicide_risk acute_mh acute_sud violence_risk runaway_risk family_crisis other	Acute reasons present (suicide_risk, acute_mh, acute_sud, violence_risk, runaway_risk, family_crisis); semicolon-delimited.
exclusion_reason_codes	array<string>		crisis_exclusions.yml#reason(5) medical_instability active_warrant_hold involuntary_commitment_required safety_not_supported other	Exclusion criteria met, if any (e.g., medical_instability); semicolon-delimited.
consent_obtained_flag	boolean	✅	—	Consent/informed participation documented.
caregiver_notified_flag	boolean	✅	—	Caregiver notification documented.
rights_explained_flag	boolean		—	Rights explained in preferred language recorded.
admit_datetime	datetime		—	Admission timestamp to crisis/respite setting.
discharge_datetime	datetime		—	Discharge timestamp.
clinician_review_24h_datetime	datetime		—	Clinician/MD review at ~24 hours.
clinician_review_48h_datetime	datetime		—	Clinician/MD review at ~48 hours.
clinician_review_72h_datetime	datetime		—	Clinician/MD review at ~72 hours.
discharge_readiness_code	enum		discharge_criteria.yml#criterion(5) symptoms_resolved plan_complete transfer_higher_care administrative other	Symptom/safety-based readiness (e.g., symptoms_resolved, plan_complete, transfer_higher_care).
mh_sud_linkage_codes	array<string>		care_pathways.yml#pathway(6) assessment medication_start therapy_start peer_support case_management other	Linkages initiated (assessment, meds, therapy_start, peer_support); semicolon-delimited.
er_diversion_flag	boolean		—	ER diversion achieved.
telehealth_used_flag	boolean		—	Telehealth used during episode.
telehealth_outcome_code	enum		telehealth_outcomes.yml#outcome(5) resolved referred_in_person no_show technical_failure other	Outcome of telehealth (resolved, referred_in_person, no_show, other).
first_community_appointment_date	date		—	First post-discharge community appointment date.
staffing_ratio_met_flag	boolean		—	Minimum staffing ratios met (policy-level).
required_staff_role_codes	array<string>		roles.yml#actor_role(7) Intake_Officer Prosecutor Defender Probation_Officer Case_Manager Facility_Staff Coach_Reentry	Required licensed/peer roles scheduled during episode; semicolon-delimited.
safety_check_cadence_code	enum		safety_check_cadences.yml#cadence(5) one_to_one q15min q30min video_monitored other	1_to_1, q15min, video_monitored, other.
family_contact_schedule_code	enum		meeting_frequencies.yml#frequency⚠️ using meeting_frequencies.yml#freq(5) weekly biweekly monthly quarterly ad_hoc	Planned caregiver contact cadence during episode.
aftercare_plan_shared_flag	boolean		—	Aftercare/safety plan shared with probation, provider, school.
adjusted_contact_cadence_per_week	number		—	Temporary increase in probation contact cadence post-discharge.
supportive_responses_flag	boolean		—	Graduated responses tailored to clinical needs used (vs. punitive).
post_discharge_review_interval_code	enum		review_intervals.yml#interval(3) review_7d review_14d review_30d	Initial review interval after discharge (7d, 14d, 30d).
restraint_events_count	integer		—	Number of restraint events during episode.
seclusion_events_count	integer		—	Number of seclusion events during episode.
injury_events_count	integer		—	Number of injury events during episode.
awol_events_count	integer		—	Number of AWOL/absconding events during episode.
deescalation_used_flag	boolean		—	De-escalation techniques used in applicable incidents.
safety_quality_flag_codes	array<string>		quality_flags.yml#flag(6) incident_cluster documentation_gap ratio_not_met late_review policy_exception other	Quality/safety flags raised; semicolon-delimited.
grievance_filed_flag	boolean		—	Youth/caregiver grievance filed.
grievance_outcome_code	enum		grievance_outcomes.yml#outcome(4) upheld not_substantiated pending withdrawn	Outcome of grievance (upheld, not_substantiated, pending, withdrawn).
Download CSVwhat_we_track.csv

EDORA • Learn

Crisis Stabilization & Therapeutic Respite (Acute Intervention)

Overview

Overview

What We Track

Entry Criteria

Stabilization Window

Care Pathways

Staffing & Clinical Practice

Return to Supervision

Equity & Safety

Typical Flow

Fields

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