NAMI-Yolo - a chapter of NAMI, the Nation's Voice on Mental Illness
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If your need is immediate &  someone is
in danger of harming themselves or someone else,
phone 911.

Crisis Toolkit

24 HOUR CRISIS SERVICES

Emergency
If your need is immediate and someone is in danger of harming themselves or someone else, phone 911.
911
Yolo County Alcohol, Drug and Mental Health Crisis Help
Make sure to indicate this is a crisis call so it can be directed to the proper person.
24 hour crisis

 
1-888-965-6647
Yolo County Drug & Alcohol Services
Monday-Friday 8am-5pm
Davis
Woodland
West Sacramento

 
(530) 757-5537
(530) 666-8650
(916) 375-6370
Suicide Prevention
  
Davis
West Sacramento
Woodland
 
(530) 756-5000
(916) 372-6565
(530) 666-7778
Sexual Assault/Battered Women West Sacramento
Woodland
 
(916) 371-1907
(530) 662-1133
Teen Crisis Hotline (ASK) Davis
Woodland
West Sacramento
 
(530) 753-0797
(530) 668-8445
(916) 371-3779
Woodland Memorial Hospital   (530) 662-3961
Sutter Davis Hospital   (530) 756-6440
Peterson Clinic/Urgent Care   (530) 666-8960
Salud Clinic   (916) 375 6400
Davis Community Clinic   (530) 758-2060

 

What should you do in an emergency?
(Source:  NAMI San Francisco)

Control Yourself don't shout into the phone or at arriving officers or medical professionals. They can't understand you if you shout.

On the phone: Be ready to give concrete examples of the dangerous behaviors and to support your contention that the person is mentally ill. For example, say, "My daughter pulled a knife" as opposed to "My daughter wants to kill me."

State over the phone the following information and be ready to repeat it to arriving police officers and/or medical professionals:

  • Your name.

  • Your address.

  • Family member's name.

  • Your relationship.

  • That the person is mentally ill and give the diagnosis.

  • State whether medications are being used, whether it was stopped and when was the last time the meds were taken.

  • Describe what your family member is doing now.

  • Say whether you feel threatened.

  • Say whether your family member is hearing voices or fears someone.

  • Say whether a weapon is in the house --- to minimize further agitation, remove any guns from the house before the police arrive

  • Say where inside the house is your family member

  • Say whether there is a history of violence

Until professionals arrive, you must STAY CALM and:

  • Be polite, respectful, reassuring, low-key and direct with your family member.

  • Maintain on-going communication directly with the person and do not include others in side conversations.

  • Do not try to trick or deceive your family member.

  • Avoid immediately moving in close or touching the person unless necessary.

  • Remove all objects with which a person may do harm to self or others.

When professionals arrive:

  • Have all the lights on inside the house.

  • Identify yourself.

  • Carry nothing in your hands especially coming outside to meet them, in which case walk, don't run to meet them.

  • Don't ramble.

  • Be prepared to repeat the information you gave over the phone.

  • State whether there is a history of suicide attempts.

  • State whether your family member is violent or delusional.

  • Have treating psychiatrist's phone number handy.


Questions to Ask the Physician
(Source:  NAMI San Francisco)

The following are questions to ask the treating physician about your family member which don't conflict with confidentiality laws in some states. If you fail to learn anything from the treating physician, try another doctor at the program or hospital where your family member is getting treatment
  • What is your diagnosis? What is the nature of this illness from a medical point of view?
     
  • What is known about the cause of this particular illness?
     
  • How certain are you of this diagnosis? If you are not certain, what other possibilities do you consider most likely and why?
     
  • Did the physical examination include a neurological exam? If so, how extensive was it, and what were the results?
     
  • Are there any additional tests or exams that you would recommend at this point?
     
  • Would you advise an independent opinion from another psychiatrist at this point?
     
  • What program of treatment do you think could be most helpful? How will it be helpful?
     
  • Will this program involve services by other specialists ( i.e. neurologist, psychologist, allied health professionals. )? If so, who will be responsible for coordinating these services?
     
  • Who will be able to answer our questions at times when you are not available?
     
  • What kind of therapy do you plan to use, and what will be the contribution of the psychiatrist to the overall program of treatment?
     
  • What do you expect this program to accomplish? About how long will it take, and how frequently will you and the other specialists be seeing the patient?
     
  • What will be the best evidence that the patient is responding to the program, and how soon will it be before these appear?
     
  • What do you see as the family's role in this program of treatment? In particular, how much access will the family have to the individuals who are providing the treatment?
     
  • If your current evaluation is a preliminary one, how soon will it be before you will be able to provide a more definite evaluation of the patient's illness?
     
  • What medication do you propose to use? ( Ask for name and dosage level and write it down.) What is the biological effect of this medication, and what do you expect it to accomplish? What are the risks associated with the medication? How soon will we be able to tell if the medication is effective, and how will we know?
     
  • Are there other medications that might be appropriate? If so, why do you prefer the one you have chosen?
     
  • Are you currently treating other patients with this illness?
    (Psychiatrists vary in their level of experience with severe or long-term mental illnesses, and it is helpful to know how involved the psychiatrist is with treatment of the kind of problem your relative has.)
     
  • When are the best times and what are the most dependable ways for getting in touch with you?
     
  • How do you monitor medications and what symptoms indicate that they should be raised, lowered or changed?
     
  • How familiar are you with the activities of the NAMI-Yolo or NAMI-California?

Rights of Families


Don't get lost in the shuffle

  • Families are not to blame
  • Find out what you have to do for your family member
  • Keep a list of questions to ask the psychiatrist. 
  • Know your rights. Protect your family.

A variety of factors - primarily the confidentiality laws regarding mental health  treatment and the historical blaming of families for mental illness - contribute to families being shut out of the treatment process. Families are often shut out even when people who have mental illness sign waivers enabling clinicians to communicate details of illness and treatment and the following information is helpful whether or not a waiver has been signed. If your family member regularly signs waivers, make sure your family member signs a new waiver each time they enter a new facility. Most waivers need renewing each year.

Here are few things to do:

  • If a  family member does not sign a confidentiality waiver, mental health professionals can't talk with you about your family member's situation.  However, you can talk with them or send them information.
     
  • If you know or suspect your family member is in a specific facility and a waiver has not been signed, you can send the clinicians letters detailing your relative's history and different characteristics you have noted about your relative's illness. You may also call the clinicians and give them information over the phone, but limited resources in the mental health system may make them difficult to reach in person. You should do this even if your relative has signed a waiver enabling the treatment professionals to communicate with you. Your historical memory of the illness and your relative is valuable to treatment and you should be keeping a diary.
     
  • If your relative has not signed a waiver, you can ask the treating psychiatrist questions about
    • "patients with symptoms similar to your relative's,"
    • how families can help in situations where patients are ________.

      These types of questions do not conflict with most confidentiality laws. If the treating psychiatrist is not helpful, ask questions of another psychiatrist on the treatment staff.
Below is a list of Statutory Rights and Guidelines regarding family participation to keep in mind.

Rights of Families - Statutory Rights and Guidelines

The following is a summary of current California Law
prepared by NAMI-California.

Family Participation
Statutory Rights & Guidelines

I. Statement of Policy
Families of clients in mental health facilities should be encouraged to participate in the assessment, treatment and aftercare planning process for each client, consistent with the best interests and wish of the client.

II. Rights of Family Members
The right [of a spouse, parent, child, or sibling] to be given notification of the client's presence in a 24-hour facility, unless the client requests that this information not be provided. [Cal. Welf. & Inst. Code 5328.1]

The right to be given information regarding the diagnosis, prognosis, prescribed medication and side effects, and progress of the client, if authorized by the client. If the client is initially unable to authorize the release of this information, daily efforts shall be made to secure the client's consent or refusal of authorization.
[Cal. Welf. & Inst. Code 5328.1]

The right to have the family make reasonable attempts to notify the immediate family of the client's admission, release, transfer, serious illness, injury or death, unless the client requests that the information not be provided.
[Cal. Welf. & Inst. Code 5328.1(b)]

The right to see and receive copies of information and records regarding the client, with the consent of the client and approval of the treating physician, psychologist or social worker. [Cal. Welf. & Inst. Code 5328(b)]

The right to a copy of the written aftercare plan when the client is discharged from an inpatient psychiatric facility, when designated by the client. (effective January 1998)  [Cal. Welf. & Inst. Code 5622, 5768.5]

The right to have removed from the client's record any information provided in confidence by the family, prior to release. [Cal. Welf. & Inst. Code 5328(b)(d)(j)(k), 5543]

The right to be given required information concerning the administration of convulsive treatment or psychosurgery, if authorized by the client. [Cal. Welf. & Inst. Code 5326.6(b), 5326.7(c)]

The right to receive copies of public information, including licensing and other reports. [Cal. Gov't Doc 6250 et seq.]

The right to visit the client every day, if desired by the client. [Cal. Welf. & Inst. Code 5325(c)]

The right to have confidential phone calls with the client and to mail and receive unopened correspondence, if desired by the client. [Cal. Welf. & Inst. Code 5325(d)&(e)]

The right to provide clothing, personal possession and a reasonable sum of money to the client for us in the facility, if desired by the client.  [Cal. Welf. & Inst. code 5325(a)]

The right to participate in the treatment and rehabilitation planning of the client, as a source of information and support. Included in the participation is the identification of service needs, and advocating for, and coordinating the provision of these services, as appropriate.
[Cal. Welf. & Inst. Code 5600.2(a), 5600.4(c)]

The right to be advised of the time and place of certification review hearings, judicial review, conservatorship proceedings, unless the client requests that this information not be provided.  [Cal. Welf. & Inst. Code 5256.4(c), 5276, 5350.2]

The right to be appointed conservator or to nominate a conservator subject to the priorities and preferences in the Probate Court. [Cal. Probate Code 1810-1813]

The right to have the first priority for conservatee placement be a facility as close as possible to the conservatee's home or home of a relative.
[Cal. Welf. & Inst. Code 5358(c)]

The right to submit a complain regarding abuse, unreasonable denial or punitive withholding of rights concerning a resident in a license health or community care facility to a clients' rights advocate for investigation.  [Cal. Welf. & Inst. Code 5520(a)]

The right (unless found not to be acting in good faith) to be immune from civil or criminal liability, penalty, sanction or restriction for participating in the filing a complaint of providing information to the patients' rights advocate.  [Cal. Welf. & Inst. Code 5550(a)]

The right to be informed of the telephone number by the facility of where to file complaints with the Department of Health Services, Licensing and Certification Program.  [Cal. Health and Safety Code 1288.4]

Profession licensing boards and other regulatory and enforcement agencies may also be contacted to register complaints about the facility or personnel

The right to not have the client discriminated or retaliated against for the family members' participation in any advocacy activity.  [Cal. Welf. & Inst. Code 5550(c)]

III. Sources

  • Cal. Government Code, Cal. Probate
  • Code, Cal. Welf & Inst. Code, Title 22
  • Cal. Code of Regs., Joint Commission on Accreditation of Healthcare
    Organization Standards, California
  • Association of Hospitals and Health

Systems Consent Manual.

This is a synopsis of current California Law. For additional information, refer to the statues cited, or consult an attorney.

NAMI California
1010 Hurley Way, Suite 195
Sacramento, CA 95825
916-567-0163
email: nami@namicalifornia.org
website: www.namicalifornia.org

October 1997