Rescuing Children in Crisis

Debra Thomas is a psychiatric social worker with VNSNY’s Mobile Crisis Team for children and adolescents.

Debra spent years as a frontline clinician with the Bronx Mobile Crisis Team for children and adolescents and is now the team’s program director. “People can sense if you’re not authentic,” she notes. “Especially kids.”

Less than two hours after a Bronx high school sent word that they had a student in an emotional crisis, Debra T. was at the school, ready to help. Debra, a psychiatric social worker with VNSNY’s Mobile Crisis Team for children and adolescents, quickly convened a meeting with the student, 16-year-old Nicole*, and a school guidance counselor. This swift response is what the Mobile Crisis Team is known for—and so is their ability to connect quickly and effectively with the youngsters they treat.

“As it turns out, Nicole was in no imminent danger,” says Debra, “but she was clearly depressed.” The teenager, who had a borderline IQ, lived with her mother and would cut herself as a way of dealing with the anxiety she felt after one of her troubling visits with her absentee father. Together, Debra and Nicole came up with a “safety plan”—actions the girl could take when she felt like cutting herself. Nicole liked poetry, so she agreed that when she felt the anxiety welling up, she’d write a poem or call a designated adult.

In the follow-up meeting, Nicole told Debra about a bad visit she’d just had with her father. The visit had left her with the urge to hurt herself—but she hadn’t. Debra asked her how she was able to restrain herself. “Because I made a contract with you,” Nicole said. Debra went on to link Nicole with outpatient mental health services at a local non-profit mental health agency, where she would receive ongoing psychological support.

For at-risk New York City youth like Nicole, VNSNY’s Mobile Crisis Team program is a proven lifesaver. The program launched its first mobile unit in the Bronx in the summer of 2013 and added two others last fall in Brooklyn and Queens. Each mobile team is staffed by a coordinator, two psychiatric social workers and two family advocates. Referrals are made through LifeNet, New York City’s 24/7 crisis call center, and may come from parents, teachers, therapists, or the children themselves. The team then has two hours to dispatch two field workers to the site.

Thanks to funding from the city’s Department of Health and Mental Hygiene, Mobile Crisis Team services are available to any child under age 18 in their service area free of charge. While Mobile Crisis Team members don’t administer actual psychiatric treatment, they provide children with coping skills, help them draw up a safety plan, review intervention techniques with the parent, and link children and families with longer-term services as needed. During the four weeks after the initial call, staffers also follow up to make sure the child is stable and receiving the services that they need.

Today, Debra works as a Program Coordinator for the Mobile Crisis Team, supervising and supporting the social workers and family advocates on the Bronx team. Her clinical experience coupled with her ability to improvise when appropriate makes her a gifted program coordinator. “People can sense if you aren’t authentic,” she says, “especially the kids. They’re street smart, and you have to meet them where they’re at.” In her program coordinator role, Debra helps instill these qualities in her team. “We have team meetings twice a week, and I also sit down with each team member individually. I might ask them, ‘What could you have done differently?’ or ‘How would you react if the child’s mother said this?’”

Debra still takes on an occasional case herself, and also goes out with her clinicians to observe their technique and give constructive suggestions. “My staff knows they can call me anytime,” she says. “As I tell my team, these people aren’t just calling out of hysteria—they’re calling for help. And we have a great track record of helping.”

* The patient’s name has been changed for privacy.

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