There was not another Texas model to draw from when Hill Country Mental Health and Developmental Disabilities Centers developed the Youth Crisis Respite Center (YCRC) in 2015. The trauma-informed, community-based center offers enhanced readily accessible services to youth with behavioral health crises, and to youth who are displaying behaviors that place them at risk. YCRC is a short-term six bed residential facility available year-round for youth ages 13-17. It is designed to provide crisis services in a structured and home-like environment to minimize the trauma associated with the child's situation.
The experiences of Hill Country MHDD’s crisis workers revealed a need for the program as there was not any existing resources for youth in the community who needed an opportunity to “take a break” from a pending or existing stressor. When the mobile crisis outreach team was called to respond to youth experiencing mental health crises, there were two options for those who were not at risk of imminent harm.
Depending on circumstances, youth were given resources and a safety plan or sent to a higher level of care. A clear need for a third option emerged that would bolster the level of support for youth who were not ready to return home, while also preventing higher levels of restrictive care that weren’t always needed.
The program’s Director Lauren Mitchell offered an apt comparison for the pressure relieved on youth by the respite center; “I compare it to a Coca-Cola bottle—they’re being shaken and tossed around by life around them. This program gives them a chance to come down, decompress, and let the bubbles dissipate to prevent an explosion.”
Youth are referred for a broad range of behavioral health challenges and related stressors. These include current or pending challenges like family problems, abuse and neglect, food insecurity, substance use, caregiver medical issues, or school-based issues like bullying, break-ups, and social stressors. Times of transition, including holidays and the start of school, tend to be the center’s busiest times.
Most youth who have utilized the YCRC have received services from Hill Country MHDD at some point and most referrals are made by Hill Country, whose catchment area covers 19 counties. School-based staff like teachers, counselors, and school resource officers are the second largest source of referrals, with others coming in from the juvenile justice system. Referrals can also be self, or family initiated.
Youth who voluntarily admit into the program receive free services, up to a seven day stay. Activities are individualized to target and alleviate the immediate challenges youth and/or family are experiencing. While at the Center, youth are offered psychoeducational support groups, lessons on life skills, recreational activities, dedicated time for schoolwork, and external referral and support linkages.
Former Director Melissa Ramirez, who now acts as Hill Country’s Director of Children Services, explained the goal of the program. “Respite is not a hotel—there are some kids who would not be a good fit. The goal is prevention. This prevents detainment, decompensation, and emergency department use in the right circumstances.”
The primary objective of YCRC services is to assist in crisis stabilization and enhance skills to help a youth and the youth’s family/caregiver better manage environmental and social stressors. YCRC is designed to decrease the need for more intensive interventions such as psychiatric hospitalization, the use of the emergency room for non-medical emergency care, and the use of juvenile detention when inappropriate.
Parents whose children have used the respite services, have stated, “The family atmosphere helped my child transition these important skills back home. Staff are genuinely supportive and have a system of learning for kids who are really struggling."
Eligible youth are those who do not meet admission criteria for hospitalization and are admitting on a voluntary basis. The center can coordinate with probation officers from Texas Juvenile Justice Department to work with justice-involved youth. Youth with high levels of suicidal ideation, recent self-injury wounds that need medical attention, and youth who are not stabilized on their medication would likely be ineligible for the center, but each case is considered individually. Also, the center will accommodate youth who want to experience a trial night before determining length of stay. Note: The program previously offered specialty programming through “respite days” that included wider age groups and may resume this in the future.
Other Youth Respite Programs in Texas
Williamson County’s Youth Respite Center is a 16-bed Youth Therapeutic Respite Program that provides a safe environment for youth in crisis, between ages 5 and 17.
The Harris County Youth Diversion Center serves as an alternate location to juvenile detention for youth ages 13-17 who have committed low-level, non-violent crimes, that temporarily need respite care due to a behavioral health crisis. Eligibility for services is determined by the Harris County District Attorney's office and the Juvenile Probation Department.
The Youth Crisis Respite House is Heart of Texas Behavioral Health Network’s 6 bed facility that provides short term respite services for youth ages 13-17, who are experiencing a behavioral health crisis.
Outcome Data
Additional Resources
Assessment Center Framework- The National Assessment Center Association (NAC) created this framework to guide implementation of assessment centers to divert youth from juvenile justice involvement.
Effective Alternatives to Youth Incarceration-Through this report, The Sentencing Project Identifies six program models that consistently produce better results than youth incarceration.
National Guidelines for Child and Youth Behavioral Health Crisis Care- Offers best practices, implementation strategies, and practical guidance for the design and development of services that meet the needs of American children and their families experiencing a behavioral health crisis.
Making the Case for a Comprehensive Children’s Crisis Continuum of Care- This guide by National Association of State Mental Health Program Directors reviews the essential components of a crisis continuum.