Relias Survey Highlights Trends, Gaps in Crisis Training for Behavioral Health and IDD Professionals

Relias, trusted partner to more than 11,000 healthcare organizations and 4.5 million caregivers, has released a new report that identifies areas of improvement for crisis prevention and intervention (CPI) training among behavioral health and intellectual and developmental disability (IDD) professionals. The 2022 Crisis Prevention and Intervention Training Report, based on a survey of 2,952 behavioral health and IDD professionals, examined how providers train their staff on CPI techniques, which are vital to mitigating crisis situations with clients.

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About 40% of U.S. adults have reported experiencing symptoms of anxiety and depression during the COVID-19 pandemic, leading to a potential rise in suicidal ideation, overdoses, and domestic violence. This mental health crisis has increased demand for local human services organizations to use evidence-based CPI techniques to de-escalate crisis situations, including suicidal or violent behavior.

Additionally, behavioral health organizations are playing an important role in helping manage crisis situations with the nationwide rollout of the 988 National Suicide Prevention Lifeline in July 2022.

Here are key findings from the Relias CPI survey:

• More CPI training needed: 75% of behavioral health respondents and 75% of IDD professionals receive crisis prevention training only once per year. About the same percentages of professionals receive training on crisis intervention/management and verbal de-escalation once per year. This despite the fact that studies have found more frequent training results in higher performance. 60% of behavioral health professionals and 40% of IDD professionals indicated that crisis management constituted part of their primary job duties.

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• Confidence levels in CPI skillsets lacking: 63% of behavioral health respondents felt “very” or “extremely” confident in their crisis prevention skills. Just 52% had the same confidence levels in their crisis intervention skills, with 56% confident in their “crisis postvention” skills. When asked what training methods would help increase confidence, the three most popular were more practice of these skills, more continuing education opportunities, and higher quality training.
• Blended learning impactful: Between 60% and 70% of respondents said they are receiving a combination of in-person, online live, and online pre-recorded training (also known as “blended learning”) in crisis prevention and verbal de-escalation techniques. Blended learning had some of the highest impact on respondents’ confidence scores of any training modality.
• Lack of awareness of 988 hotline: Concerningly, though the survey was conducted in March 2022, four months before the 988 hotline was launched, 73% of behavioral health respondents said they were “not at all familiar” with the 988 hotline or that the hotline was intended to expand access to crisis services.

The Relias report makes several recommendations for behavioral health organizations to address their staff’s confidence levels in CPI techniques. These include implementing more frequent training and more blended learning opportunities, increasing access to simulation courses that help them practice their skills in a low-risk environment, and improving education on how the 988 hotline rollout will impact demand for services.

“Behavioral health and IDD professionals are on the front lines of the mental health crisis, providing direct care to people experiencing crisis,” said Vicki Ittel, PhD, MBA, Director of Behavioral Health Solutions at Relias. “Their effectiveness in using CPI techniques can play a decisive role in managing a crisis situation and even saving a life. Our report found that many of these professionals are only moderately confident in their de-escalation skills, and more training and continuing education opportunities are badly needed.”

“The importance of effective CPI skills can’t be overstated,” said Rola Aamar, PhD, Principal, Behavioral Health Solutions, Relias. “When a person is experiencing a crisis, mitigating physical harm to themselves or others often comes down to the ability of a behavioral health or IDD professional to confidently assess that person’s risk to use the most effective intervention strategies. Based on this report, we recommend all human services organizations immediately assess their staff’s CPI skills and determine a training plan to meet their learning needs.”

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