Emergency Protocol

Emergency Protocol

Crisis Response Model

The safety of you and the client is your priority and needs to be responded to with immediacy.  After their immediate needs are addressed, notify the Clinical Supervisor (or Director if Clinical Supervisor not available) immediately of the circumstances.

All contact, referrals and communication regarding the situation must be documented in Theranest contact log, progress note and crisis intervention note.

Counselor Safety: If counselors are alone in the office and do not feel safe with a client, they should contact 9-1-1 immediately via call or text.

Toms River Dispatch: 732-349-0150                                              Howell Dispatch: 732-938-4575

Phone Assessment: If client needs immediate assessment, this can be done over the phone to address client well-being and safety. These sessions will be considered Crisis/Emergency appointments and will be billed accordingly.  Counselors are to notify Office Manager, Clinical Supervisor (or Director if Clinical Supervisor not available) immediately post session.

Non-Crisis/Non-Emergency Sessions: Counselors will use their judgement to verify if client is in a non-crisis/non-emergency situation to establish a preventative plan, resources and referrals.  A Contract for Safety should be filled out for these clients and are not limited to the below examples of common non-crisis/non-emergency situations that may occur:

  • Non-Suicidal Self-Injury: Self-injury that is providing emotional regulation or being used as an unhealthy coping strategy is not considered a crisis situation unless the self-injurious behavior is deemed by the counselor to pose an immediate high risk of serious injury. Counselor is to consult with Clinical Supervisor before making said decision. Parents/Legal Guardians can be notified if counseling a minor (according to confidentiality) to minimize access to materials used to self-harm at home.
  • Suicidal Ideation without intent: These clients may be thinking about ending their life or having thoughts associated with death, however do not have a plan or intent.  Parents of minors should be given the number for mobile response in case counselor is not available for same day assessment: 1-877-652-7624 as well as Suicide 24/7 Hotline: 1-800-273-8255 and Psychiatric Emergency Screening Service (PESS):

Ocean County 866-904-4474                                     Monmouth County 732-886-4474

  • Domestic Violence: These are adult clients who are experiencing threats or abuse at home.  A Contract for Safety can be filled out including 24/7 hotlines for assistance:

Women’s Referral Central: 1 (800) 322-8092         NJ Domestic Violence: 1 (800) 572-SAFE (7233)

*Please note that if client presents fear of returning home, there are threats/a history of past abuse and there are children in the home, this needs to be considered a crisis with DCPP involvement to ensure safety of the children.

Crisis/Emergency Sessions: If crisis/emergency assessment is needed during session or a session is created to address this type of situation, these sessions will be considered Crisis/Emergency appointments and will be billed accordingly once counselor alerts Office Manager and Clinical Supervisor. During session, the counselor will assess client’s mental/emotional status and determine if a higher level of care is necessary.

Any counselor that is supervised will need to speak with the Clinical Supervisor (or Director in Clinical Supervisor’s absence) prior to any level of care recommendations.

*A Crisis Intervention Form should be completed after each crisis situation as well as an contacts in the contact log*

*Post crisis, the client’s treatment plan and progress notes should be updated to reflect crisis area for monitoring/addressing.

Psychiatric Emergency Screening Service (PESS)

Ocean County 866-904-4474                                     Monmouth County 732-886-4474

**During a suicidal/homicidal crisis, per NJ Duty to Warn Law, Section 1 of P.L.1991, c.270 (C.2A:62A-16) the police station where the client resides must be notified and given the client’s contact information, nature of crisis and action taken (i.e. sent client to PESS for screening).  If the client’s local police department is not operating during the time you call, you must call the state police.  If the client is a minor, their parent/legal guardian must be notified as well.  Counselors are to ask clients if there are any arms/weapons in the house prior to making the call to further ensure client safety when they return home, this includes clients whom a contract for ideation is made in case there are attempts outside contract**

Toms River Dispatch: 732-349-0150                                              Howell Dispatch: 732-938-4575                                             NJ State Police: 609-882-2000

  • Suicidal Ideation with intent: This is intent to cause significant harm to self with a plan of action. These clients will fall into the following categories:
    • Cooperative Adult: emergency contact notified to transport client to nearest hospital ER/PESS center. Notify office staff to reschedule following appointments if needed.
    • Non-Cooperative Adult: 9-1-1 should be called; informed of situation; ambulance and/or police will be sent to office. If client leaves, still complete process. A release does not need to be completed during crisis situation, only with follow-up referral from higher level of care.
    • Child/Adolescent: Parent/legal guardian are notified to transport client to nearest hospital/PESS center and educated on process. If parent/legal guardian refuses, call 911 and inform of situation; ambulance and/or police will be sent to office.  If you are unsure of case, call Clinical Supervisor first, followed by PESS directly for guidance.

Counselor to contact PESS within hour of client leaving premises to confirm client arrival at PESS. If confirmed client has not yet arrived, counselor to contact 911 and inform of situation. Counselor to follow up with PESS case manager next day.

In crisis situations, it is important to assist in helping the client remain calm while also informing them of the policy and procedures that you need to follow.  Clients referred to PESS must understand the process and that you will call PESS center to confirm screening, outcome and provide any pertinent information to the screening employee present during situation.

Clients or in case of minors-parents/legal guardians are to be informed that prior to or at their next session they will need to bring in:

  • Discharge paperwork from PESS/IOP/other higher level of care including treatment recommendations and medications.
  • Any treatment paperwork from a higher level of care provider if referred after PESS.  A release will be needed from the client or parent/guardians prior to being sent from an institution that can be signed by either party, doesn’t have to be both.

Post discharge from higher level of care:

  • The client must be re-assessed for the following 3 sessions to confirm there is no intent or ideation.  this also needs to be reflected in all of their pertinent notes.
  • Please note, if the client cannot provide discharge forms, the counselor can still see the client to ensure care.  The counselor can have the client sign a release and the counselor can request these documents directly.
  • Homicidal Ideation: Any client who expresses thoughts of harming someone else falls under this category. Complete names and addresses of individuals should be obtained if possible. Police should be notified immediately and client should remain in office until police arrival. If client leaves premises, continue to contact police and inform.
  • Domestic Violence/Sexual Assault/Rape Situations: These situations do not require mandated reporting, however if client is concerned for their safety, you may call 9-1-1 and encourage client to report for the safety and well-being. NJ has the following 24/7 hotlines for these situations:
    • New Jersey Domestic Violence Hotline: 1 (800) 572-SAFE (7233), 24/7
      The New Jersey Domestic Violence Hotline provides confidential access to domestic violence information and services, including crisis intervention, referral, and advocacy.  Bilingual and accessible to the deaf and hearing impaired.
    • New Jersey Coalition Against Sexual Assault (NJCASA) Hotline: 1 (800) 601-7200, 24/7
      The New Jersey Coalition Against Sexual Assault (NJCASA) connects individuals affected by sexual violence with professionals that provide assistance and referrals.  Calls are routed to the closest rape crisis care center.
    • Women’s Referral Central Hotline: 1 (800) 322-8092, 24/7
      The toll-free Women’s Referral Central Hotline provides comprehensive information, referrals, active listening, and crisis response for issues confronting New Jersey residents, including but not limited to:

      • Child Care
      • Discrimination
      • Displaced Homemaker
      • Divorce
      • Employment
      • Housing
      • Job Training
      • Legal Assistance
      • Single Parenting
      • Social Services
    • NJ Coalition Against Sexual Assault: 1-800-601-7200, 24/7
  • Adult Abuse: Any adult or elderly persons who due to physical or mental illness, disability or deficiency, lacks sufficient understanding or capacity to make, communicate, or carry out decisions concerning his or her well-being that may be experiencing abuse, neglect or safety concerns is to be reported to the Director or Clinical Supervisor as well as a mandated report made to Adult Protective Services:
    • Monmouth Family and Children Services: 732-531-9191
      After Hrs.: 911 or local police, 732-531-9191 to leave a message for the next business day 
    • Ocean County Board of Social Services: 732-286-5933, 732-286-5929. After Hrs.: 732-240-6100, 609-693-5834
  • Child Abuse: Any suspicion that a minor is experiencing abuse, neglect or safety issues is a concern is to be reported to the Director or Clinical Supervisor as well as make a mandated report to:
    • NJ Child Abuse/ Neglect Hotline: 1-877-NJ ABUSE (652-2873), 1-800-835-5510, 24/7
    • Other important contacts pertaining to children/adolescents:
      • Family Crisis Intervention Program: 732-240-3638
      • Mobile Response: 1-877-652-7624
      • Division of Child Protection and Permanency (DCP&P): Do not call these numbers to report abuse, this is strictly to ask questions or once a case has been established to communicate:
        • Ocean County:
          • Ocean North LO – #672: 1510 Hooper Avenue, Suite 210 Toms River, NJ 08753. Phone: 732-255-8015 or 866-544-9197, Fax: 732-255-0845
          • Ocean South LO – #671: 333 U.S. Routes 9, 
Bayville, NJ 08721. Phone: 732-908-5900 or 800-442-6232, Fax: 732-269-8961
        • Monmouth County:
          • Monmouth North LO-#663: 1185 Route 36 West, Building E West Long Branch, NJ 07764. Phone: 732-571-2190 or 800-392-9511, Fax: 732-229-2950
          • Monmouth South LO – #666: 630 Bangs Avenue Asbury Park, NJ 07712. Phone: 732-897-6300 or 800-392-9512, Fax: 732-988-7025

Crisis Office Codes: These codes are for counselors to use in communication and collaboration as a staff, with direct supervisors and with each other if back up assistance is needed in the office.