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Behavioural Crisis Debrief Conversation: A Guide or Primary Care Providers

Behavioural Crisis Debrief Conversation

A Guide for Primary Care Providers

Introduction

A debrief meeting between a primary care provider and a patient with intellectual and developmental disabilities (IDD) who has been discharged from the hospital or emergency department following an episode of emotional distress or behavioural crisis is an important aspect of continuity of care. The steps in this document guide the crisis debrief conversation with a patient and caregiver and highlight aspects that are specifically important for patients with IDD.

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Clinical lead

Dr. Ullanda Niel is the Chief of Family Medicine and a Developmental Consultant at Surrey Place. She is also a Professor in the Department of Family and Community Medicine at the University of Toronto and Queen’s University. She has a robust clinical practice as a Family Physician at a Community Health Centre and a group home in Toronto, Canada. Dr. Niel has completed a fellowship in the Primary Care of Adults with Intellectual Disabilities at Queen’s University. She participated in creating The 2018 Canadian Consensus Guidelines on Primary Care for Adults with Intellectual and Developmental Disabilities and clinical resources for the transition of youth with intellectual disabilities to adult care and other point of care tools.

Authors

Yona Lunsky, PhD, C.Psych, Senior Scientist, Director of the Azrieli Adult Neurodevelopmental Centre, and Director, Centre for Addiction and Mental Health, Toronto; Full Professor, Department of Psychiatry, University of Toronto; Adjunct Scientist at ICES, Toronto

Kerry Boyd, MD, FRCPC, Associate Clinical Professor, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario

Elspeth Bradley, MBBS, PhD, FRCPC, FRCPsych, Associate Professor, Department of Psychiatry, University of Toronto; consulting psychiatrist and psychotherapist in intellectual disabilities

Laurie Green, MD, CCFP(EM), FCFP, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario

Karen McNeil, MD, CCFP, FCFP, family physician and Assistant Professor, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia

Anupam Thakur, MBBS, MD, MSc, Psychiatrist-in-Chief,Surrey Place, Toronto; staff psychiatrist and education scholar, Centre for Addiction and Mental Health, Toronto; Assistant Professor, Department of Psychiatry, University of Toronto

Alicia Thatcher, MD, CCFP, Regina, Saskatchewan

William Sullivan, MD, CCFP(COE), FCFP, PhD, Joseph P. Kennedy Sr. Chair in Bioethics, Senior Research Scholar, Kennedy Institute of Ethics; Full Professor of Family Medicine, Georgetown University

This tool was developed in the context of the update of the 2011 primary care mental health toolkit, published in: Sullivan WF, Developmental Disabilities Primary Care Initiative Scientific and Editorial Staff, editors. Tools for the primary care of people with developmental disabilities. Toronto: MUMS Guideline Clearing House; 2011. The content development for this tool was subject to review by primary care providers.

  • Meet the team

    Clinical lead

    Dr. Ullanda Niel is the Chief of Family Medicine and a Developmental Consultant at Surrey Place. She is also a Professor in the Department of Family and Community Medicine at the University of Toronto and Queen’s University. She has a robust clinical practice as a Family Physician at a Community Health Centre and a group home in Toronto, Canada. Dr. Niel has completed a fellowship in the Primary Care of Adults with Intellectual Disabilities at Queen’s University. She participated in creating The 2018 Canadian Consensus Guidelines on Primary Care for Adults with Intellectual and Developmental Disabilities and clinical resources for the transition of youth with intellectual disabilities to adult care and other point of care tools.

    Authors

    Yona Lunsky, PhD, C.Psych, Senior Scientist, Director of the Azrieli Adult Neurodevelopmental Centre, and Director, Centre for Addiction and Mental Health, Toronto; Full Professor, Department of Psychiatry, University of Toronto; Adjunct Scientist at ICES, Toronto

    Kerry Boyd, MD, FRCPC, Associate Clinical Professor, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario

    Elspeth Bradley, MBBS, PhD, FRCPC, FRCPsych, Associate Professor, Department of Psychiatry, University of Toronto; consulting psychiatrist and psychotherapist in intellectual disabilities

    Laurie Green, MD, CCFP(EM), FCFP, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario

    Karen McNeil, MD, CCFP, FCFP, family physician and Assistant Professor, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia

    Anupam Thakur, MBBS, MD, MSc, Psychiatrist-in-Chief,Surrey Place, Toronto; staff psychiatrist and education scholar, Centre for Addiction and Mental Health, Toronto; Assistant Professor, Department of Psychiatry, University of Toronto

    Alicia Thatcher, MD, CCFP, Regina, Saskatchewan

    William Sullivan, MD, CCFP(COE), FCFP, PhD, Joseph P. Kennedy Sr. Chair in Bioethics, Senior Research Scholar, Kennedy Institute of Ethics; Full Professor of Family Medicine, Georgetown University

  • About the tool development

    This tool was developed in the context of the update of the 2011 primary care mental health toolkit, published in: Sullivan WF, Developmental Disabilities Primary Care Initiative Scientific and Editorial Staff, editors. Tools for the primary care of people with developmental disabilities. Toronto: MUMS Guideline Clearing House; 2011. The content development for this tool was subject to review by primary care providers.

All rights reserved. No part of this website may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the prior written permission of the copyright owner, Surrey Place. Contact the Developmental Disabilities Primary Care Program at Surrey Place at ddpcp@surreyplace.ca for permission to adapt information and tools to your local practice setting.