Partnering with families to effectively support children experiencing mental health crises

HBCI clinicians meet families where they live and navigate each unique situation with care.

By Melissa Aase, CEO of University Settlement


Our Home-Based Crisis Intervention (HBCI) program partners with children (ages 5-20) experiencing psychiatric crisis and their families

We’ve been doing this work since 2003, and now serve 100+ families in Manhattan and Brooklyn every year

In short-term, six week-long interventions, HBCI clinicians approach each family with care, sensitively navigating established relationship dynamics and mental health stigma while making connections to longer-term supports 

Please be warned that this article discusses potentially triggering topics including suicide.

When children in our neighborhoods experience significant mental health issues that put them at risk of hospitalization, our Home-Based Crisis intervention team is here to partner with them and their families and keep them safe in their own homes.

Having effective, open conversations about mental health with our loved ones is difficult under the best of circumstances – and when our clinicians begin their engagements with families, we’re meeting them on one of the most challenging days of their lives. 

I recently spoke with a mom whose son partnered with HBCI last year, who shared how her family’s experience with the program continues to strengthen their relationships and the way they navigate mental health discussions:

“My teenage son was born prematurely, and my husband was diagnosed with cancer and died a few months later.  I became a single parent right after my son was born.

My son’s prematurity created challenges: He needed speech therapy in the early months and was later diagnosed with learning disabilities which caused him to be held back in school.

My deceased spouse had struggled with his mental health, but I didn’t. So when my son started having issues with depression and anxiety, I didn’t see it at first. He was train surfing and going places he shouldn’t. His friends alerted a school psychologist, and he was evaluated at Bellevue Hospital, which led to an inpatient stay. When he was released, his care team put me in touch with University Settlement’s Home-Based Crisis Intervention.

I was immediately comfortable with Emily from the HBCI team. She was amazing in how she adapted her style to our family. She made sure that we all understood the situation we were dealing with. We were in a bit of denial at first – my son wasn’t writing suicide notes. But Emily explained how suicidality could show up as impulsiveness in teenagers. Although my son wasn’t consciously trying to harm himself, behavior like train surfing could have led to horrible outcomes.

My boyfriend has been around for almost my son’s entire life. He didn’t believe in therapy, and he had his guardrails up. He has good intentions and a good heart, but he also hoped this would all go away. He was concerned my son was on medication. It’s hard when two parents have two very different, very strong opinions. But Emily had an amazing conversation with him, talking through his concerns step-by-step, helping him see that I’d done my research and my son needed to be on medication.

Emily taught us some important things we have incorporated into our lives. For example, people with depression and anxiety benefit from structure. We have a note up in our kitchen that reminds us when to get up and shower, and to put our phones away before bed.

For a child who is struggling with depression, you need family support to be successful – the whole family dynamic needs to change. If you’re doing things the way you were doing them before, you could wind up in the hospital again, or worse. Emily and her team partner with the whole family to ensure that doesn’t happen.

My boyfriend and I are loud, and my son is quiet. He didn’t know how he was feeling, much less how to tell us how he felt. Emily and HBCI helped us create a space where we could have those kinds of conversations. Your program gave my son the words to express how he was feeling and, even more, how to cope with his feelings.


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