Considerations for Standardizing Safety Planning, Crisis Prevention, and Crisis Response in Ryan White Funded Clinics: Lessons Learned from Current Practices in Ryan White Clinics, Mental Health Clinics, and Domestic Violence Shelters Open Access

Abstract

In making considerations for the standardization of safety planning, crisis prevention, and crisis response in Ryan White-Funded Clinics (RWCs), it is important to highlight its significance as a pillar to providing Trauma Informed Care (TIC). The data that was used in this thesis was nested within a study that focused on TIC in RWCs. For this thesis, qualitative interview data from participants in various clinical roles were used to assess their level of awareness of site safety and crisis protocols and the extent to which they are regularly implemented. Participants discussed methods used to standardize safety and crisis planning protocols, such as: collecting information through the patient intake process, peer navigators, using social workers as mediators, addressing environmental factors, and leveraging community advocacy boards. Crisis response strategies discussed the need for consistent clear policies and protocols, police officers, and creating safety plans based on patient or healthcare professional needs. Safety planning tactics included monitoring potential conflicting schedules for involved parties, creating safety contracts, installing panic buttons, having protocols for domestic violence affairs, and room placement for staff. These methods provide an effective approach to creating and maintaining safe environments in such clinics while reducing the risk of harm. RWCs can consider providing education and resources on coping skills, having regular mental health screenings, partnering with domestic violence shelters, and offering support groups.

Table of Contents

Table of Contents

Chapter 1: Literature Review…………………………………………………………………..................1

History of HIV Epidemic…………………………………………………………………………...............1

HIV Care Continuum…………………………………………………………………………….................2

Significance of Ryan White Clinics………………………………………………………………............5

Trauma Among PLWHA ………..…………………………………………………………….…...............6

Defining Crisis….………………………………………………………………………………...................8

Crisis Planning………………..…………………………...…………………………………….................10

Safety Planning………………………………...………………………………………………..................11

Potential Challenges with Implementation of Safety and Crisis Planning…………….…………12

Existing Safety Protocols and Procedures in Clinical Settings………………………………..…....12

Gaps in Literature……………………………………………………………………………….................13

Chapter 2: Introduction……………………………………………….............................................15

Chapter 3: Methods…………………………………………………………………………………….........16

Recruitment and Data Collection………………………………………………………………..............16

Data Collection Tools and Analysis……………………………………………………………..............17

Chapter 4: Results…………………………………..……………………………………………..…….......19

Crisis Prevention……………………………………………………………………………….…...............19

Crisis Response……………………………………………………………………………….….................22

Safety Planning and Response…………………………………………………………........................26

Chapter 5: Discussion…………………………………………………………………….……………........29

Chapter 6: Conclusion…………………………………………………………………………………........33

Chapter 7: Public Health Implications…………………………………………………………………...34

References…………………………………………………….…………………………………………........36

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Sociology, Public and Social Welfare Health Sciences, Public Health
Keyword	Crisis Prevention Protocols and Procedures Safety Planning Crisis Response HIV Domestic Violence Shelters Ryan White Clinics
Committee Chair / Thesis Advisor	Kalokhe, Ameeta, Emory University

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