If the patient is in the community, determine if they are in crisis and need immediate assistance. Refer the patient to your state’s mobile crisis unit or 911, depending on the level of need. Call for support on their behalf if necessary.

Resources for patients who have thoughts of self-harm or suicide:

• Call 911 or go to the closest emergency department

• Call 988 for the National Suicide & Crisis Life Line

• Text HOME to 741741 for the Crisis Text Line

Do you think this patient needs inpatient/residential SUD treatment or can they be treated in the community? Please see Assessing patient behavioral health needs and options for intervention for more information. If the BD treatment team believes that the patient needs and is ready for residential treatment, ensure that their insurance will cover it. Please note: the inpatient/residential facilities will conduct their own assessments and determine whether the patient requires inpatient/residential level of care.

Consider whether there is another provider who might be more successful than a member of the bleeding disorders (BD) treatment team (primary care provider, emergency department (ED) provider, a non-BD social worker) who could make the initial referral and serve as the primary provider contact for the referral.

Best Practice Recommendation

BD SUMHAC recommends that the referring provider is NOT a member of the bleeding disorder treatment team. We have found that BD treatment teams have more success in securing SUD placements for their patients when they partner with other providers (ED, hospital, primary care physician, or other mental health provider). BD SUMHAC has also created a resource for ED/hospital providers to help them better understand the issue of barriers to access for people with BD and offer suggested language for them to use during the initial outreach call. Please see the section Resources for ED/hospital-based providers.

The provider prepares and collaborates with the patient to make the initial outreach call to the treatment facility to determine bed availability and request an intake call. Facilities are often more likely to take patients who advocate for themselves and are willing to do their own outreach (with support). If necessary, the provider makes the initial referral call to the facility. 

Click here for our tips on how to discuss bleeding disorders with a mental health or substance use disorder treatment facility.

The facility sends over the admissions paperwork or denies admission.

The provider completes and submits the admissions paperwork to the facility.

The patient, with provider support, does an intake call with the facility.

Resource Alert!

BD SUMHAC has specific recommendations for language that patients can use during these intake calls with SUD facilities. Preparing the patient with a BD for the initial outreach or intake call with the residential SUD facility in Recommendations for referring patients with bleeding disorders to behavioral health treatment facilities.

The facility accepts or denies the patient admission. If the non-BD provider informs you that your patient has been denied access to a SUD facility, ask them to explain the reason. There are many appropriate reasons that people are denied access to SUD facilities that have nothing to do with BD. For example, no beds are available, the facility determined the patient does not need the level of care that they provide, or the facility determined that your patient is not yet ready for treatment.

If the facility denies the patient because of their BD, that is not the end of the story. It is the beginning of the provider’s advocacy on behalf of the patient. Don’t give up and encourage your patient not to give up either. This toolkit contains significant resources that have been used successfully to secure admission for patients who had previously received denials because of their BD. Please see the section Responding to a behavioral health facility denial for more information on how to advocate for your patient.

Resource Alert!

This toolkit has numerous resources that can be used to secure placements for bleeding disorder patients after they have received a denial because of their BD. Please see the section Responding to a behavioral health facility denial.