Are mental health disorders' characteristics such as presence and severity related to the nature of a crisis, its dangerousness and the types of services offered?

The mandate of crisis centres varies substantially from one country to the next according to the government policies in effect. In the United States, crisis centres were developed based on Caplan's theory, which defines crisis as a psychosocial disorganization following a life event that is resolved with a return to balance. This approach aims at preventing the onset of mental health disorders through short-term intervention. It is different in Quebec, where crisis centres were developed in a deinstitutionalization context and ought to constitute an alternative to hospitalisation. Such mandate of Quebec crisis centres is not necessarily of the preventive nature associated with Caplan's theory and it has led to services having to be adapted to a heterogeneous clientele that may or may not suffer from mental health problems. It has implications related to the crisis characteristics such as its nature, intensity, and dangerosity, as well as implications regarding the organization of crisis centre services, which have been the object of few studies so far. The present study aims at distinguishing clinical profiles of crisis centre callers according to the presence or absence of a mental health disorder and its nature, that is severe and persistent (psychotic or bipolar disorder) or not (mood, anxiety or personality disorder). In order to do so, participants are compared on the characteristics of the crisis and the services they received. In this descriptive study, the files of 1170 new assistance applicants are retrospectively analyzed based on a predetermined grid that was used to collect data according to the main clinical characteristics of persons in distress, as recognized in the literature. The subgroup of persons presenting a psychotic or bipolar disorder was examined separately from the one comprising persons with an anxiety, mood or personality disorder because of its clinical complexity, which generally requires intensive, multidisciplinary follow-up. Among the new applicants, 48% had a mental health disorder and, of these, 9% reported a serious mental health disorder, that is, a psychotic or bipolar disorder. The results indicate that having an anxiety-, mood- or personality-type disorder is associated with a higher probability of reporting stressful interpersonal-type events, a more intense crisis, as well as a greater risk of auto-aggressive behaviours. Meanwhile, persons with a psychotic or bipolar disorder are more frequently provided with accom