LOCUS

Question 1

WHAT IS the LOCUS

Answer 1

Leve of Care Utilization System: tool designed to assess level of care needs of individuals experiencing psychiatric and addiction challenges. Used all over country

Question 2

advantages of LOCUS

Answer 2

Not diagnostically driven
 Looks at current needs – recognizes that
some individuals need similar treatment
models even with different diagnoses
 Prioritizes needs: current needs
 Snapshot only: things change – in some
cases quite rapidly
 Adaptable - allows for a changing
continuum
AT
Fundamental principles
 Simple to use
 Able to be completed after or during assessment –
removes redundancy
 Measures both psychiatric and addiction problems
and their impact on client together
 Levels of care are flexible – describes resources and
intensity not programs – adaptable to any continuum
of care
 Dynamic model – measures client needs over time –
eliminates need for separate admission, discharge and continuing stay criteria when using this
instrument

Question 3

6 dimensions of assessment

Answer 3

1. Risk of Harm;
2. Functional Status;
3. Medical, Addictive and Psychiatric
   Co-Morbidity;
4. Recovery Environment;
5. Treatment and Recovery History; and
6. Engagement.

Question 4

“ingredients” of each level

Answer 4

Each level made
up of 4 “main
ingredients:”
 Care Environment,
 Clinical Services
 Support Services,
and
 Crisis Resolution
and Prevention
Services

Question 5

6 LOCUS service levels of care

Answer 5

I. Recovery maintenance and health
management
II. Low Intensity Community-Based
III. High Intensity Community-Based
IV. Medically monitored non-residential
V. Medically monitored residential
VI. Medically managed residential

Question 6

LOCUS dimensional rating system

Answer 6

Assesses level of severity of client’s needs
 Each dimension has a 5-point rating scale
 Each point has one or more criteria
 Only 1 criteria needs to be met for the rating
to be assigned
 If there is criteria in two points pick the
highest
 Do not add criteria to get a higher score
Ratings range from minimal (0) to
extreme (5)
 If nothing fits exactly, pick the closest
fit – err on the side of caution
 Use interview, clinical judgment,
records, family, school, and
collaborative data
Score is based on an evaluation of 6
dimensions
 Must use a primary presenting issue to
complete the evaluation: e.g. dually
diagnosed – choose one
 Other conditions seen as co-morbidity
 Think of the condition most readily apparent,
the primary reason why someone came into
care or is still in care

Question 7

Scoring the LOCUS

Answer 7

Always stand back and regard the point chosen –
does it make sense for the client?
 Err on the side of caution, but do not choose a level
of need that exaggerates the client’s situation.
 Use all the incoming data including the interview,
most recent MSE, intuition, data from client, family,
others, and history.
 Remember you are concentrating on now and the
current needs,
 However in both risk of h

Question 8

Chronbic vs. Acute scores

Answer 8

Chronic issues usually fall in the 1,2,3 scores

 Acute issues in the 3,4,5 scores

Question 9

NSPL CORE PRINCIPLES & SUBCOMPONENTS

Answer 9

suicidal: desire, capability, intent, connectedness/buffers

Question 10

NSPL suicidal DESIRE

Answer 10

• Suicidal Ideation;
• Psychological Pain
• Hopelessness
• helplessness
• Perceived Burden on others
• Feeling trapped
• Feeling intolerably alone

Question 11

NSPL CAPABILITY

Answer 11

• history of attempts
• exposure to someone else’s death by suicide
• History of Violence to self/others
• available means of killing self
• currently intoxicated
• substance abuse
• Acute sx. of mental illness- recent mood change; out of touch with reality
• extreme agitation/rage– increased anxiety; decreased sleep

Question 12

NSPL INTENT

Answer 12

• attempt in progress
• Plan to kill self/others
• preparatory bx.
• expressed intent to die

Question 13

NSPL Buffers/Connectedness

Answer 13

• immediate supports
• Social supports
• Planning for the future
• engagement with helper/telephone worker
• Ambivalence for living/dying
• Core values/beliefs
• Sense of purpose

Question 14

ATC model for crisis services theory

Answer 14

• Always know where the aircraft is and never lose contact;

* verify the hand-off has occurred and airplane is safely in hand of another controller;

Question 15

ATC model for crisis services

Answer 15

tracking of status and disposition of linkage/referrals;; speed of accessibility; including where they are, how long they have been waiting, and wha is needed to advance dservice linkage; 24-7 patient scheduling; crisis bed registry; GPS-enabled mobile crisis dispatch; real-time performance outcomes;