The requirement to involve or contact the call center prior to initiating either of these services for children can create a barrier by increasing the time involved before intervention can begin as well as leading to escalated behaviors whilst waiting for intervention to begin.  For example, many crisis situations with youth begin in school where we already have a case manager or other staff present to assess and refer to crisis services immediately.  Adding the step to contact the call center, especially if the family is required to complete this step, could lead to escalated behavioral and emotional situations that ultimately would require a higher level of care.  In small, rural community settings, many upstream connections and relationships are already cultivated to maintain comprehensive care for children.  Youth are often already known and identified among multiple systems to provide upstream preventative care in the crisis system.  Expecting families to reach outside of this support systems adds an extra burden to effective and timely care and can create unnecessary stress and trauma for children/adolescents.