Robert Haggard, CRSS
Recovery Support Specialist
Turning Point Behavioral Health Care Center, Skokie IL
The answer is a resounding yes, there are alternatives to emergency departments (EDs) for psychiatric emergencies. Person-centric, community-based crisis interventions found outside of traditional emergency departments serve a population with much-need, save lives and money, and offer hope. The Turning Point Behavioral Health Care Center (TP) where I work is a viable, safe, accessible, welcoming, warm, and caring space that has provided an alternative to EDs since 2011 with an amazing 97% deflection rate from the hospitals in its surrounding area.
Focusing on disabilities, shortcomings, tragedies, downfalls, heartaches, and misfortunes and labeling people are not what we are all about at TP. Instead, we refer to visitors—who are experiencing a wide variety of psychiatric crises—as “guests” as we visit with them in The Living Room (TLR) at TP.
The Living Room experience
Five days a week a savvy, dedicated team made up of two clinical supervisors, a psychiatric registered nurse, and peer counselors provide support, problem solving, verbal de-escalation, relaxation skills, community resources, and a variety of proven and effective interventions. Our goal is to empower our guests to implement coping skills and a plan of safety for the days that follow their visit to TLR. We actively listen, follow the direction of our guests’ needs as they determine them to be, and work together to address the crisis at hand. Intervention sessions last as needed from 1 to 5 hours and sometimes days, until the crisis is manageable.
Turning Point’s TLR project has possibly saved a few lives and acts as a safety net for those people in acute crisis who may have otherwise fallen through cracks in the system. Our professional team of peer counselors and clinical staff offer less intrusive and less clinical acute care in a far more enjoyable and nurturing environment than typical EDs. We support a wide array of experience and dedication to people in crisis. We provide a respite during stress-inducing times, such as gaps in insurance coverage, employment, or access to ongoing services and housing, or as part of aftercare programs for guests who have visited a psychiatric unit.
TLR model provides an alternative to connect with someone or to talk through a crisis rapidly without going through the rigors of an ED. Having people in crisis talk face-to-face with a peer counselor can be less costly to the health system and often a less disruptive experience for the guest. As a result, TLR has saved approximately $1.8 million through ED diversion while offering support and resources that are in high demand.
A growing alternative
TLR is a part of a movement of Alternatives to Emergency Departments (ALT EDs). The goal is to improve the experience of the individual by offering alternatives that are safe and welcoming at times of high stress which, in turn, can shift a person’s approach toward accessing care.
TLR was heavily influenced by an organization in Arizona, where the original “Living Room” idea organically germinated. Located throughout the country, these ALT EDs offer more cost-effective and person-centric interventions, functioning as reliable and trusted preventive health measures for people who choose to access care outside of the ED. Some ALT EDs have beds, some are paired with hospital EDs, and still others are in close proximity to police departments, courts, or hospitals.
Peer specialists are key to success
ALT EDs are staffed by peer specialists who have come to terms with their own diagnosed mental health condition. As such, they can relate to an experience personally or to something similar to that which the guests are experiencing. This empathic approach and honesty can break down barriers and form a bond enabling the individual to work things out more quickly than is often achieved in traditional therapies because the focus is on interventions in a safe, non-clinical, person-centric, community-based environment.
People in crisis are vulnerable and can experience interactions with police, the courts, or EDs as intimidating or scary. Offering alternative spaces to develop a plan that is driven by the individual can prove to be a more positive experience for a person experiencing acute crisis. That’s a win for everyone.