Spotlight
Individuals experiencing acute behavioral crises often end up in the emergency room (ER). However, ERs do not always provide the care needed in these scenarios, with some ERs lacking staff with behavioral health crisis experience and/or requiring individuals in crisis to wait hours for care. Additionally, the ER may be an over-stimulating environment for individuals in crisis, which can escalate feelings of crisis. One promising solution to these issues is the Living Room model, a community crisis respite center offering individuals in crisis an alternative to the ER.
Living Rooms incorporate many principles of recovery into the traditional crisis model such as autonomy, respect, hope, empowerment and social inclusion. Living Room crisis centers are open, inviting spaces, reminiscent of their name—living rooms—with clients referred to as guests to avoid clinical overtones. These centers serve individuals 18 and older experiencing any acute mental health challenge or crisis that would warrant a trip to the ER. Guests coming to Living Rooms can self-refer or be referred by police, fire or emergency departments. Services are typically free for guests, with reimbursement secured through Medicaid and/or a state agency. For example, Illinois has a variety of living rooms across the state, with the Department of Mental Health reimbursing costs for center guests with no insurance.
Living Rooms are staffed with peer counselors who de-escalate crises, establish safety plans, teach coping skills and can generally relate to the individual experiencing a crisis through their own lived experience. Unlike the ER, guests are never held involuntarily in Living Rooms. The Living Room model may not be appropriate for all crises—such as overdose or suicide attempts, which require ER expertise, or at odd hours, as these centers are typically not open 24 hours a day. However, Living Rooms offer a promising crisis alternative, allowing individuals in crisis more options for care and services and reducing trips to the ER.
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