Mental health crisis may be better served in homelike environment instead of traditional ER, says study

Published on January 8, 2014 at 1:25 AM · No Comments

Emergency departments may not be the best choice for persons suffering from severe mental illness or emotional distress. According to a new qualitative study by DePaul University School of Nursing researchers, persons in a mental health crisis may be better served in an alternative recovery-oriented, homelike environment instead of a traditional emergency department.

"Hospital emergency departments are not set up for people with emotional problems. Most people with emotional distress come from a chaotic environment and need a safe or calm space to receive proper attention and treatment," said Mona Shattell, a co-author on a paper published Jan. 7 in the journal Issues in Mental Health Nursing titled "A Recovery-Oriented Alternative to Hospital Emergency Departments For Persons in Emotional Distress: 'The Living Room.'" Shattell is an associate professor of nursing in DePaul's College of Science and Health where she also serves as associate dean for research and faculty development.

The DePaul research team interviewed 18 participants who spent time at The Living Room - an outpatient, voluntary program for persons in emotional distress, operated by Turning Point Behavioral Health Care Center in the Chicago suburb of Skokie, and funded through the Illinois Department of Mental Health. The program, which is staffed with a licensed professional counselor, registered nurse and trained peer counselors, is in a space that is arranged and furnished like a living room in a person's home.

"As researchers and community partners, we were interested in the individual experience of The Living Room," wrote the authors. Those interviewed for the study included the professional clinical staff and peer counselors, as well as patients (referred to as "guests") who were in a crisis, suffering from self-reported psychiatric diagnoses ranging from depression to Asperger's syndrome.

"Participants in our study had experiences as either a person in emotional distress who went to an (emergency department) for help, or as a person who worked with persons in emotional distress in these settings," the authors wrote.

"The experiences of (emergency departments) for persons in emotional distress were characterized by feelings of insecurity, loneliness, intimidation, fear, and discomfort," the study noted. "Participants described feeling unsupported by (emergency department) staff."

"Most patients who came to The Living Room stayed for a few hours, received treatment or help, and left. What makes the space unique is that it is staffed with peer counselors who have experienced mental health issues and are specifically trained to treat the patients, who have responded well to that type of care because they see that recovery is possible," said Shattell, who specializes in mental health and treatment environments.

According to the study's findings, The Living Room helped people with emotional distress or mental illness address their crisis within the context of their life, which helped them utilize their own strengths by talking through problems, calming down and problem-solving to help their illness.

At The Living Room, guests reported being welcomed as "a fellow human being, not like a patient" and that the program was "a helping, not judging zone."

Specific interventions by The Living Room staff were cited in the study as being identified by guests as "helpful and caring." Those interventions included "being understanding, attentive and respectful, exploration of coping techniques, and use of a gentle, calming voice."

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