Responding to Crisis: The Crisis Living Room

SEP. 28, 2020

By Kristen Fuller, M.D.

Approximately 1 in 5 people
 visit an emergency room at least once per year in the U.S., typically due to chest pain, broken bones, falls, strokes or back pain. Although emergency rooms are designed for acute physical ailments such as these, approximately 4% of all visits are due to mental illness or substance use, including overdose, acute psychotic features, a panic attack or a suicide attempt. 

Unfortunately, emergency rooms — and even most hospitals — are not set up to adequately treat mental illness due to time constraints and stressful surroundings. The fast-paced environment is often filled with bright lights, loud noises and other factors that can cause anxiety for those undergoing treatment. Most emergency room doctors also do not specialize in mental health or addiction, and will often treat the medical symptoms rather than the mental and emotional causes of a person’s condition. As a result, many people with mental illness leave the emergency room in emotional pain and turmoil because the origin of their crisis was never addressed. 

We need an alternative.

Crisis Living Rooms May Reduce ER Visits

Reducing unnecessary emergency room visits is challenging, especially with the lack of awareness and funding for mental health resources. However, a small town in Colorado has produced a great example of one potential option: the “crisis living room.” The crisis living room is a small house open to the public that caters to patients who need help due to mental illness. 

This open, airy environment provides counseling, monitoring and medication management for those who need it. With five mental health clinicians and two social workers on staff, the home served 28 visitors in May 2014, potentially preventing these 28 people from needing to visit an emergency room. However, national data comparing the two types of facilities is not available, making it difficult to determine their true relative efficacy.  

Crisis living rooms may be used as an alternative to emergency rooms for some psychiatric illnesses, but may not suffice for all conditions. For example, some crises, such as an overdose or suicide attempt, need to be treated in an emergency room setting by a physician as medical intervention is often necessary. Additionally, emergency rooms are open 24 hours a day, seven days a week, while some mental crisis living room centers are only open Monday-Friday during business hours. 

Despite these setbacks, there is a lot of potential for community-based alternatives like the crisis living room model for mental health treatment and crisis care. 

Knowing the location and contact information of a safe alternative to the emergency room may be just what a person needs to get through their darkest days. And providing help in the most caring, humane way possible is a step in the right direction toward changing the mental health system in our country.

Kristen Fuller M.D. is a family medicine physician with a passion for mental health. She spends her days writing content for a well-known mental health and eating disorder treatment facility, treating patients in the Emergency Room and managing an outdoor women's blog. To read more of Dr. Fuller's work visit her Psychology Today blog and her outdoor blog, GoldenStateofMinds

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