By Shannon White
In 1963, President John F. Kennedy signed The Community Mental Health Act that shifted funding and services from institutionalized settings to community-based behavioral health services.
It helped people with mental illness who were “warehoused” in hospitals and institutions move back into their communities to seek treatment.
However, one of the unfortunate trends of deinstitutionalization has been a persistent gap in emergency crisis services. This gap in services leaves those in a behavioral health or an addiction crisis to receive treatment in hospital emergency rooms.
Providing behavioral health and addiction crisis assessment and treatment in busy emergency departments that produce long waits for care can be a challenging environment for those in need of immediate treatment for psychological or substance misuse needs.
Centerstone Steps Up
Centerstone Kentucky has built two facilities to fill that gap. The Addiction Stabilization Unit, located at The Addiction Recovery Center (previously JADAC) allows Peer Support Specialists, who are in long-term recovery, to be deployed to local emergency rooms to meet with people suffering from a substance use disorder.
“It’s such an incredible opportunity to meet someone right where they are to offer them immediate treatment,” said Scott Hesseltine, VP, Addiction Services for Centerstone Kentucky.
One Centerstone Kentucky Peer Support Specialist said, “Keep in mind, a lot of these people have no one left, and so to have a stranger show up at their bedside in the hospital to say, ‘Man, I know exactly what that feels like,’ and help them see that there is a better way is awesome. I understand what it’s like to be in the emergency room with one set of clothes. I know what it’s like to be a convicted felon without an address or cellphone, and desperately want to say yes to treatment.”
Once a person agrees to treatment, they are brought to the Addiction Stabilization Unit (ASU) to ensure they are medically stable and then a treatment plan is developed. The ASU uses a person-centered approach making sure the person seeking treatment is actively involved in their process of recovery.
Some people stay in the ASU for as little as 90 minutes, while others can stay for up to 23 hours.
“What we find is that the window of opportunity, what we call a ‘moment of clarity,’ where someone says, ‘Hey, I want help. I want to take action,’ can close very quickly. The ASU allows people who are ready for treatment to be connected to services immediately in a supportive environment,” Hesseltine explained.
Since June, the Centerstone Kentucky Addiction Stabilization Unit has served over 900 people in a substance use crisis. By capitalizing on that critical window of opportunity for treatment, the ASU is offering an alternative to emergency department overcrowding and allowing clients to start their recovery journey in a safe and secure setting.
Focus on Children
Centerstone Kentucky also operates a Crisis Stabilization Unit for youth under 18 who are experiencing a mental health crisis.
Often, when children experience a behavioral health crisis, parents and caregivers may not know what to do, or who is available to help meet the family’s needs. The Centerstone Kentucky Crisis Stabilization Unit (CSU) is an alternative to an emergency room visit or inpatient psychiatric hospitalization and can help families return to a pre-crisis level of functioning.
Children at the CSU receive a combination of individual therapy, family and group therapy, nursing services and psychiatric evaluations with medication management follow-up. The length of stay can vary, but typically is less than five days.
In 2013, the Substance Abuse and Mental Health Services Administration (SAMHSA) and Center for Medicaid and CHIP Services (CMCS) recognized Crisis Stabilization Services as “not only clinically effective but cost effective as well.”
The Centerstone Crisis Stabilization Unit is specifically designed to meet the needs of children and their parents/caregivers. This allows children to avoid more restrictive and costly interventions while ensuring connection to necessary services and supports.
The CSU is effective at providing suicide prevention services, addressing behavioral health treatment and tackling the distress experienced by families involved in a behavioral health crisis. It allows kids to get back to a place before the crisis and benefits the entire family as well.
A recent 12-year-old CSU client said, “It’s crazy how much I have changed and figured out about myself in five days. I feel much better now.”
Both the Centerstone Kentucky Addiction Stabilization Unit (ASU) and the Crisis Stabilization Unit (CSU) for children are effective at providing immediate substance use disorder treatment, addressing behavioral health issues, and diverting individuals from entering a higher level of care across our community. These programs are filling a gap for patients across the region and allowing them to begin the road to recovery.
-Shannon White is VP of marketing and external affairs at Centerstone.