The Living Room, a community crisis respite program: Offering people in crisis an alternative to emergency departments

Objective: To describe The Living Room, a community crisis respite center that offers individuals in crisis an alternative to obtaining services in an emergency department (ED). Methods: This article describes the problems individuals in a mental health crisis may encounter in traditional EDs and explains how The Living Room addresses these problems. The Living Room’s development, setting, staffing and procedures are described in order to promote increased use of this type of program. Results: In its first year of operation, The Living Room hosted 228 visits by 87 distinct individuals (termed “guests”). Guests were deflected from EDs on 213 of those visits – a 93% deflection rate. These deflections represent a savings of approximately $550,000 to the State of Illinois since guests of The Living Room are overwhelmingly individuals with Medicaid or no insurance of any kind. On 84% (n=192) of the occurrences in which guests were deflected from EDs, they alleviated their crises sufficiently to decide to leave The Living Room and return to the community. These guests reported an average decrease of 2.13 points on the Subjective Units of Distress Scale. Conclusions: Community crisis respite centers such as The Living Room represent an important alternative to EDs by remedying many criticisms of traditional EDs made by individuals in crisis. Outcomes from The Living Room’s first year of operation suggest that community crisis respite centers are cost-effective, effective in helping many individuals alleviate crises, and have the potential to decrease the use of EDs for mental health crisis.