Crisis stabilization a critical component of strong mental health system

Melanie Dallas, LPC

When someone suffers an acute physical illness or injury, he or she will usually go to the nearest hospital emergency room for help. The ER is designed to treat almost any type of physical health crisis – medical staff help stabilize the patient and can provide antibiotics, oxygen, blood, sutures and splints, or prepare someone for emergency surgery. Once the patient is treated, he or she usually follows- up with an appropriate doctor on an outpatient basis.

But as good as emergency rooms are at treating physical health emergencies, they are often not as equipped to treat individuals in mental health crisis. Unfortunately, individuals in mental health crisis are sometimes unaware of other community resources that might be better able to help them and often go the emergency department instead.

Mental Health Corporations or America (MHCA), a mental health provider association, reports that substance abuse and mental health issues account for approximately one of every eight visits to the emergency room. Research by the Agency for Healthcare Research and Quality found that in 2010, 5.3 million emergency department visits involved a diagnosis related to a mental health condition.

This is not only expensive, but often inefficient. According to MHCA, the average cost of an emergency room visit for behavioral health problems ( mental health or substance use) is $ 4,487, three- andhalf times the average cost of an ER visit ($ 1,265). Further, patients with behavioral health needs spend an average of 11 hours in the ER – 40 percent more time than a typical ER visit – and often that time is spent waiting for a bed to become available in a psychiatric facility.

Many times, however, psychiatric hospitalization is not needed, especially once an individual in mental health crisis has been stabilized and referred to an appropriate community mental health provider for follow- up. In addition, many patients in behavioral health crisis can be stabilized in community- based crisis stabilization units, which is not only less costly but provides a more direct link to follow- up services.

In Northwest Georgia, Highland Rivers Health operates three crisis stabilization units ( CSUs) that are available 24 hours a day, seven days a week as emergency receiving and evaluation facilities. These facilities are a first- line alternative to hospitalization in psychiatric or acute care hospitals – and, often, to the emergency room – and provide medically supervised psychiatric stabilization and detoxification for adults on a short- term basis ( generally between three and eight days).

The CSUs – which are located on Rome, Cedartown and Dalton – serve all 31 counties in Georgia Department of Behavioral Health and Developmental Disabilities Region 1, including all 12 counties served by Highland Rivers. Not only can these facilities help individuals avoid unnecessary trips to the emergency room, they provide a direct link to outpatient mental health or substance use treatment services at our clinics for follow- up.

Of course, stabilization services are only one component of a community- based mental health crisis response system that also includes mobile mental health crisis response teams, law enforcement officers and first responders trained in mental health crisis intervention, observation beds in local healthcare facilities, hotlines and peer support services.

Many of those services are already available in northwest Georgia, and Highland Rivers continues to work to strengthen the system by partnering with law enforcement agencies – who often are the first to encounter an individual in mental health crisis – and local hospital emergency departments. We also work to educate members of our communities about the availability of affordable community mental health services so people can get the help they need before reaching a crisis.

If you or someone you know needs immediate help due to a mental health crisis, you can call the Georgia Crisis and Access Line ( GCAL) toll- free from anywhere in Georgia at 1- 800- 715- 4225 for help and referral to the most appropriate treatment.

Melanie Dallas is a licensed professional counselor and CEO of Highland Rivers Health, which provides treatment and recovery services for individuals with mental illness, substance use disorders, and intellectual and developmental disabilities in a 12- county region of northwest Georgia that includes Bartow, Cherokee, Floyd, Fannin, Gilmer, Gordon, Haralson, Murray, Paulding, Pickens, Polk and Whitfield counties.