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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EThis article reviews a fiscal year 2014 results from a community crisis respite program called The Living Room. This program offers a cost-saving alternative to the emergency department for individuals in crisis.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Emood disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Epersonality disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Esubstance-related disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eschizophrenia\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EMichelle Heyland, MSN, APN, Rush University College of Nursing, Chicago, Illinois, USA, shared fiscal year 2014 results from a community crisis respite program called The Living Room. This program offers a cost-saving alternative to the emergency department (ED) for individuals in crisis.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EAccording to Ms Heyland, approximately 12.5% of all ED visits in the United States involve a mental health or substance abuse diagnosis, and these are more than twice as likely to result in hospitalization than visits without such a diagnosis [Owens PL et al. \u003Cem\u003EAgency for Healthcare Research Quality Statistical Brief #92.\u003C\/em\u003E 2010]. These patients tend to receive inappropriate care, for reasons including ED overcrowding, lack of priority triage, and the absence of trained psychiatric professionals to help with crisis de-escalation [Shattell MM, Andes M. \u003Cem\u003EIssues Ment Health Nurs.\u003C\/em\u003E 2011; Clarke DE et al. \u003Cem\u003EInt J Ment Health Nurs.\u003C\/em\u003E 2007]. Studies have shown that individuals in crisis want to visit a place where they feel safe and respected, and can talk to trained psychiatric professionals who understand their needs [Agar-Jacomb K, Read J. \u003Cem\u003EJ Mental Health.\u003C\/em\u003E 2009; Clarke DE et al. \u003Cem\u003EInt J Ment Health Nurs.\u003C\/em\u003E 2007].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EMs Heyland described a community crisis respite center called The Living Room as one alternative to the ED for providing service to people in crisis. This was named after the familiar home space, and is offered free of charge to clients who are referred to as \u201cguests,\u201d in an attempt to emphasize its nonclinical environment. It provides an inviting atmosphere that is warm, welcoming, and without excessive stimuli. The layout allows for guest privacy with a separate area for rest and relaxation.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EStaff members are trained psychiatric professionals, and include a therapist and a psychiatric nurse; there are also peer counselors who have a mental illness but have recovered enough to be able to offer help to others in need.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EGuests who visit The Living Room are triaged by the therapist to obtain some basic demographics (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E), determine the nature of the crisis, and assess the guest\u0027s levels of distress, risk, and safety. They then meet with the psychiatric nurse, who establishes the guest\u0027s vital signs and also addresses any issues they may have regarding medical conditions or medications, for example.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15135\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15135\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15135\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EDemographics of Guests Visiting The Living Room in Fiscal Year 2014\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003EGuests also meet with a peer counselor for in-depth discussion of the nature of the crisis, and to help identify coping skills the guest can use to decrease distress. Ms Heyland emphasized that, due to their own experiences, peer counselors are uniquely positioned to offer support and empathy and to advocate for guests.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EAccording to Ms Heyland, initial results of this program have been positive. In the 2014 fiscal year, of 262 total visits to The Living Room, guests were deflected from attending the ED on 258 visits (98.5% deflection rate), with an average decrease of 2.44 points on the subjective units of distress scale. Since the average cost of a visit to The Living Room is $269, compared with $2500 for a visit to the ED for a psychiatric reason, the 98.5% ED deflection rate represents an estimated savings of approximately $2231 per visit, for a total annual cost savings of \u0026gt; $575 000 to the State of Illinois. Importantly, guests who visit The Living Room are also receiving more appropriate psychiatric care, she concluded.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/44\/12.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzluhq\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzluhq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}