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9. Establishing Specialized Mental Health and Substance Use Emergency/Urgent Care Centers

Providing Appropriate Emergency Care for Behavioral Health Crises​

Hospital emergency rooms (ERs) are often the first point of contact for individuals experiencing acute mental health or substance use crises. However, traditional ERs are typically designed for medical emergencies and are often ill-equipped to provide the specialized, de-escalated, and therapeutic environment needed for behavioral health crises. This can lead to long waits, inadequate assessment, premature discharge, reliance on sedation or restraints, and traumatic experiences for patients, while also straining ER resources.

Our platform advocates for the establishment of specialized emergency and urgent care centers specifically designed for mental health and substance use crises. These facilities would serve as readily accessible, expert alternatives to traditional ERs, providing immediate, appropriate care in a therapeutic setting.

Key Features of Specialized Behavioral Health Emergency Centers:​

  1. Dedicated Facilities and Environment:

    • Create physically separate or distinct units within hospitals, or standalone community-based centers, designed to be calming, safe, and non-institutional environments conducive to de-escalation and stabilization.

  2. Specialized Staffing:

    • Staff these centers 24/7 with multidisciplinary teams including psychiatrists, psychiatric nurses, clinical social workers, addiction counselors, peer support specialists, and medical personnel trained in behavioral health crisis intervention.

  3. Rapid Assessment and Stabilization:

    • Provide immediate, comprehensive assessment of psychiatric and substance use crises.
    • Offer short-term stabilization services, including medication management, brief counseling, detoxification initiation (where appropriate), and connection to basic needs.

  4. Linkage to Ongoing Care:

    • Serve as a crucial hub for connecting individuals to the appropriate level of ongoing care upon discharge. This includes warm handoffs and scheduled appointments with outpatient mental health clinics, SUD treatment programs, crisis stabilization units (CSUs), supportive housing, and other community resources.

  5. Alternative to ER and Jail:

    • Function as a primary receiving center for referrals from 988, mobile crisis teams (see section 6.4.2), and law enforcement (for individuals diverted from arrest), providing a more appropriate destination than crowded ERs or jails.

  6. Integration with Community Services:

    • Work closely with community mental health centers, hospitals, social services, and housing providers to ensure coordinated care and smooth transitions for patients.

  7. Funding and Accessibility:

    • Ensure these centers are adequately funded through federal grants, state appropriations, and reimbursement under universal healthcare/parity provisions (see section 6.4.1) to be accessible regardless of a patient's ability to pay.

Conclusion:​

Specialized emergency centers for mental health and substance use crises offer a more humane and effective alternative to traditional ERs for individuals in acute distress. By providing immediate access to expert care in a therapeutic environment and facilitating seamless linkage to ongoing treatment, these centers can improve patient outcomes, reduce hospital overcrowding, decrease reliance on law enforcement, and ultimately build a more responsive and compassionate behavioral healthcare system.