The Effectiveness of a Peer-Staffed Crisis Respite Program as an Alternative to Hospitalization

Bouchery, Ellen; Babalola, Elizabeth; Friend, Daniel J.; Brown, J.; Blyler, Crystal R.; Ireys, Henry T.

doi:10.1176/appi.ps.201700451

Cited by 26 publications

(40 citation statements)

References 12 publications

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“…Biopsychosocial treatments including medication management were previously found to increase patient satisfaction [46], as also evidenced in the present brief intervention team. Surveys have found that patients in crisis prefer to be treated in a friendly, homelike environment like that offered in the study crisis center team rather than in ED or hospitals [30,36].…”

Section: Aggressive or Overly Critical Family Membersmentioning

confidence: 99%

“…The risk of cultural clash between community organization or peer support staff providing services and health care professionals, particularly concerning recognition of professional expertise, was another important issue identified [ 27 – 29 ]. Training and supervision of peer support staff by health professionals were viewed as key indicators of success [ 30 ]. Regarding individual factors, interpersonal skills were identified as critical [ 24 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

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Implementation of three innovative interventions in a psychiatric emergency department aimed at improving service use: a mixed-method study

Gabet

Grenier

Cao

et al. 2020

BMC Health Serv Res

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Background Emergency department (ED) use is often viewed as an indicator of health system quality. ED use for mental health (MH) reasons is increasing and costly for health systems, patients, and their families. Patients with mental disorders (MD) including substance use disorders (SUD) and suicidal behaviors are high ED users. Improving ED services for these patients and their families, and developing alternatives to ED use are thus key issues. This study aimed to: (1) describe the implementation of three innovative interventions provided by a brief intervention team, crisis center team, and family-peer support team in a Quebec psychiatric ED, including the identification of implementation barriers, and (2) evaluate the impacts of these ED innovations on MH service use and response to needs. Method Using mixed methods with data triangulation, the implementation and impact of the three above-named ED interventions were studied. Quantitative data were collected from 101 participants (81 patients, 20 family members) using a user questionnaire and patient medical records. Qualitative data were gathered from focus groups (n = 3) with key intervention staff members (n = 14). The user questionnaire also included open-ended questions. Descriptive, comparative and content analyses were produced. Results Key implementation issues were identified in relation to system, organizational and patient profiles, similar to results identified in most studies in the ED implementation literature aimed at improving responsiveness to patients with MD. Results were encouraging, as the innovations had a significant impact for improved patient MH service use and adequacy of care. Services also seemed adapted to patient profiles. Family members were grateful for the help received in the ED. Conclusions Before implementing innovations, managers need to recognize the basic issues common to all new healthcare interventions: the need for staff training and strong involvement, particularly among physicians, development of collaborative tools especially in cases of potential cultural clash between staff and organizations, and continuous quality assessment. Future research needs to confirm the pertinence of these interventions, especially use of family-peer support teams in ED, as a highly innovative intervention. Broader ED strategies could also be deployed to improve MH services and decrease ED use for MH reasons.

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Section: Aggressive or Overly Critical Family Membersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Implementation of three innovative interventions in a psychiatric emergency department aimed at improving service use: a mixed-method study

Gabet

Grenier

Cao

et al. 2020

BMC Health Serv Res

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“…Jedes der eingeschlossenen CR beschreibt eigene Ziele und Werte, worunter sich einige an der Definition der National Coalition for Mental Health Recovery (NCMHR) orientieren, die in den USA die Implementierung von CR vorantreibt [19]. Häufig wird das Ziel benannt, die Inanspruchnahme von psychiatrischen Rettungsstellen und Krankenhäusern und damit verbundene Belastungen, lange Behandlungsverläufe sowie teilweise auch Kosten zu reduzieren [6,10,[20][21][22]. Einige CR sind strukturell in das Versorgungssystem eingebettet.…”

Section: Ziele Werte Und Selbstverständnisunclassified

“…Die angewendeten Aufnahmekriterien variieren z. T. erheblich: Einige CR nehmen nur Personen mit festem Wohnsitz und Krankenversicherung auf [22,23,26]. Andere nutzen als Kriterium bestimmte Diagnosegruppen (Psychose oder Sucht) [4,6]. In vielen Projekten wird das Nichtvorliegen von Eigen-oder Fremdgefährdung vorausgesetzt.…”

Section: Modelle Und Umsetzungsvariantenunclassified

“…schädigend erlebt haben und deshalb nach Alternativen suchten [3]. Im angloamerikanischen Raum wird mit der Gründung von CR häufig zusätzlich das Ziel einer Kostenreduktion angestrebt [4][5][6]. Es gibt verschiedene Organisationstypen von CR, die danach unterschieden werden, zu welchem Grad Peers tätig werden und wie stark sie mit dem psychiatrischen Versorgungssystem zusammenarbeiten [7,8]: In "peer-run respites" besteht das Leitungsgremium mehrheitlich (mindestens zu 51 %) aus Peers, während diese in "peer-operated respites" in der Minderheit sind [9].…”

Section: Introductionunclassified

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Gegenseitige Unterstützung Psychiatrieerfahrener in Krisenunterkünften – ein Scoping Review

Peter¹,

Schwarz²

2020

Psychiatr Prax

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Zusammenfassung Ziel Als Alternative zur psychiatrischen Versorgung gibt es v. a. im angloamerikanischen Raum sogenannte Crisis Respites (CR), in denen sich krisen- und genesungserfahrene Menschen (Peers) gegenseitig unterstützen. In dieser Arbeit wird untersucht, wie CR aufgebaut sind und mit welchen Ansätzen und Ergebnissen sie evaluiert werden. Methodik Systematische Literaturrecherche. Studien wurden eingeschlossen, auch der „grauen“ Literatur, sofern sie empirisches Material enthielten. Ergebnisse Auswahl von 12 Publikationen mit Bezug zu insgesamt 10 CR. Die Arbeits- und Organisationsformen von CR sind sehr heterogen. Es wurden unterschiedliche Evaluationsansätze (RCT, qualitativ, Mixed-Methods) genutzt. Schlussfolgerung CR sind kein Ersatz für die psychiatrische Versorgung, sondern eine eigene, wirksame Unterstützungsform. Der Einfluss von Peers bei der Umsetzung und Evaluation ist von zentraler Bedeutung, damit ihre Eigenheiten erhalten bleiben.

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Peer‐based interventions targeting suicide prevention: A scoping review

Bowersox

Jagusch

Garlick

et al. 2021

American J of Comm Psychol

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Peers of individuals at risk for suicide may be able to play important roles in suicide prevention. The aim of the current study is to conduct a scoping review to characterize the breadth of peer‐delivered suicide prevention services and their outcomes to inform future service delivery and research. Articles were selected based on search terms related to peers, suicide, or crisis. After reviews of identified abstracts (N = 2681), selected full‐text articles (N = 286), and additional references (N = 62), a total of 84 articles were retained for the final review sample. Types of suicide prevention services delivered by peers included being a gatekeeper, on‐demand crisis support, crisis support in acute care settings, and crisis or relapse prevention. Peer relationships employed in suicide prevention services included fellow laypersons; members of the same sociodemographic subgroup (e.g., racial minority), workplace, or institution (e.g., university, correctional facility); and the shared experience of having a mental condition. The majority of published studies were program descriptions or uncontrolled trials, with only three of 84 articles qualifying as randomized controlled trials. Despite a lack of methodological rigor in identified studies, peer support interventions for suicide prevention have been implemented utilizing a diverse range of peer provider types and functions. New and existing peer‐delivered suicide prevention services should incorporate more rigorous evaluation methods regarding acceptability and effectiveness.

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The Effectiveness of a Peer-Staffed Crisis Respite Program as an Alternative to Hospitalization

Abstract: Peer-staffed crisis respite services resulted in lowered rates of Medicaid-funded hospitalizations and health expenditures for participants compared with a comparison group. The findings suggest that peer-staffed crisis respites can achieve system-level impacts.

Cited by 26 publications

References 12 publications

Implementation of three innovative interventions in a psychiatric emergency department aimed at improving service use: a mixed-method study

Implementation of three innovative interventions in a psychiatric emergency department aimed at improving service use: a mixed-method study

Gegenseitige Unterstützung Psychiatrieerfahrener in Krisenunterkünften – ein Scoping Review

Peer‐based interventions targeting suicide prevention: A scoping review

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