If you have been following my blog for any length of time, you know that I recently took on a position as a contractor of the State to help establish Crisis Stabilization Units, or CSUs. These are amazing alternatives to hospital ERs and inpatient facilities for people who are in psychiatric crisis. Instead of spending hours laying on a bed in the hallway of a hospital, you will be able to go to one of these locations, be seen sooner, receive the help you need, and be admitted for up to 72 hours, as compared to an average 9 day stay, and ideally be sent home with better coping skills and supports. They have only established these units in a few places and Michigan is one of these pioneering states. One of a handful of CSUs has been established in Michigan today, is COPE, Community Outreach for Psychiatric Emergencies in Livonia. I recently had the opportunity to sit down with some of the administrators of COPE and find out more about their establishment, and I’d like to share it with you.
One of the biggest problems with inpatient experiences is the PTSD that comes from the experiences. I know for me, because I have had so many awful experiences, when I really need the help I fight to get it because it terrifies me so much. It means that I am less safe and that my support team has to work so much harder to keep me safe.
One way that COPE is a step up, is that if a person can’t be stabilized within the 72 hour period and needs to be sent to an inpatient stay, their needs and desires are taken into consideration. COPE tries hard to place everyone at units that are good fits for them and will be the most helpful. Also, instead of jumping straight to an inpatient stay, COPE works hard to give people the lowest level of care that is safe.
Unlike hospitals, COPE has a behavioral specialist who can help intervene and make decisions. They offer treatment on-site, even if they don’t have an available bed, and they have the option to offer a PRN medication to help the person calm down and get through the experience. As I’ve mentioned in previous blog posts, at hospitals you are taken off all of your medication as soon as you get there, which can make a difficult situation even more difficult.
Even better, the intake process is, on average, 6-8 hours, which can be as little as a third of the time you might spend in an emergency room. It is obviously longer if they need to find a bed at an inpatient unit, but at least you are kept in a safe and comfortable location. Finally, COPE has an additional option of a crisis-residential stay, which is not locked and home-like, causing even less trauma.
One of the common problems with behavioral centers is that they have a difficult time keeping staff because the pay is low and the job is difficult. At COPE they offer competitive pay, and an approach to mental health that is appealing to people in the field. They are doing something different, and the staff is on-board. Finally, they employ peer supports, which are paid at a lesser rate than nurses but are equally as valuable. Sometimes when a person is in crisis, talking to someone who just “gets it” and has been there is the best medicine.
Overall, COPE has received great feedback, and they know that they are on the path to making a difference in the mental health field in Michigan. Their mission is to serve people with mental health crises in a quick but effective manner, decreasing the amount of trauma, and they are doing a great job. All of Michigan is committed to this model, and it is so exciting that COPE has been able to take the first step forward. So, if you are in the area, and in crisis, consider checking them out. They may be able to help you in a much more effective and timely manner than you have ever experienced.
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