In keeping with our theme from October’s issue of Invested, we continue discussing Viewpoint Foundation’s vision of mental health care. We believe in having equal access to humane, compassionate, and competent supports, regardless of the nature of the crisis, and we aim to reduce harmful outcomes of mental health crises for individuals, families, and communities.

We see this vision being achieved through two main avenues:

1. Natural supports: The informal, non-professional assistance and resources provided by friends, family, and community networks to individuals experiencing mental health challenges, aiming to enhance their well-being and recovery.

2. Crisis supports: Expanding the diversity and availability of “anyone, anywhere, anytime” facilities and programs that promote hope and recovery and enable more individuals to choose to “stay safe for now.”

We want to make progress in the following areas:

• Providing spaces designed to divert people who don’t need medically-supported care away from the emergency room ("ER") and hospitals to community-based alternatives;
• Expanding treatments delivered within the ERs for patients waiting for a bed; and,
• Enhancing supports that can de-escalate an emerging crisis and prevent the need for intensive interventions.

Last month, we discussed natural supports. This month, we are diving into the three areas of crisis support that Viewpoint Foundation sees as critical to the advancement of mental health care.

Diverting from ERs [1][2][3][4]

In recent years, there has been a growing awareness of the importance of mental health and the need for accessible and effective care. While ERs are vital for acute medical emergencies, they may not always be the most suitable or efficient option for individuals experiencing mental health crises. We want to increase knowledge of, and access to, alternative avenues for mental health care and divert away from ER visits. 

Creating community-based alternatives to ERs and hospitals for individuals experiencing a mental health crisis is a vital step towards fostering a more compassionate and effective system of care. Recognizing that not everyone in crisis requires a medically-supported intervention, it becomes imperative to establish spaces designed specifically to divert such individuals toward community-centric solutions. These spaces should be thoughtfully crafted environments that prioritize empathy, understanding, and a holistic approach to mental well-being.

One effective model for diverting individuals away from emergency settings involves establishing crisis stabilization centres or respite facilities within communities. These centres offer a safe and welcoming atmosphere where individuals in crisis can receive immediate support from trained mental health professionals, peer support specialists, and counselors. These spaces would be designed to be non-institutional, with a focus on creating a calming environment that encourages open communication and a sense of community. By providing a range of therapeutic activities, counseling services, and peer-led initiatives, these alternatives aim to address the root causes of distress and empower individuals to navigate their mental health challenges with resilience.

Furthermore, community-based alternatives should incorporate collaboration with local mental health organizations, law enforcement agencies, and community leaders to ensure a comprehensive network of support. Educating the community about these alternatives and reducing the stigma associated with mental health is crucial in fostering a more understanding and empathetic society. By investing in these community-driven solutions, we can move towards a mental health care system that not only meets the diverse needs of individuals in crisis but also actively promotes long-term recovery and well-being.

Expanding Treatments Delivered Within ERs [5][6][7]

The ER is still a critical component of mental health care, and not all patients should be diverted away from it. Expanding mental health treatments within ERs for patients awaiting a psychiatric bed is a critical and compassionate initiative aimed at addressing the immediate needs of individuals experiencing mental health crises needing medical support. The demand for psychiatric beds often exceeds the available supply, leaving patients stranded in ERs for extended periods. During this waiting period, it is imperative to provide comprehensive and timely mental health care to alleviate distress and promote stability.

ERs can enhance mental health services by employing dedicated psychiatric staff, including psychiatrists, psychologists, and psychiatric nurses, who are trained to assess and manage acute mental health crises. Collaborative care models involving mental health professionals working alongside emergency medical teams can facilitate a holistic approach to patient care. This entails the development of protocols for the assessment and treatment of mental health emergencies, ensuring that patients receive appropriate interventions while waiting for a psychiatric bed.

Moreover, creating safe and comfortable spaces within ERs designed specifically for mental health patients can contribute to a therapeutic environment. Incorporating elements such as calming colours, low sensory stimulation, and privacy can help mitigate anxiety and enhance the overall well-being of individuals in crisis. Additionally, implementing telehealth services can connect patients with off-site mental health professionals, allowing for ongoing assessment, counseling, and treatment planning. By expanding mental health services within ERs, healthcare systems can better address the immediate needs of individuals in crisis, ultimately improving outcomes and reducing the strain on psychiatric bed resources. 

Enhancing Supports That Can De-Escalate an Emerging Mental Health Crisis [8][9]

Enhancing supports to de-escalate an emerging mental health crisis is a crucial aspect of fostering a proactive and compassionate approach to mental health care. Prevention and early intervention strategies play a pivotal role in minimizing the need for intensive interventions. First and foremost, community education and awareness campaigns can help destigmatize mental health issues, encouraging individuals to seek support before crises escalate. This includes promoting mental health literacy and teaching coping skills that can be applied in times of stress.

Moreover, implementing comprehensive mental health training for frontline responders, such as law enforcement officers, educators, coaches, parents, and healthcare professionals, is essential. These training programs should emphasize de-escalation techniques, empathy-building, and crisis communication to equip individuals with the skills needed to manage challenging situations without resorting to force. Additionally, fostering collaboration between mental health professionals and community organizations can create a network of support that addresses underlying issues before they reach a critical point. This might involve establishing crisis intervention teams that include mental health professionals alongside traditional emergency responders.

Furthermore, technology can play a role in enhancing mental health supports. Mobile applications and online platforms can provide accessible resources, crisis helplines, and virtual counseling services, ensuring that individuals have immediate access to support when needed. By prioritizing prevention and early intervention through a multifaceted approach, society can work towards reducing the frequency of mental health crises and mitigating the need for more intensive interventions.

To summarize, after much research and discussion with professionals in the mental health sector, Viewpoint Foundation has determined that these areas of crisis support are critical to advocate for. By strategically redirecting individuals who do not require medically-supported care away from ERs and hospitals to community-based alternatives, we can alleviate the burden on acute care settings. Simultaneously, bolstering treatments within ERs for mental health patients awaiting admission to a bed fosters a more supportive environment. Moreover, emphasizing and enhancing community-based supports capable of de-escalating emerging mental health crises not only ensures more timely and appropriate interventions but also works towards preventing the escalation to intensive interventions. This comprehensive strategy strives to create a more responsive and effective mental health care system that addresses the diverse needs of individuals, ultimately promoting better outcomes and reducing strain on emergency services. 

Next month, we will go deeper into examples of community-based mental health care. Stay tuned!

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