The Living Room

Program Description

The Living Room (TLR) is a 24 hour/7 day a week community-based, stabilization program with a capacity for 10 guests at one time, of which, six may remain overnight. Thirty to forty individuals or guests visit during day and evening hours in a typical day. Guests are assisted in researching and applying for insurance, housing, and finding helpful community services. TLR is open to all. Many are seeking recovery support and services. We offer engagement and education related to available services. Guests in immediate crisis are evaluated by a crisis clinician on-site. Peer Specialists support and stabilize persons in developing crisis and post-crisis in an attempt to decrease the need for inpatient hospitalizations. Persons in emerging behavioral health crisis situations are often successfully stabilized in the community setting without the need for a trip to the ED and/or an inpatient admission. BHN fully utilizes Peer Specialists in TLR with the goal of maintaining people in the community. Peer staff intervention is a key component to this community-based stabilization. Peer Specialists are persons with similar lived experiences who are specially trained to intervene in a crisis situation as a remarkably calming and trusted influence.

Creativity

At the core of TLR’s originality and ingenuity is a paradigm shift from a symptomatic and deficit focused intervention between a client and provider, and endeavors to draw from the inherent strengths and intuition of our guests in order to support them on their unique journey towards their own personal goals. Peer workers assist guests by encouraging independence, competency and decision-making. Peers support a quality of life of empowerment, respect and dignity. TLR is a resource center. TLR groups are run by trained facilitators of Hearing Voices and Alternatives to Suicide groups. TLR has a Mindfulness Group and a 90-day Early Recovery Group. Collaborative outreach in the Springfield Police Department’s Project Hope program enables the TLR to function as a safe alternative to EDs and “the streets” for homeless persons with mental health issues who are afraid to utilize traditional services, when they encounter police in the community.

Leadership

TLR program design is an innovative approach organizations can emulate to assist persons seeking behavioral healthcare. Collaboration with local police departments, health care organizations and nonprofits is essential for successful program implementation. Strong collaborative relationships are forged with two broad goals: 1. Safely diverting individuals in need of mental health services from emergency departments and 2. Providing high-risk populations access to behavioral health services. Replicable processes include Peer Specialists working with police officers when they encounter persons in crisis or SUD. Referrals are received from other medical facilities, community organizations and self-referrals are welcomed. BHN program leaders disseminate TLR information via community relationships and encouraging guests to spread the word.

Sustainability

The Living Room is supported by grants awarded by Massachusetts Behavioral Health Council, Massachusetts Department of Mental Health and in-kind support from BHN. BHN is currently seeking additional support to build the capacity of the program, train additional peer specialist counselors and continue serving persons 24/7 with behavioral health needs in our communities. Partner organizations who have a vested interest in the continuation of the program are Bay State Medical Center (one of the highest volume EDs in the state), PBHH, Mercy Medical Center, Noble Hospital, Holyoke Medical Center, CHD, Holyoke Health Center, Caring Health Center, Valley Psychiatric Services, Beacon Health OPTIONS/Strategies, and Health New England. Local police departments rely on TLR’s services including Springfield Holyoke, Westfield, West Springfield, Chicopee, East Longmeadow, Longmeadow, Hampden, Wilbraham, Ludlow and South Hadley.

Replicability

This program can be replicated in other settings by creating a safe and comfortable site in an accessible geographic location and by creating 24 hour peer staffing and ready access to crisis services. TLR’s structure includes 1 FTE Certified Peer Specialist Supervisor who receives supervision from the BHN Senior Program Manager. This supervisor leads the BHN Peer Support Services Program. The Peer Specialist Supervisor manages 9.2 FTE Peer Specialist Counselors. Seven counselors have completed and passed the certification program for Certified Peer Specialist (CPS). TLR program adheres to the ethics and philosophy of the Peer Recovery Model. MOU’s with local law enforcement agencies, ED’s and community organizations working with persons needing behavioral healthcare is essential.

Results/Outcomes

In FY’16 program outcomes include: • 3480 guest stays • 1288 unduplicated guests • 675 ED diversions based on self report and crisis referrals • 20 police drop offs (the number of police referrals is unknown as TLR information is given to everyone they encountered that the police believe may have a mental health or SUD issue) • Data is collected by our “entrance discussions” and satisfaction surveys. Our data focuses on total stays, unduplicated guests, self reported and crisis reports of ED diversions and police referrals. This will allow us to determine program successes in ED diversion and public safety. BHN uses the following outcome measures for the data listed above; • Specific referral sources that could significantly impact our ED diversion rates, specifically police, self and mental health clinics. • ED diversion rates • Barriers to implementation of project with actions taken to address barriers