Consumer Perspectives on a Consumer-led Short-stay Crisis Stabilisation Unit (CSU) as an Alternative to Emergency Departments for the Treatment of Acute Mental Health Crises

Abstract A significant and growing number of people present to hospital emergency departments (EDs) with mental health crises (distress, agitation, behavioural disturbance, suicidal ideation, etc.). However, EDs are crowded, noisy, and busy places, and they are not always the most appropriate environments for management of a mental health crisis. There is increasing interest in the use of therapeutic environments for people experiencing an acute mental health crisis which, with time and intervention, is likely to reduce in severity of distress or resolve. This paper reports on one such unit, a Crisis Stabilisation Unit (CSU), in Queensland, Australia. It is the first published evaluation of a CSU which has focused on consumers’ perspectives. Consumers were sent a brief, mixed-methods electronic survey after discharge from the CSU, and 657 responded. Consumers rated their experiences in the CSU, the impact of the CSU on their mental health and wellbeing, and their experiences in comparison to ED (if applicable). They gave positive feedback about the CSU staff including the lived-experience peer support workers, the clinical care they received, and the atmosphere and environment in the CSU. They provided constructive feedback about the processes of admission to and discharge from the CSU, and about the waiting time to see a clinician. Consumers identifying as Aboriginal and/or Torres Strait Islander, culturally and/or linguistically diverse, a person with a physical disability, and/or LGBTIQAP+ also rated the CSU highly. Significantly, consumers agreed that the CSU gave them hope for recovery, empowerment, and dignity and respect. They were strongly supportive of the broader use of CSU-like models of care for people experiencing a mental health crisis.