A new program is taking an innovative approach to helping New York adults with mental health issues and those who may be on the brink of a psychiatric crisis.
Parachute NYC, a federally funded project more than two years in the making, has created respite centers where guests can check in and talk through their concerns and fears with staff members who have their own experiences with the mental health system.
The centers are a “soft landing,” community-based alternative to emergency hospitalization, according to Steve Coe, CEO of Community Access, the organization that runs Parachute NYC.
“There are a lot of people stuck in hospitals who really don’t need to be there,” he told CNN. “Our centers give them temporary relief from whatever they may be going through.”
The facilities, which opened in 2013, are located in four boroughs and have apartment-style common rooms and bedrooms. The idea is to create a free, comfortable and supportive space for adults anticipating or experiencing emotional crisis.
A safe place to get help
People seeking help come in voluntarily. They can talk to trained staff members and can stay for up to 10 nights if they’d like to. The doors are never locked. There are no needles or medications. Fresh cooked meals are available, and staff members assess guests’ levels of need. Medical attention can be recommended if a staff member deems it necessary, but no medical services are offered on site.
The hope is that those who come to the respite centers develop recovery and relapse-prevention skills, and avoid being hospitalized by talking with peers who can relate to them. “In most systems of care, these comforts have been overlooked,” said Alysia Pascaris, deputy CEO of Community Access.
Without facilities like this, many adults have no other option but to check in to a hospital, Coe said. Parachute NYC also offers phone counseling and has a mobile treatment center.
Facilities where people can walk in and receive treatment for mental health issues, or crisis diversion centers, are not unique to New York, Coe said.
But Parachute NYC’s approach is different in that its staffers have firsthand experiences in using mental health services, he explained. “Most have been taken by the police or EMS in an ambulance to a hospital,” he said.”So the ‘lived experience’ we talk about is more than just going to counseling a few times.”
“We made an effort to hire staff who ‘have been there’ and understand what it’s like being a client,” Pascaris said, adding that staffers often have histories of homelessness, substance use, and involvement with the criminal justice system.
Coe said that unlike Parachute NYC centers, many other centers around the country are set up for clinical intervention, and use “medication heavily to achieve stabilization.”
Peer programs may cut costs
There are several other peer respite centers across the country. Laysha Ostrow, a postdoctoral fellow at University of California, San Francisco has done research on peer respite centers, some of which also have peers in management positions within the organization. Ostrow says these programs “potentially reduce costs and provide community-based, trauma-informed, person-centered support,” but that more research needs to be done to determine their effectiveness.
This trend comes as state psychiatric hospitals are being closed around the country. From 2009-2012, as many as 3,222 beds were closed in state psychiatric hospitals across the United States, largely due to the economic recession, according to the National Association of State Mental Health Program Directors. Nine states have only one state-run psychiatric hospital, and another 14 only have two, according to the NASMHPD.
It’s not all about a lack of funds though.
“There are many reasons why a state facility would close,” Meighan Haupt, associate to the executive director of NASMHPD, told CNN.
There has also been a shift in philosophy among mental health experts, some of whom believe that “having a comprehensive array of services that include state facilities, inpatient services, and community services are most beneficial as a whole.”
Millions of adults affected by mental illness
Parachute NYC was implemented after New York City’s Department of Health and Mental Hygiene won nearly $18 million in award funding for the project from the U.S. Department of Health and Human Services in 2013. It’s hoped the crisis respite centers will save more than $50 million in hospital expenses over three years, according to the Center for Medicare & Medicaid website.
In 2012, there were an estimated 43.7 million adults in the United States reported as having AMI, or “Any Mental Illness,” in the year prior, according to data from the National Institute of Mental Health (NIMH). This represented 18.6% of all U.S. adults, according to the NIMH. AMI is defined as a mental, behavioral, or emotional disorder (excluding developmental and substance use disorders), and can range in impact from no or mild impairment to significantly disabling impairment.
In 2008, 13.4% of adults in the United States received treatment for a mental health problem, and 58.7% of the adults with a serious mental illness received treatment, according to the Substance Abuse and Mental Health Services Administration.
