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Crisis Stabilization Unit Helps Divert Patients from ED, Jail

Association member Sinai Health System, in Chicago, operates a crisis stabilization unit (CSU) to divert patients with behavioral health problems from the emergency department (ED) and criminal justice system.

Upon arrival to the CSU, patients are welcomed to a calm and safe space, where recliner chairs replace the beds and gurneys typically found in a hospital. Patients then meet their care team, who work collaboratively to observe, treat, and counsel them before they are discharged with necessary medications and follow-up appointments.

The CSU, located at Sinai Health’s Holy Cross Hospital, aids patients who come into the emergency department with a behavioral health crisis. After being triaged in the ED, patients who can forgo an inpatient admission are directly referred to the CSU for behavioral health treatment. The care team there comprises psychiatrists, psychiatric nurses, nurse practitioners, licensed social workers, and other mental health workers.

Since the unit opened in 2016, 72 percent of CSU patients have been treated without being sent back to the hospital for an admission or more intensive treatment. While patients waiting to be admitted to the hospital often spend 18 to 36 hours in the ED, those referred to the CSU often are there for only 1.5 to 3 hours. This process is not only less mentally and financially taxing on the patient, but also less expensive for the hospital.

The CSU also provides an important alternative for Chicago law enforcement. Sinai worked with the Cook County sheriff’s office to make the CSU a drop-off site for the Chicago Police department. Now, when officers arrest someone with a behavioral health condition, they can avoid entering them into the criminal justice system and bring them directly to the unit for effective treatment.

Sinai Health System works with several community partners to refer CSU patients to appropriate services and treatment. Patients often are linked to substance abuse counseling, safe housing, and other community resources.

Sinai is currently expanding the size of the unit and plans to open a second CSU location at the Mount Sinai Hospital.

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About the Author

Katherine Susman is a research associate at America's Essential Hospitals.