The Living Room, a Community Crisis Respite Program: Offering People in Crisis an Alternative to Emergency Departments

Objective: To describe The Living Room, a community crisis respite center that offers individuals in crisis an alternative to obtaining services in an emergency department (ED).Methods: This article describes the problems individuals in a mental health crisis may encounter in traditional EDs and explains how The Living Room addresses these problems.  The Living Room’s development, setting, staffing and procedures are described in order to promote increased use of this type of program. Results: In its first year of operation, The Living Room hosted 228 visits by 87 distinct individuals (termed “guests”).  Guests were deflected from EDs on 213 of those visits – a 93% deflection rate.  These deflections represent a savings of approximately $550,000 to the State of Illinois since guests of The Living Room are overwhelmingly individuals with Medicaid or no insurance of any kind.  On 84% (n=192) of the occurrences in which guests were deflected from EDs, they alleviated their crises sufficiently to decide to leave The Living Room and return to the community.  These guests reported an average decrease of 2.13 points on the Subjective Units of Distress Scale. Conclusions: Community crisis respite centers such as The Living Room represent an important alternative to EDs by remedying many criticisms of traditional EDs made by individuals in crisis. Outcomes from The Living Room’s first year of operation suggest that community crisis respite centers are cost-effective, effective in helping many individuals alleviate crises, and have the potential to decrease the use of EDs for mental health crisis

The Living Room, a Community Crisis Respite Program: Offering People in Crisis an Alternative to Emergency Departments

Objective: To describe The Living Room, a community crisis respite center that offers individuals in crisis an alternative to obtaining services in an emergency department (ED).Methods: This article describes the problems individuals in a mental health crisis may encounter in traditional EDs and explains how The Living Room addresses these problems.  The Living Room’s development, setting, staffing and procedures are described in order to promote increased use of this type of program. Results: In its first year of operation, The Living Room hosted 228 visits by 87 distinct individuals (termed “guests”).  Guests were deflected from EDs on 213 of those visits – a 93% deflection rate.  These deflections represent a savings of approximately $550,000 to the State of Illinois since guests of The Living Room are overwhelmingly individuals with Medicaid or no insurance of any kind.  On 84% (n=192) of the occurrences in which guests were deflected from EDs, they alleviated their crises sufficiently to decide to leave The Living Room and return to the community.  These guests reported an average decrease of 2.13 points on the Subjective Units of Distress Scale. Conclusions: Community crisis respite centers such as The Living Room represent an important alternative to EDs by remedying many criticisms of traditional EDs made by individuals in crisis. Outcomes from The Living Room’s first year of operation suggest that community crisis respite centers are cost-effective, effective in helping many individuals alleviate crises, and have the potential to decrease the use of EDs for mental health crisis

Exploring Community-Based Advocacy Work Against Human Trafficking in the U.S.

Research on community organizations suggests there are a variety of factors related to the success of an organization’s mission. This study identifies general facilitators and challenges advocates working against human trafficking experience and the strategies utilized to overcome these barriers. Fifteen individuals who are advocates in the Chicagoland area participated in the study. Qualitative methods using the social ecological theoretical framework show personal, organizational, and system-wide factors impacting advocates. Individual support systems and advocates’ collaborations with other organizations are encouraging factors in their work. Furthermore, advocates feel motivated by trafficked persons’ stories and by the capacity to raise awareness through social media. Challenges advocates face include a lack of time and money, a lack of communication among organizations, and negative cultural attitudes related to trafficking. Results focus on the specific experiences of anti-trafficking advocates and convey strategies to provide quality services to survivors and effectively raise awareness in the general public.&nbsp

Exploring Community-Based Advocacy Work Against Human Trafficking in the U.S.

Research on community organizations suggests there are a variety of factors related to the success of an organization’s mission. This study identifies general facilitators and challenges advocates working against human trafficking experience and the strategies utilized to overcome these barriers. Fifteen individuals who are advocates in the Chicagoland area participated in the study. Qualitative methods using the social ecological theoretical framework show personal, organizational, and system-wide factors impacting advocates. Individual support systems and advocates’ collaborations with other organizations are encouraging factors in their work. Furthermore, advocates feel motivated by trafficked persons’ stories and by the capacity to raise awareness through social media. Challenges advocates face include a lack of time and money, a lack of communication among organizations, and negative cultural attitudes related to trafficking. Results focus on the specific experiences of anti-trafficking advocates and convey strategies to provide quality services to survivors and effectively raise awareness in the general public.&nbsp

Empowering Women through Alternative Settings: Michigan Womyn’s Music Festival

Sexism is a form of oppression impacting women in multiple spheres of their lives. The current study examines the Michigan Womyn’s Music Festival as an alternative setting in which attendees create a unique culture apart from dominant patriarchal systems. An ethnophenomenological approach was used to examine experiences of empowerment and healing among festival attendees. Twenty women were interviewed at the festival and this data was analyzed using content analysis. The women-only, feminist space offered attendees both physical and emotional safety, which yielded healing. Participants defied gender-prescribed roles through work duties, gender non-conforming dress, and festival events/ceremonies. The development of a “festival family” and close relationships within the festival, quiet times of introspection, and designated spaces of healing were empowering. Results from this study add to the understanding of empowering settings and may inform efforts to create safe spaces for other oppressed groups

Empowering Women through Alternative Settings: Michigan Womyn’s Music Festival

Sexism is a form of oppression impacting women in multiple spheres of their lives. The current study examines the Michigan Womyn’s Music Festival as an alternative setting in which attendees create a unique culture apart from dominant patriarchal systems. An ethnophenomenological approach was used to examine experiences of empowerment and healing among festival attendees. Twenty women were interviewed at the festival and this data was analyzed using content analysis. The women-only, feminist space offered attendees both physical and emotional safety, which yielded healing. Participants defied gender-prescribed roles through work duties, gender non-conforming dress, and festival events/ceremonies. The development of a “festival family” and close relationships within the festival, quiet times of introspection, and designated spaces of healing were empowering. Results from this study add to the understanding of empowering settings and may inform efforts to create safe spaces for other oppressed groups

Review: Community-Based Participatory Research Approach to Address Mental Health in Minority Populations

In this review, a synthesis of studies employing community-based participatory research (CBPR) to address mental health problems of minorities, strengths and challenges of the CBPR approach with minority populations are highlighted. Despite the fact that minority community members voiced a need for innovative approaches to address culturally unique issues, findings revealed that most researchers continued to use the traditional methods in which they were trained. Moreover, researchers continued to view mental health treatment from a health service perspective

"Take my hand, help me out:" Mental health service recipients‘ experience of the therapeutic relationship

The purpose of this study was to describe mental health service recipients‘ experience of the therapeutic relationship. The research question was 'what is therapeutic about the therapeutic relationship?‘ This study was a secondary analysis of qualitative interviews conducted with persons with mental illness as part of a study of the experience of being understood. This secondary analysis used data from 20 interviews with community-dwelling adults with mental illness, who were asked to talk about the experience of being understood by a health-care provider. Data were analysed using an existential phenomenological approach. Individuals experienced therapeutic relationships against a backdrop of challenges, including mental illness, domestic violence, substance abuse, and homelessness. They had therapeutic relationships with nurses (psychiatric/mental health nurses and dialysis nurses), physicians (psychiatrists and general practitioners), psychologists, social workers, and counselors. Experiences of the therapeutic relationship were expressed in three figural themes, titled using participants‘ own words: 'relate to me‘, 'know me as a person‘, and 'get to the solution‘. The ways in which these participants described therapeutic relationships challenge some long-held beliefs, such as the use of touch, self-disclosure, and blunt feedback. A therapeutic relationship for persons with mental illness requires in-depth personal knowledge, which is acquired only with time, understanding, and skills. Knowing the whole person, rather than knowing the person only as a service recipient, is key for practising nurses and nurse educators interested in enhancing the therapeutic potential of relationships

Hall‘s essay on an authentic meaning of medicalization: An extended discourse.

The purpose of this article is to inform emerging theoretical understanding of medicalization by challenging, updating, and affirming a previously published essay on this topic by Hall. We accomplished this through the creation of a discourse among the 3 authors using the essay, written entirely from a personal perspective, and integrated our own personal experiences as nurses and patients. Hall's essay on the authentic meaning of medicalization provided a critical understanding of medicalization of cancer describing the factors, forces, and consequences, seeking to raise consciousness and provoke reform. The 3 of us added our voices to her narrative seeking to expand the discourse on medicalization and inform theory development. We have shared our individual and collective voices and identified elements that might point the way to theoretical emergence and ending with our own call for nursing to evolve further as a field worthy of human inspiration

Peaceful awakenings: Taking the “alarm” out of the alarm clock.

The quality of my daily awakening ritual changed dramatically a few months ago when I was exposed to the Timex Nature Sounds alarm clock. Prior to this, it had never occurred to me to use something other than the traditional buzzer-type alarm clock that I had had since 1986 because “it still worked.” While this was true, it worked by emitting a loud obnoxious sound that stimulated a fight or flight response. Now, I start the day with nature sounds (“ocean surf”), which is much more peaceful than my old alarm clock