Breaking News: Peer-Run Respite Care

  • Think about this for a moment: you're in a psychiatric crisis. Would you rather be treated in a hospital or by peers at a respite center? Daniel B. Fisher, a psychiatrist in Massachusetts, would like to open a three-bed peer-run crisis center next year in that state. He suggests peer-run respite would not need to be regulated and would be cost effective, citing Stepping Stone, a center founded in 1997 that costs only $250 per night, or 21 percent of the cost of traditional psychiatric care.

    At this respite home, the peers meet with potential guests before they are in crisis so that consumers learn "triggers" to know when to go to the center before a problem becomes a full-blown crisis. In such respite care programs, peer staff cannot prescribe or handle drugs, so patients are given a lock box and expected to handle their own medications, according to Dr. Fisher. Guests would have the freedom to come and go from the center and see providers in the community.

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    Stepping Stone is considered an alternative to hospitalization, as would other respite care facilities. Executive director Jude Dolan likens the reduction in cost to a vacation: in terms of mental health care, her program would be Hampton Beach rather than Bermuda.

    The Department of Mental Health, the coveted source of $300,000 for the first three-bed center in Massachusetts, is reviewing recommendations regarding such a program and the deputy directors are scheduled to visit Stepping Stone, which has two beds. David Matteodo, head of the Massachusetts Association of Behavioral Health Systems, believes that if respite crisis centers accept people who are committable to a hospital, the centers need to meet the same standards as hospitals. That would require regulation by multiple agencies.

    According to Ms. Dolan, Stepping Stone does not provide support to individuals whose safety is in jeopardy. Dr. Fisher envisions that 720 peer-run respite beds would ideally direct 60 percent to 70 percent of patients from traditional psychiatric hospitals. In New York, bills introduced to float respite care as an option passed in the House and Assembly.

    What do you think? Is peer-run respite care an alternative whose time has come? Would you prefer to be treated by peers if you were experiencing psychiatric distress? I'd love to open up this debate, so I'll start off with the first comment.

Published On: September 04, 2009