For psychiatric patients, waiting for care in an emergency room can be a therapeutic dead space. Could it be transformed into a period of healing?
mental-health treatment
This approach came to be known as the Alameda Model. After it was implemented, the number of psychiatric patients who stayed overnight in the area’s emergency departments fell almost to zero. In a traditional emergency department, as many as twenty per cent of patients experiencing a mental-health crisis might end up being restrained in some way; in Zeller’s unit, the number was 0.1 per cent, a difference that he attributes to the calmer environment and specialized staff.
Next, the therapist told Andish about a woman who was manic, and might benefit from another day of observation, but was determined to leave. I tried to imagine the frustrations of a patient who wasn’t here by choice; for her, the relative comfort of the unit might not make much difference. “She told me that there are people like her walking around out there all day, every day,” the therapist said. A gentle laughter filled the room.“Shows good insight,” Mitlyng chimed in.
“I’ve thought about hanging myself or walking into traffic,” Emma said, tears in her eyes. “But I’m scared about how it would feel.” As a clinical manager walked through the unit, asking patients if they’d like to join, I wondered how people in crisis would respond to something so earnest. Some ignored the invitation, but two men and two women—including Emma, now in a hoodie—gathered around a table that was covered with markers, crayons, paintbrushes, and flat gray stones. “Has anyone made worry stones before?” Atkins asked the group. “They’re fun to decorate and nice to rub if you’re feeling anxious.
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