Schenectady ‘Living Room,’ a mental health ER alternative, eases crises

Clinic that tries not to look like a clinic is joint effort of Ellis Medicine, Rehabilitation Support Services
Jen DeCrescente, program direction for RSS, gives a tour on Jan. 18 of the main living room at The Living Room.
Jen DeCrescente, program direction for RSS, gives a tour on Jan. 18 of the main living room at The Living Room.

SCHENECTADY — The Living Room lives up to its name, offering a comfortable setting for mental health patients who need a place to calm their stress and anxiety.

The setting was designed to provide an alternative to emergency room care for those who need help but aren’t facing a crisis that would require them to be hospitalized.

The State Street facility is a collaboration between Rehabilitation Support Services and Ellis Medicine. Since opening on Oct. 1, its monthly average has been 38 patients — whom it calls guests — said Jen DeCrescente, program director for RSS.

“This is a crisis-diversion program, keeping people out of the emergency room in a crisis,” she said last week, while leading a tour of The Living Room.

“We see a lot of depression, anxiety,” DeCrescente said. “The emergency room can be a very stressful and overwhelming place, especially when you may be waiting for a long time. It’s very noisy, crowded, which isn’t conducive to someone experiencing a mental health crisis — it may exacerbate their symptoms. So we wanted to create a really comfortable, relaxing, homelike environment as an alternative.”

Soft lighting and subdued colors, beautiful images on the walls and low background music define the entry area, which, with its plush couches, does resemble a living room. 

Beyond the entry area are staff offices, a smaller, more enclosed version of the entry area called the den and a meditation room with dimmable lights and no furniture. 

When designing the space, DeCrescente said, RSS looked at similar facilities in Westchester County and Chicago. While those facilities offer a similar aesthetic, they are not partnered with a hospital and have a more limited range of treatment options, relying heavily on peer-based counseling, she said.

When a new guest arrives at The Living Room, DeCrescente said, staff will meet with them in an office to assess whether there is an actual crisis and ascertain that he or she is not a threat to self or others. The guest can then retreat to one of the patient areas.

The Ellis Medicine Mental Health Clinic is right across the hallway, at 1023 State St., and sees about 1,400 patients a year. Its clinical manager, Mary May, said The Living Room complements the clinic and serves the larger goal of keeping patients out of the emergency department, which is a more expensive venue for treatment and offers a level of care not not needed by many patients. 

“Depression and anxiety are the main things,” May said. “People often go to the ER because they’re very anxious about some loss that they’ve experienced — grief. Sometimes they’re anxious about some concrete thing, like losing their housing, jobs, and oftentimes they’re lonely.

“That’s what we want to do, is help those people that don’t need to go over there,” she added. “You don’t have to have a mental illness to use The Living Room; it’s any kind of behavioral health crisis. So they don’t have to have a formal diagnosis or be on medications to use our services.”

Clinicians at Ellis Mental Health have been taking their patients across to The Living Room for tours, May said, and advising them to go there if they are experiencing stress, particularly after the clinic closes for the day — The Living Room is open from noon to 8 p.m. weekdays.

Through a grant from the Alliance For Better Health, visits to The Living Room are free for Schenectady County residents during its first year of operation. The majority of guests so far have been residents of the city, and most of the rest have been residents of its suburbs.

By other demographics, such as age and diagnosis, the people who have used The Living Room have had a broader profile. Some have previously received therapy. Some have been in substance abuse rehab, and some are new to mental health treatment. Some have private insurance. Some have Medicare or Medicaid, and some are uninsured.

The target is six to eight guests a day, as The Living Room becomes better-known within the community.

DeCrescente said there have been quantifiable results at The Living Room over its nearly four months in operation: A social worker has been evaluating guests at the start and end of each visit with the SUDS system, or Subjective Units of Distress Scale, and their scores show an average 30 percent decrease.

As of last week, only four guests at The Living Room have needed to go on to the Emergency Department.

“We try to make it as non-clinical as we can to make it more approachable and more comfortable,” she said.

Categories: Business, News, Schenectady County

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