The Retreat Model

In general, even when in great distress, people can be very wary of getting support in a crisis if it means overnight care in a facility. This Associated Press story from 1958 is an example of why…

AP Exclusive: Psychiatric Hospital Called “Hell:” “Behind tall brick walls and secure windows, hundreds of patients at the state’s largest psychiatric hospital live in conditions that fail US health and safety standards. ‘Going there was like going to hell…'”

The problem… This AP story wasn’t from 1958… but 2018, earlier this month…

PowerPoint: The Retreat Model in Action

Crisis Now suggests an alternative, with the model Urgent Care Crisis Center possessing a continuum with three programs:

  • 24/7 Outpatient Lobby with Immediate Care
  • 23 Hour Temporary Observation Recliners
  • Sub-acute Crisis Stabilization with 2 – 4 day average length of stay

The Retreat Model of Crisis Urgent Care targets those same three programs, but three additional elements make these facilities very different…

  • Physical layout is an open retreat
  • Staffing prominently features lived expertise
  • Substantial impact on hospitals, law enforcement, jails and psychiatric inpatient

In the mid-1990s Recovery Innovations begins hiring significant numbers of peer supports and launches the first crisis living room model just outside Phoenix, Arizona.

Over the past four years, more than 13,195 individuals have admitted to this crisis urgent care center by police… none of those had to go to the ER and wait.

Despite very high acuity…

  • Individuals are greeted by a caring peer support staff orienting the person in distress to care
  • They are referred to as a guest, not patient or consumer
  • The space is warm and welcoming

What the Retreat is not:

  • Staff aren’t hiding behind a plexiglass fishbowl. They are actively engaged
  • Guests aren’t arranged in neat rows of recliners like a factory production line. It feels more like your living room.
  • But this isn’t a boutique for the worried well. People in real crisis are in pain, and sometimes get agitated and/or aggressive. Safety for all guests and staff is paramount.

About one in four staff are Certified Peers:

  • Peers have been there, and provide valuable social and emotional support.
  • They help turn the focus from crisis to strengths, assets and goals, and this activates hope
  • The link to clinical and community resources and provide ongoing support

Inside and out, this Retreat welcomes and heals. The space is designed for recovery.


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