The facility I work in is a non-profit, acute detox/mental health stabilization unit. We often take involuntary committed clients for suicidal ideations. We have 16 beds & are full most of the time. Our state mandates that facilities like ours have 12-16 beds and one nurse on the unit at all times (LPN or RN). We must have a minimum of 3 staff members when we have 16 clients. I'm not sure what all the rules are, but the ratio changes depending how many mental health vs. detox vs. IVC clients we have. We accept referrals from other facilities as well as those who walk up & request help. We can really get busy with walk-ups, it does get frustrating if we have walk-ups & only one nurse and one counselor. Our director is in the process of recruiting more since we have been so busy & is finally realizing that one nurse and one counselor cannot sufficiently divide their time between walk-ups & current clients. In my opinion, my current clients have priority over walk-ups. But, when walk-ups complain that they had to wait too long, our LME gets upset and we have mandatory employee meetings where they tell us we're not meeting our expectations. It's very frustrating. Recently, our director quit and someone from higher up had to fill in. After spending time with us, she started to realize how frustrated and understaffed we are and created more positions so we can hire more employees. All this time, management never looked into our staffing situations and just continued to send us e-mails and have meetings telling us to step up our game & how unhappy they were with the complaints from walk-ups saying they waited too long to get in.
So, to answer your question, we are only required to have one nurse on unit at all times (can be either LPN or RN). We usually have a receptionist, 2 crisis workers(one of which may be out picking up meals and/or transporting clients), 0-2 counselors(if no counselor is on, we have to call our mobile crisis center to send someone to do assessments for walk-ups, but current clients are out of luck if they need a counselor & no one is on staff. On day shift, there are usually 2 counselors, as well as our site director, assistant director, medical records technician, after care coordinator, 1-2 nurses,2 crisis workers, and one receptionist. 2nd shift, there's usually 1 receptionist(recently started keeping 2 during visitations), 0-2 counselors, 1-2 nurses, 2 crisis workers. 3rd shift is just one nurse and 1-2 crisis workers.