Mental health peers

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I’m volunteering with a shelter/resource centre for the homeless, and they want to hook up with the ER by providing companions for mental health patients in the ER while they wait. Does anyone have a program like that in their hospital? I imagine peer counselling would be the closest comparison. Any, ANY information on the program, like education before volunteering and hospital policies would be helpful. How did you roll it out?

Any contact numbers for existing programs would be wonderful too.

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Specializes in Adult and pediatric emergency and critical care.

The goal of the ED is to rapidly triage, stabilize, and disposition emergency medical conditions. EDs also struggle to have even neutral productivity so I seriously doubt you will find any large ED who is instituting a program like this.

In our ED either nurses or social workers will offer resources to homeless patients, but they also need to provide the self motivation to help themselves and take advantage of the resources already available..

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Hmm.

Has this organization simply provided staff educational materials about their services and made it known that they can take ED referrals? That seems like the main thing to do. I could be wrong but I think companions not solicited by patients, regardless how well meaning, may invite a few other complications into the care of patients there for evaluation of their mental health needs, including the evaluation of whether or not they are going to hospitalized for further psychiatric evaluation/care.

What are they envisioning that they would do in the ED? Just sit there with the person having pleasant conversation?

You mention homeless patients and also mental health patients. These two populations are not one in the same, although there is overlap.

The ED should have an interest in resources for homeless patients, though.

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We were thinking a volunteer contacted through the local homeless shelter to sit with a patient while they are waiting in the ER. It can take hours, and someone acting as a buffer could help everyone. I could have sworn I’d seen a program like this in Toronto somewhere...maybe BC.

It would help to see policies from other hospitals that have tried this. But good or bad points of the idea would help too. I expect the volunteers would, at minimum, get oriented to the ER, and go through a nonviolent crisis intervention course.

At minimum, we’d need consent from the patient, and an ok from the ER to stay with the patient.

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Specializes in Adult and pediatric emergency and critical care.

I'm sorry to come off a bit brash, but what is your goal here?

If you have already found those programs why don't you call them and network with the programs you already know exist?

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There’s only one actual program I’ve found, but I expected there were a lot more, and I was hoping to make contact with more than one. From my research, peer support is more used in substance abuse, rather than mental health.

Feedback from ER nurses actually using the programs would help too. But making some phone calls is definitely in the cards.

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Specializes in ICU/community health/school nursing.
On 5/5/2019 at 6:21 PM, PeakRN said:

The goal of the ED is to rapidly triage, stabilize, and disposition emergency medical conditions. EDs also struggle to have even neutral productivity so I seriously doubt you will find any large ED who is instituting a program like this.

In our ED either nurses or social workers will offer resources to homeless patients, but they also need to provide the self motivation to help themselves and take advantage of the resources already available..

There's a parallel thread about people's use of the ED for "someone stole my hat." PeakRN hits the nail on the (EMTLA) head.

However, this sounds like a great program for some social work interns. Do you have a college with a social work program? MH concerns drive a bunch of ED visits, no doubt. Good luck!

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Specializes in Psychiatry.
On 5/8/2019 at 8:45 AM, ruby_jane said:

There's a parallel thread about people's use of the ED for "someone stole my hat." PeakRN hits the nail on the (EMTLA) head.

However, this sounds like a great program for some social work interns. Do you have a college with a social work program? MH concerns drive a bunch of ED visits, no doubt. Good luck!

Yeah, it could work for more than social work as well. We have peer support for outpatient and inpatient psych, but the idea isn't financially feasible for employed people in an ED setting.

We used to have two stapled pages of community resources by type (food, housing, Transpo, prescription support, etc) with names, numbers, addresses, and would hand them out for service de jour rather than spending (losing) productivity.

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