Integrated Community Stabilization Unit
Safe and Crisis Bed Services
The goals of the safe and crisis bed services are to assist clients to address their situation in a safe and calm setting, reduce unnecessary hospitalization and contact with police, and facilitate access to longer-term supports.
In order to qualify for admission to a crisis or safe bed, individuals must be
- Experiencing a mental health crisis or have a serious mental illness and require short-term accommodation;
- Voluntarily seeking service;
- 16 years of age or older;
- Not under the influence of drugs or alcohol;
- Eligible for admission according to applicable readmission criteria;
- In agreement to abide by the Unit’s no self-harm/harm to others contract;
- In agreement to access case management services the following business day.
Withdrawal Management Service
The goals of the withdrawal management services are to promote stabilization in an alcohol and drug-free environment, assist clients to abstain from substance use as part of their recovery process, and link with ongoing supports.
To be considered for withdrawal management services, individuals must
- Want to make a change in their substance use and need 24-hour non-medical monitoring of withdrawal symptoms and/or a protected setting to be able to abstain;
- Require support in order to abstain;
- Agree to abstain from addictive medication except when following physician’s orders;
- Have medical clearance in the event that potential medical complications exist;
- Voluntarily seek service;
- Be 16 years of age or older;
- Be eligible for admission according to applicable readmission criteria;
- In agreement to abide by the Unit’s no self-harm/harm to others contract.
In the event that the individual is severely intoxicated and is unable to provide the necessary information to determine the appropriate level of service, he or she will be referred to their physician or the emergency department for medical clearance. Medical clearance is also required if the individual:
- Has a previous history of severe withdrawal complications such as DTs, hospital admission for withdrawal, severe dehydration;
- Is a female who suspects or knows that she is pregnant;
- Has a prior history of withdrawal seizures;
- Requires medication for chronic medical/psychiatric condition and does not have this medication readily accessible;
- Has a history of cardiac, respiratory or other severe medical problems;
- Has a cough;
- Has a head injury with loss of consciousness or other injury or trauma;
- Has a history of intense drug usage such as long-term cocaine or benzodiazepines use, or combines alcohol and barbiturates;
- Has severe vomiting or diarrhea and is at risk of dehydration from fluid loss;
- Has medication-controlled diabetes but has not been eating properly;
- Reports a physical presentation that does not match information given on substances used.
Individuals who do not meet the admission criteria for withdrawal management services are those who have acute medical complications. An ambulance may be contacted or the individual referred to the emergency department for an immediate medical assessment if they:
- Cannot be roused, are unconscious or semi-conscious, do not appear to be breathing or breathing is laboured;
- Are experiencing hallucinations, severe tremor or extreme agitation or confusion;
- Have Insulin dependant diabetes;
- Are experiencing seizures;
- Have a history of having more than one seizure at a time per episode;
- Are threatening harm to self or to others;
- Are suspected of having taken an overdose
Integrated Community Stabilization Unit Exclusionary Criteria
The individual being considered for admission to a safe bed, crisis bed or withdrawal management bed will be asked about all applicable exclusionary criteria. If a third party is assisting with the referral and it is appropriate, they may also provide additional information related to any exclusionary criteria that may apply.
In terms of exclusionary criteria, individuals will not qualify for admission if they
- Are combative;
- Need a secured setting due to a high risk of self-harm or harm to others;
- Have a history of significant and/or repeated acts of violence;
- Require medical observation, medical stabilization or vitals to be taken;
- Have current or past charges of sexual assault;
- Have a primary diagnosis of organic brain syndrome or severe physical health problems;
- Are seeking crisis or safe bed services and are under the influence of drugs or alcohol.
Frequently Asked Questions/Comments
What about the safety of children living in the neighbourhood where the Unit will be established?
- The safety of children is an issue that parents everywhere face. With that in mind, there is no evidence that crime or risks to children’s safety increases in the vicinity of supportive housing of any kind. In our six year’s experience running the Stabilization Unit, increased crime and risks to the public have not arisen.
The house is too close schools and family homes
- This implies that people with mental illness are dangerous. This is simply not the case. Just think for a moment about the most common mental illnesses: depression and anxiety. These are illnesses that cause people to turn inward, not to lash out or endanger others.
- The media has helped stir up the notion of the “dangerous” person with mental illness. But an overwhelming number of studies report that people with mental illness are no more likely than anyone else to commit a violent crime. For example, two excellent and extensive studies found that only 3% of violent criminal acts are committed by people with mental illness while the remaining 97% are committed by people with no psychiatric diagnosis whatsoever (Arboleda-Florez, Holley & Crisanti, 1996; Monahan & Arnold, 1996).
This has always been a good neighbourhood.
- Here is the fascinating fact, revealed in study after study. Once supportive housing is up and running, neighbours either don’t know it exists, or they support it. The people who are most afraid of supportive housing are people who have never lived near it. Why? Because people with mental illness have the same stake in the community as you. They want a neighbourhood that is safe, clean and welcoming, and that is close to friends and family. In fact, you probably already have neighbours with mental illness. People rarely disclose they have mental illness because there is so much stigma and fear associated with this type of illness. The difference between the neighbours you have now and our clients is that you know our clients have mental illness. On the other hand, you also know our clients are receiving the supports they need.
- In 1994, the University of Toronto studied three buildings owned by the Supportive Housing Coalition in Toronto. The study talked to people living in the inner ring (within 30 meters of each building), and the outer ring (between 30 and 120 meters of each building). The study revealed that only 55% of inner ring and 30% of outer ring neighbours were familiar with the SHC buildings. Nearly 75% did not recall seeing anyone from the buildings, 85% reported no problems with noise, and 81% expressed no concerns for safety in their neighbourhoods. Over 70% gave positive responses about the attractiveness of the buildings while only 3% felt building maintenance was inadequate.
When you bring in problem people, you get problem neighbourhoods
- People who use the Stabilization Unit do have a problem. The problems may be the loss of a loved one, relationship issues, stress, depression, inadequate housing or inadequate support services. However, these problems do not create problem neighbourhoods. Instead, have safe housing and supportive services such as the ones we offer make the community a better place for everyone. There is less pressure on the emergency department, hospital and medical clinic.