Providing crisis care in a pandemic: a virtual based crisis stabilization unit

Area of Science:

• Mental Health Services
• Digital Health
• Crisis Intervention

Background:

• Winnipeg, Canada established a 16-bed in-person Crisis Stabilization Unit (CSU) for voluntary patients.
• The virtual CSU (vCSU) was launched in March 2020 as a remote adjunct to the in-person CSU during the COVID-19 pandemic.
• The vCSU aimed to provide similar resources to patients, enabling them to receive care at home.

Purpose of the Study:

• To examine patient characteristics and discharge outcomes of the vCSU.
• To compare vCSU admissions with in-person CSU admissions.
• To assess the feasibility of a virtual model for mental health crisis care.

Main Methods:

• Program data for vCSU admissions (n=266) between April 2020 and April 2021 were collected.
• Electronic patient records for in-person CSU admissions (n=712) during the same period were used for comparison.
• Binary logistic regression was used to compare vCSU (n=191) and in-person CSU (n=521) admissions on demographics and clinical factors.

Main Results:

• 30.1% of vCSU patients received all care virtually at home.
• Common presenting symptoms included depression/anxiety (39.0%) and suicidal behaviour/self-harm (27.4%).
• vCSU referrals were associated with absence of psychosis (OR 0.40) and no prior contact with the referral site (OR 0.43). Patients living farther away were more likely to receive vCSU referrals.

Conclusions:

• The virtual Crisis Stabilization Unit (vCSU) model demonstrates feasibility for diverse patients experiencing mental health crises.
• Further research is required to refine patient selection criteria for the vCSU model.
• Longer-term outcomes of the vCSU model need to be examined.