Community-Based Crisis Care Beyond the Emergency Department: A Scoping Review.

Area of Science:

• Mental Health Research
• Public Health Initiatives
• Community Psychology

Background:

• Suicide and mental ill-health are global concerns, with emergency departments (EDs) often ill-equipped for crisis care.
• There is a growing need for accessible, community-based alternatives to EDs that provide supportive crisis responses.

Purpose of the Study:

• To examine the needs, motivations, and experiences of individuals using community-based crisis services as alternatives to EDs.
• To explore the integration of peer support and lived experience within these community models.

Main Methods:

• A scoping review of academic databases and grey literature from the past 20 years.
• Inclusion of studies on short-term, community-based crisis services for adults, excluding telehealth, mobile, or hospital-based care.
• Screening of 12 eligible papers (8 mixed-methods, 3 qualitative, 1 quantitative) from five countries.

Main Results:

• Community crisis models (cafés, respite centers, stabilization units, peer-led services) commonly support individuals with suicidal distress, anxiety, depression, or life stressors.
• Peer support was integral, correlating with reduced distress and enhanced emotional connection, potentially lowering ED use.
• Identified barriers include limited availability, accessibility issues, funding constraints, and inadequate aftercare.

Conclusions:

• Place-based, community crisis alternatives offer promising, person-centered care for individuals in distress, complementing suicide prevention efforts.
• Further research on long-term outcomes, economic impacts, and comparative effectiveness of peer-led models is needed.
• Addressing accessibility and funding challenges is crucial to strengthen the role of community crisis services.