Impact of the 2nd story peer respite program on use of inpatient and emergency services.
OBJECTIVE
By providing a safe and supportive space for individuals experiencing or at risk of experiencing a mental health crisis, a peer respite may reduce the need for traditional crisis interventions. This study examined the relationship between peer respite and use of inpatient and emergency services among adults receiving publicly funded behavioral health services.


METHODS
This analysis used propensity score matching to create matched pairs of 139 users of peer respite and 139 nonusers of respite with similar histories of behavioral health service use and clinical and demographic characteristics. A two-stage regression model first predicted the likelihood of inpatient or emergency service use after peer respite start date and then predicted hours of inpatient and emergency service use among 89 individuals who used any inpatient or emergency services.


RESULTS
After the authors controlled for relevant covariates, the odds of using any inpatient or emergency services after the program start date were approximately 70% lower among respite users than nonrespite users, although the odds increased with each additional respite day. Among individuals who used any inpatient or emergency services, a longer stay in respite was associated with fewer hours of inpatient and emergency service use. However, the association was one of diminishing returns, with negligible decreases predicted beyond 14 respite days.


CONCLUSIONS
By reducing the need for inpatient and emergency services for some individuals, peer respites may increase meaningful choices for recovery and decrease the behavioral health system's reliance on costly, coercive, and less person-centered modes of service delivery.
The authors are with the Human Services Research Institute, Cambridge, Massachusetts (e-mail: bcroft@hsri.org).
Bevin
B
Croft
The authors are with the Human Services Research Institute, Cambridge, Massachusetts (e-mail: bcroft@hsri.org).
Nilüfer
N
İsvan
D000328:Adult; D016022:Case-Control Studies; D003419:Crisis Intervention / Q000379:methods*; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D010379:Peer Group; D057216:Propensity Score; D012114:Residential Treatment / Q000379:methods*; D012144:Respite Care / Q000379:methods*