The Crisis Stabilization Unit: A calm and safe space

The Crisis Stabilization Unit (CSU) at University of Iowa Hospitals & Clinics is designed to offer a calm, shared space for people experiencing emotional or psychiatric emergencies.

So when COVID-19 emerged in Iowa, nurse manager Heidi Robinson, RN, had to act quickly in order to keep it a safe place.

Heidi Robinson, RN, responded to the pandemic by promoting safety: changing the environment and care delivery in the Crisis Stabilization Unit.

Patients typically stay on the unit for 24 to 48 hours where staff help them develop an appropriate treatment plan.

“One to two days is the goal,” says Robinson. “Research shows that most critical emotional and psychological behavior can be resolved with an intensive and interdisciplinary care approach.”

COVID-19 changed delivery of care, environment

“On our unit, we all work in close proximity with our patients, who participate in group therapy and group dining,” Robinson says. “With COVID-19, we were immediately concerned about our community setting and how to balance peer support and group therapy with social distancing.”

In an effort to keep everyone safe, the CSU switched to individual therapy sessions, Zoom group sessions, and private Zoom sessions in one of CSU’s two calming rooms, private dining, and an emphasis on personal hygiene and personal protective equipment.

Common area recliners are now spaced six feet apart and staff members provide masks to patients, conduct twice daily temperature assessments, and clean common touch areas every hour. All patients are screened for COVID-19 before being admitted to the CSU.

“We have not cut down on the number of patients we are able to see because we are screening and monitoring both patients and staff [for COVID-19],” Robinson says.

As a result, the unit continues to treat patients who, without it, might have ended up in the UI Emergency Department (ED). And as COVID-19 continues to spread in the community, Robinson says this new routine will continue for the foreseeable future, with updates as medical response to the disease evolves.

“We’ve been educating the patients and they have been very understanding,” she says. “They want to feel safe.”

Crisis Stabilization Unit helps triage mental health patients

UI Hospitals & Clinics is one of a few hospitals in the Midwest with a CSU care model, which is designed to divert mentally ill patients from the ED. Patients may wait for hours to be seen in an emergency room due to high-traffic or other pressing demands of treating patients with serious medical conditions. The CSU opened in 2018 and was designed to encourage patients to take their health into their own hands.

The pandemic has certainly affected those patients.

“This is a very stressful time economically and emotionally and people choose to cope in different ways,” says Robinson. “I think we’ll continue to see an uptick in mental health service needs.”

Working during the pandemic has reinforced Robinson’s belief that even in a crisis, her colleagues are the best.

“We are all encountering this [pandemic] for the first time together, and everyone has been willing to jump in and help,” says Robinson.