Peer-run and alternative crisis services

Domain V · Systemic, relational, group & community · 2008

What it is

This entry is not a single therapy. It is a family of services: residential or home-based alternatives to psychiatric admission that respond to a mental health crisis without coercion, keep the person in or near their community, and give lived experience a central role. WHO's 2021 guidance presents…

Format

• No service publishes a manualised phase model; the stages below are the course of a typical crisis contact as the sources describe it.
• This entry is not a single therapy. It is a family of services: residential or home-based alternatives to psychiatric admission that respond to a mental health crisis without coercion, keep the person in or near their community, and give lived experience a central role. WHO's 2021 guidance presents…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• : the post-stay dip when support ends abruptly.
• : the network tiring; reduce frequency as the crisis settles, by joint decision.
• : using the chart as an eligibility or performance test rather than a conversation.
• : clients expecting hospital-style care, or fearing that the house is a locked unit.
• : a plan written by staff in clinical language; plans that never reach community teams.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.