When an individual is in crisis, it is hard for them to picture a way out. They may be dealing with a psychosocial stressor, such as a relationship issue or grief, on top of an economic issue. They may find it impossible to get up for work, to shower, or to eat. "A crisis is something that renders someone unable to attend to their normal functioning," says Presque Isle's Adult Crisis Stabilization Unit (ACSU) site Clinical supervisor Christina Wall, LCSW. The ACSU provides 24-hour, short-term residency for adults 18 years and older experiencing a behavioral health crisis. The service ensures that individuals in crisis know where they will be sleeping that night, where their next meal will come from, and that someone is there to listen to them.

Crisis resolution is about re-establishing normal levels of functioning while fostering the skills to better deal with issues in the future. "We're giving people the skillset to tolerate pain without causing more pain," says Christina. Clients are taught how to sit and distract from emotional pain rather than to act on it in a harmful way immediately. The safe environment the ACSU provides increases a client's insight into their issues, which they can take with them when they are ready to leave. The work clients do in the ACSU is not always easy. "Change is very hard," Christina explains. "I would really like to eat less sugar, but when it's 3 p.m., and I want a Snickers, do I still want to change?" Part of the ACSU's work is to prepare clients to navigate the difficulty of growing and to support them in that process without judgement. One-on-one and group therapy sessions are offered to clients throughout their stay.

Access to the ACSU is designed to be as low-barrier as possible. Clients can call to self-refer or be referred by AMHC's Mobile Crisis team. This team can provide assessments and decide the level of care the client needs. Clients may also be transferred from a hospital's Emergency Room or the Psychiatric Ward to the ACSU if they can step down to a less restrictive care environment. Admission into the ACSU is always voluntary. Once a client is admitted to the ACSU, staff perform an assessment, establish goals for the client's visit, and create a treatment plan. Staff is ready and available 24/7, 365 days a year. If a client has trouble sleeping due to a condition such as Post-Traumatic Stress Disorder and needs someone to talk to at 3 in the morning, a qualified and non-judgmental staff member is there and ready to listen.

While they may appear functionally similar, the ACSU is not a psychiatric ward. There is no psychiatrist on site at the ACSU; clients bring their own medication or collaborate with their provider via telehealth. ACSU units encourage the highest level of independence that clients can achieve. If they demonstrate the ability to self-determine their current mental state and keep themselves safe, they can come and go from the building. Outings are subject to staff assessment.

Often, clients find they can already cope healthily and just need someone kind to remind them how. During their visit, clients frequently say they wish they had known that the ACSU existed earlier and that they appreciate the emotional break it provides. It has been described as a place to get "an emotional tune-up" or as "my lighthouse" by former clients. They find that being able to stay somewhere safe and avoid a hospital stay fosters their ability to process their stressors healthily. Christina says, "We serve as a grounding place for people, and that is really rewarding work."

AMHC Adult Crisis Stabilization Units in Presque Isle and Calais. The service is paid on a sliding fee scale. AMHC's ACSU locations are:

Adult Crisis Stabilization Unit, Aroostook County

180 Academy Street, Suite 1, Presque Isle

207-768-3304

Adult Crisis Stabilization Unit, Washington County

127 Palmer Street, Calais

207-454-1910