New St. Paul calming room designed as ER alternative for mental health crises

It may only be four tan walls, a faux fireplace and comfy chairs, but creators hope the new Living Room in St. Paul will fill a mental health care gap by giving people a free place to relax and receive support when they feel overwhelmed.

Nonprofit Emma Norton Services built the room adjacent to its new supporting housing unit on the Highland Park riverfront to help a growing population cope with depression, anxiety, and the stresses of unstable housing or jobs. Similar approaches in Chicago have reduced emergency room and hospital visits by supporting people before they suffer mental health crises — which has long been a goal of Minnesota health care advocates.

"We de-escalate situations and we just help everybody from someone who is feeling like they might lose their job to someone with that impending doom feeling — all the way up to if someone is in active psychosis," said Jacqueline Yellowflower, a peer support supervisor for the program.

The Living Room is open daily, noon to 8 p.m., and pairs people with peer support specialists who can relate to their stresses and hardships, and connect them with medical or charitable resources as needed. People can call ahead to access the room, but walk-ins also are accepted through the facility's locked outer door.

Some crises require medical care, but research has shown that many can be addressed by peers who have earned state certification through training and experiencing mental illness themselves or in their families, said Shawna Nelsen-Wills, Emma Norton's advancement director.

"You will receive a certain kind of care that can only come from somebody who maybe has walked in your same shoes," she said during a grand opening ceremony Tuesday.

Lacking options, people in crisis often end up in emergency rooms, where they can sit for hours or days until they de-escalate or limited space opens in overcrowded psychiatric inpatient units or treatment centers.

Groups such as the East Metro Mental Health Roundtable have been trying for years to reduce these ER visits, which also clog up hospitals and delay care for others. Solutions have included a stabilization unit in the St. Paul Police Department that dispatches counselors to non-criminal calls involving people in mental health crises. Minnesota also created a level of short-term rehabilitative care that moves people out of hospitals and helps them stabilize after psychiatric crises.

Pressures have worsened since the COVID-19 pandemic. The share of Minnesota adults reporting depression increased from 20% in 2019 to 23% in 2023, according to new federal survey data.

M Health Fairview reported an 8% increase in mental health crisis assessments at its emergency departments from 2021 to 2023. The health system responded by creating a so-called EmPATH unit at Southdale Hospital in Edina, which offers more calm for patients than the busy ER. It's also building a mental health hospital in partnership with for-profit Acadia Healthcare that will open next year in St. Paul.

The Living Room is designed to help people before they reach crises, and comes with no cost, Yellowflower said. Patients don't need insurance and don't need to meet any clinical criteria to qualify for support.

Minnesota and Ramsey County provided grants for the program alongside $200,000 from the Medica Foundation — the charitable arm of one of Minnesota's largest nonprofit health insurers.

Andrew Marshall, the market leader for the Medica health plan in Minnesota and the Dakotas, said he felt a personal connection to the Living Room after receiving so much personal support during his battle with alcohol addiction 15 years ago: "It's hard for me to think about how much more challenging my journey would have been or where I would be if I didn't have anywhere to go or anyone to talk to."

Emma Norton's mission has broadened since it was founded in 1917 as a shelter for women traveling from rural Minnesota to the Twin Cities for work and education. The Living Room is adjacent to Restoring Waters, the organization's new transitional housing development for 60 individuals or families.

The St. Paul nonprofit drew from successes in the Chicago area, including a Living Room in suburban La Grange, Ill., where operators reported that they prevented 218 ER visits in their first year. That saved an estimated $550,000 for the state of Illinois because many of the visitors otherwise would have used state-funded Medicaid insurance for ER visits.