Father and son near a lake

St. John’s Crisis Stabilization Unit (CSU)

Behavioral Health illness is a growing problem in the U.S. that crosses all socioeconomic boundaries and age groups. Related health disorders include conditions such as clinical depression, bipolar disorder, and schizophrenia. Depressive illnesses tend to present with substance abuse. According to the National Alliance on Mental Illness (NAMI), 1 in 5 U.S. adults experience a mental illness, with:

  • 1 in 25 adults experiencing a serious or acute mental illness, and 17% of youth between the ages of 6-17 experience a mental health disorder.
  • Mood disorders are the most common cause of hospitalization for all people in the U.S. under the age of 45.

While devastating for patients and their loved ones, those who suffer from an acute psychiatric illness would benefit from treatment.

St. John’s Regional Medical Center in Oxnard and St. John’s in Camarillo are dedicated to addressing this public health crisis through its commitment to build a Crisis Stabilization Unit (CSU) a signature element of the Behavioral Health Services program. With the increased identification and prevalence of mental health disorders, St. John’s Emergency Departments are often overwhelmed with a surge of patients who require behavioral health services that extend beyond its service capabilities.

  • A minimum of 50 inpatient mental health beds are recommended to serve every 100,000 people.¹ Ventura County has only 10 for every 100,000 people.

The shortage often leads to critical health needs going unmet. Thus, a pattern emerges of patients presenting themselves in crisis to the ED, finding inadequate options for further care, whether it be inpatient or outpatient.

It is estimated that nationally 1 of every 8 visits to an emergency department stems from mental health or substance abuse issues (NAMI), and the local landscape at St. John’s is no different. St. John’s cares for thousands of patients with acute behavioral health needs annually, treating everyone and every need imaginable. A CSU is intended to deescalate the severity of a person’s level of distress and/or need for urgent care associated with behavioral health conditions or those stemming from substance abuse. Implementing a hospital-run CSU in our community will provide a much-needed and critical element in local care for patients in crisis. This is something unavailable currently.

¹Office of Statewide Health Planning and Development as reported in the California Hospital Association 2019 California Annual Report.


1. What is a CSU?
The Crisis Stabilization Unit (CSU) is a facility open 24 hours daily for crisis intervention, assessment, evaluation, therapy and support.

2. Who can be seen in the CSU?
Any person having a mental health crisis requiring prompt care, either on a voluntary or involuntary basis.

3. What are the benefits to our local patients?
Instead of waiting hours/days in our Emergency Department for a transfer to an out-of-county inpatient mental health facility, our CSU will see patients as soon as they are medically cleared, providing early treatment initiation. This new, local treatment option for urgent situations will fill an unmet need of our community. The CSU treatment will result in less need for out-of-town transfers for inpatient mental health care. We expect that 50-75% of the CSU patients will be safely discharged home, thus avoiding the need for transfer out of town for many people. Our expert staff will also more effectively coordinate follow-up care with local resources, compared to out-of-town facilities.

4. Who staffs a CSU?
A psychiatrist runs the CSU, seeing every patient, working closely with specially trained nurses and technicians along with licensed clinical social workers (LCSW’s) and case managers.

5. What happens to the patient in the CSU?
After arrival in the CSU, the patient will be seen by the multidisciplinary staff that includes a psychiatrist, nurses and social workers/case managers. A treatment plan will be quickly formulated and implemented, and the patient will be continually reassessed by staff.

6. Describe the typical flow of patients into the CSU.
CSU patients will first receive a medical evaluation in the St. John’s ED to ensure there is not a medical condition requiring prompt treatment. After medical clearance, the patient will be transported from the Emergency Department to the CSU.

7. What happens to patients when they are discharged from the CSU?
The majority of patients will be safely discharged home instead of going to an out-of-town inpatient mental health facility. Our CSU staff will work closely with community resources and mental health providers to link patients to the care they need. This will provide improved coordination with local community services.

8. How long does a typical patient stay in the CSU?
The average length of stay will likely vary between 16-20 hours, although it may be longer or shorter depending on the individual scenario and needs of the patient.

9. What effect will COVID-19 have on the CSU?
Largescale disasters and economic crises such as the Coronavirus pandemic are documented to increase the prevalence of mental health conditions in populations and lead to higher rates of suicide, substance use, anxiety, and depression. The Coronavirus pandemic has already impacted the need for services locally. The number of behavioral health patients presenting in the Emergency Department has risen past what we have seen historically.