Adult Step-up Step-down: A sub-acute short-term residential mental health service

Aim: This article describes the Adult Step-up Step-down mental health service that operates in Canberra, Australia, as a short-term sub-acute residential rehabilitation service. Description: The service accepts mental health clients who are preparing for discharge from an inpatient unit, as a transitional service to support them as they prepare to return to living in the community (step down). The service also accepts mental health clients living in the community who are experiencing an escalation in symptoms and a short stay in a residential rehabilitation program may avoid hospitalization (step up). The service provides 5 beds in an open, home-like environment, with 24 hour staffing, including clinical support. Conclusion: Step-up step-down services are increasingly being implemented in Australia to address the service gap between inpatient and community care, providing a personal and tailored support base for clients prior to returning to independent living.