1. Summer Savon, MD, PhD, James Dilley, MD, Christina Mangurian, MD, Emily Martin, BA, Jaspreet Uppal, BS, Richard Patel, MD, Richard Oliva, MD, Martha Shumway, PhD University of California, San Francisco and San Francisco General Hospital Research Questions How do WCC clients describe themselves in terms of health, well-being, and socioeconomic status? How do WCC clients feel about the services they receive here? Are there areas where client satisfaction is higher, and other areas where improvement is needed? Background The goals of contemporary behavioral health treatment have expanded to include more broadly defined concepts of self-direction, respect, responsibility and hope. A successful treatment plan incorporates these concepts and moves a person toward greater and greater lasting recovery. On the other hand, a gradual loss of well-being can occur which eventually includes a cessation of medication for any of a variety of reasons. The lack of medication is an important pivot point as either an intervention that restarts medication can occur, or a further plummet of functioning takes place that often ends up with the individual going to the psychiatric emergency room. “Psychiatric urgent care” can address this crucial pivot point. However, there is limited literature describing the individuals who use these urgent care services or how the services are perceived by those who use them. Methods Participants: All English-speaking WCC clients who were not cognitively impaired or being placed on a legal hold for psychiatric evaluation were eligible to participate. The current, preliminary sample includes 17 clients. Study Procedure: When research interviewers were available, all eligible clients were asked to participate in interviews. Consenting clients completed at 67-question survey that included demographic characteristics, objective and subjective socioeconomic status, the WHO-5 Well-Being Scale, the General Self-Efficacy Scale, an adapted version of the Multidimensional Scale of Perceived Social Support, and the MHSIP Consumer Survey of satisfaction with mental health services. Data Analysis: Descriptive statistics were used to summarize the data. Results  Discussion These preliminary findings help delineate a segment of the chronically ill in the general population that is still functioning socially, but carries a high risk of future difficulties due to lack of medication. It is interesting that the majority of clients seen at WCC, regardless of their specific situation, are very satisfied with the services they received. There are two themes that arise from this study which may apply to this client population in general: 1.These clients are optimistic and view themselves as problem solvers with good support systems. Yet, they realize the need for urgent psychiatric care. Once back in treatment, clients are better able to participate in on- going care. This clinic model can be seen as analogous to the harm reduction model, in that it constitutes a way to provide critical emergent psychiatric medication without first requiring complete connection with an outpatient mental health clinic. 2.Although clinic participants feel positive about their lives in several ways, some of the initial data indicates that clients are not as satisfied with: a.physical aspects of well-being: waking up refreshed, feeling able to handle difficulties b.spiritual aspects of well-being: good quality of life, feeling that life is interesting This suggests that education on practical matters of general nutritional/preventative health could be very helpful if provided in a manner that is easy to implement. Similarly, there may be ways to provide access to enriching activities either on site, or in the community.    Setting The Westside Crisis Clinic (WCC), a “psychiatric urgent care” facility located in downtown San Francisco, is a program that provides re-initiation of medication to individuals who are stable enough to be in the community, but are at risk due to lack of medications. WCC was founded in 1967 and has transitioned from being a 24-hour clinic to a structured six-day, 8 am-5 pm clinic. Most clients are SF residents who are currently in rehab facilities, have recently been incarcerated, or have lost benefits due to unemployment, etc. The Westside Crisis Clinic opens at 8 am, with a line of about 15-20 clients that began to form at 7 am. Clients sign in, are assessed for risk and appropriateness. As appropriate, clients are given an appointment time for later in the day. The appointment involves meeting with a psychiatrist or a psychiatric nurse practitioner for about 40 minutes and typically results in a prescription for a month’s supply of medication. Clients understand that this is an interim arrangement and that they are expected to establish on-going treatment at one of several area mental health clinics. The client leaves the visit with a list of locations and directions to area follow-up clinics and handouts with information about area shelters, free food and other resources. Additionally, the clinic offers several visits with a staff psychotherapist.  NR2-212  Results  For additional information, contact: Summer Savon, MD, PhD summer.savon@ucsf.edu This work was supported by Westside Community Services. 