A Better Approach to Treating Behavioral Health Crises in the ED

All too often we hear about health systems struggling with acute psychiatric services in their emergency departments. As a first point of contact, Emergency Departments (EDs) can be completely appropriate for emergency, high-acuity psychiatric patients and, in fact, the federal Emergency Medical Treatment and Active Labor Act (EMTALA) categorizes psychiatric emergencies as legally equivalent to medical emergencies like trauma and heart attacks.

Despite this, the majority of EDs are simply not well-equipped to treat psychiatric crises. Too often at many hospitals, the default treatment has been to hold patients for transfer to inpatient facilities, which is not only stressful for patients and staff but costly to health systems.

There is a better option for treating acute psychiatric emergencies – and one that is gaining traction across EDs nationwide – the EmPath model. EmPath stands for “Emergency Psychiatry Assessment, Treatment and Healing”, and it concisely describes the function of these soothing, trauma-informed environments.  I helped develop this care delivery approach 10 years ago after witnessing that traditional acute care settings and protocols were not effective for those experiencing a psychiatric crisis. The goal of EmPath is to achieve better outcomes for patients with acute mental health issues by getting them immediate provider evaluations and commencing treatment in a comfortable setting, with an involved, interactive staff and regular opportunities for reassessment. 

Using the EmPath approach, high-acuity patients, including those on involuntary status or considered dangerous to themselves or others, can be stabilized and treated in a less stressful, less restrictive setting, -- resulting in a 75% or higher avoidance of inpatient psychiatric hospitalization in less than 24 hours for patients who would have been hospitalized in traditional systems.

This model is currently used in a number of hospitals nationwide, with phenomenal results. My colleagues and I at Vituity are excited to launch this approach most recently at Mercy San Juan in Carmichael, California, in their new facility opening this month. The 4,000 Sacramento County residents who seek treatment there for a behavioral health crisis each year deserve to get the services they need quickly and safely to begin the road to wellness and recovery sooner, and this will now be available to them.

Congratulations to the team at Mercy San Juan, and everyone who has worked so hard to make this a reality!