How 3 Hospitals Are Reimagining Behavioral Crisis Care
Inova Fairfax Hospital, Lexington Medical Center and Overlook Medical Center are using EmPATH units to replace psychiatric boarding with therapeutic spaces designed for faster stabilization, stronger engagement and fewer inpatient admissions.
Original reporting by Rylee Wilson, Becker’s Behavioral Health • December 20, 2024
What changes when behavioral crisis care moves beyond the traditional ER?
EmPATH units create a dedicated, living-room-style environment where patients can receive observation, assessment, medication management and clinical intervention. The three hospitals profiled by Becker’s show how physical design, treatment programming and staff engagement can change the path from crisis to recovery.
Mental-health emergencies account for a growing share of emergency visits, but the conventional ED can intensify distress. EmPATH—emergency psychiatric assessment, treatment and healing—units offer an alternative built around open nursing stations, shared therapeutic space, reclining chairs and quiet areas rather than isolated beds and plexiglass barriers.
Although each hospital operates its unit differently, the goal is consistent: begin treatment promptly, help more people stabilize without hospitalization and create a better experience for patients and staff.
Three EmPATH programs by the numbers
14 recliners
Capacity in Inova Fairfax Hospital’s newly opened EmPATH unit.
12.1 hours
Average time patients spend in Lexington Medical Center’s EmPATH unit.
70% → 44%
Lexington’s reported decline in patients requiring inpatient hospitalization.
8 beds
Capacity in Overlook Medical Center’s EmPATH unit in Summit, New Jersey.
A different environment for psychiatric emergencies
EmPATH units are intentionally designed to feel less like emergency departments and more like welcoming shared spaces. Patients typically use recliners instead of beds, while open nursing stations make staff more visible and accessible.
The physical environment supports observation and safety while reducing the institutional cues that can make a behavioral-health crisis more difficult.
1. Inova Fairfax designed for comfort and flexibility
Inova Fairfax Hospital in Virginia opened its EmPATH unit in November 2024. The 14-recliner space includes dim lighting, televisions and quiet areas where patients can step away from the shared milieu when they need less stimulation.
Behavioral-health director Sonja Flood described the environment as a core part of care—not simply a backdrop for assessment, medication management and clinical intervention.
2. Lexington shortened stays and reduced admissions
Lexington Medical Center in South Carolina converted a medical office near its emergency department into a 14-bed EmPATH unit. Some leaders and staff initially questioned whether the model would deliver meaningful results.
Early performance changed that view. Patients spent an average of 12.1 hours in EmPATH, compared with approximately 26 hours previously spent in the ED while waiting for a psychiatric bed.
3. Overlook refined engagement through experience
Overlook Medical Center, part of Atlantic Health System, opened its eight-bed EmPATH unit in January 2024. Over the following year, staff became more attentive to the patient experience and more deliberate about how they engage people in crisis.
That learning shaped treatment-planning exercises and the unit’s therapeutic curriculum, showing that implementation continues well after the doors open.
4. Staff experience improves alongside patient care
Lexington leaders reported that the EmPATH environment improved job satisfaction as well as clinical outcomes. Staff felt more engaged in helping patients progress toward a different level of recovery.
The model gives nurses, technicians and therapists a setting built for interaction and active care rather than prolonged supervision in an emergency holding area.
More patients can return home with follow-up care
Lexington reported that its inpatient hospitalization rate fell from 70% before EmPATH to 44% after implementation. More patients were able to leave with referrals for outpatient treatment.
Across the model more broadly, EmPATH developer Scott Zeller, MD, has said that roughly 70% to 80% of patients who might otherwise be hospitalized can stabilize and discharge within 24 hours. Individual results depend on each program and population.
State investment can accelerate adoption
South Carolina approved $35 million in grant funding in 2023 to help hospitals develop EmPATH units. Lexington Medical Center was among the organizations that received support.
Grant programs can help systems address the substantial upfront costs of construction, renovation and program development—especially when the necessary space does not already exist beside the emergency department.
Leadership support and space remain essential
Hospital leaders identified executive backing, appropriate physical space and funding as core requirements for a successful EmPATH unit. Each factor affects whether the program can operate as a true therapeutic service instead of another holding area.
Space is an especially difficult constraint for hospitals with crowded campuses or emergency departments that cannot easily create a separate behavioral-health environment.
The financial model remains a challenge
Even when EmPATH units improve flow and reduce inpatient admissions, they may operate at a financial loss. Reimbursement does not always reflect the staffing, therapeutic programming and facility investment required to deliver the model.
That tension makes sustained payer support and hospital commitment as important as early grant funding.
What these three programs show
- Design is clinical: Lighting, open space, recliners and quiet rooms can support stabilization.
- Measure the care pathway: Track time in care, inpatient admissions and successful outpatient referrals.
- Develop the program after opening: Staff learning should continually shape engagement and therapeutic activities.
- Include the workforce outcome: A more effective care environment can improve staff ownership and satisfaction.
- Plan for sustainability: Leadership, space, grants and reliable reimbursement all influence long-term success.
Article Highlights
- Inova Fairfax opened a 14-recliner EmPATH unit designed around comfort and decompression.
- Lexington reduced average behavioral-crisis care time from 26 hours in the ED to 12.1 hours in EmPATH.
- Lexington’s inpatient hospitalization rate fell from 70% to 44%.
- Overlook used its first year to strengthen patient engagement and treatment programming.
Original Reporting
Read Rylee Wilson’s full report on how Inova Fairfax, Lexington Medical Center and Overlook Medical Center are redesigning behavioral crisis care.