Mental Health Crisis Leads Hospitals to Create a New Type of ER
Bloomberg examines how EmPATH units use recliners, open space and rapid psychiatric treatment to move medically stable patients out of conventional emergency rooms, help them stabilize and avoid unnecessary hospitalization.
Original reporting by John Tozzi, Bloomberg Businessweek • September 26, 2022
What problem are EmPATH units designed to solve?
People experiencing a psychiatric crisis frequently arrive in emergency departments because other treatment is unavailable. They may then spend hours or days on a gurney with little active mental health care while waiting to be discharged or transferred to an inpatient psychiatric bed. EmPATH units create a dedicated pathway where treatment can begin sooner in a calmer environment.
EmPATH stands for Emergency Psychiatric Assessment, Treatment and Healing. Developed by psychiatrist Scott Zeller, MD, the model is intended for medically stable patients experiencing conditions such as depression, anxiety, post-traumatic stress, suicidal thoughts or substance-use problems.
Bloomberg reports that these patients can be seen quickly by psychiatric specialists, begin medication or other treatment when appropriate, and receive time to stabilize without automatically being sent to a psychiatric hospital.
Why EmPATH matters by the numbers
1 in 8
Emergency-department visits nationally involve mental health concerns or substance use.
962 patients
Adults included in a peer-reviewed study of EmPATH outcomes for suicidal ideation or attempts.
52% lower
Relative risk of psychiatric admission after EmPATH implementation in that study.
~2/3 less
Emergency-department boarding time among admitted patients in the study.
The emergency room is often the default—not the right environment
Traditional emergency departments are designed for medical emergencies, rapid procedures and constant monitoring. Their alarms, bright lights, security presence and limited privacy can intensify fear and agitation for someone already experiencing a mental health crisis.
Psychiatric patients may receive medical clearance but little treatment for the crisis itself while they wait for another placement. The delay also keeps scarce emergency beds occupied and adds pressure to already crowded departments.
1. Medical screening comes first
EmPATH does not replace emergency medical evaluation. Patients first receive screening to rule out injuries, intoxication, medication complications or other medical conditions requiring conventional emergency care.
Once they are medically stable, eligible patients can transition into the EmPATH setting instead of remaining in a standard ER bay or hallway.
2. Patients enter a calmer, living room-style setting
Bloomberg highlights the EmPATH unit at M Health Fairview Southdale Hospital in Edina, Minnesota, where open space and recliners create a more serene setting than a conventional emergency room. Games and activities give patients ways to occupy themselves while care is underway.
The layout supports observation without requiring every patient to remain isolated in a room. Patients have space to sit, move, rest and interact with staff when it is safe to do so.
3. Psychiatric specialists begin treatment quickly
Instead of waiting for an inpatient bed to become the treatment plan, patients can receive rapid psychiatric assessment, medication when appropriate, crisis counseling and help identifying the next level of care.
The distinction is central to the model: EmPATH is not another holding area. It is a short-term treatment environment built to address the immediate crisis.
4. Stabilization can prevent an automatic hospital admission
Some people who appear to need inpatient psychiatric care when they first arrive may be able to return home safely after focused treatment and observation. Time in a lower-stimulation setting allows symptoms to settle and gives clinicians a clearer picture of what the patient actually needs.
Patients who still require hospitalization can be transferred with a more complete assessment, while others leave with follow-up care and a safety plan.
Inside M Health Fairview Southdale’s EmPATH unit
M Health Fairview opened Minnesota’s first EmPATH unit at Southdale Hospital in 2021. The hospital’s approach places medically stable behavioral-health patients in a therapeutic, living room-style area with rapid access to specialized support.
The unit featured in Bloomberg’s reporting reflects the model’s broader philosophy: reduce unnecessary stress, make treatment available immediately and give patients a setting where stabilization is possible.
A setting designed around movement and connection
Recliners and games may sound like modest changes, but they represent a different understanding of psychiatric emergencies. Remaining strapped to a gurney or alone in a bare room can reinforce fear and helplessness. A more open environment can support conversation, activity and voluntary engagement with care.
Staff can build rapport, monitor behavior and respond to distress while using less restrictive interventions whenever clinically appropriate.
The benefits extend beyond psychiatric care
Moving appropriate patients into a specialized crisis unit frees emergency beds for people with acute medical needs. It can also reduce the frustration emergency clinicians experience when they lack the time, setting or psychiatric resources to treat behavioral-health patients effectively.
For hospitals, the model connects better patient care with improved flow: treatment starts sooner, boarding can fall and inpatient psychiatric beds are reserved for patients who truly need them.
Why the model gained momentum after the pandemic
Bloomberg’s reporting came as hospitals were reassessing mental health services after the COVID-19 pandemic intensified behavioral-health needs and exposed gaps in crisis care. EmPATH offered a practical alternative to expanding traditional psychiatric wards or continuing to board patients in the ER.
The model can be adapted to different hospitals, but successful programs still require dedicated psychiatric staffing, clear eligibility criteria, reliable referral workflows and strong connections to outpatient and community care.
What health systems can take from Bloomberg’s reporting
- Treat the crisis instead of holding the patient: Rapid psychiatric assessment and intervention are the heart of the model.
- Use the environment therapeutically: Recliners, open space, activities and lower stimulation can support stabilization.
- Reserve inpatient care for those who need it: Short-term treatment gives clinicians time to make a more informed decision.
- Protect emergency-department capacity: A dedicated behavioral-health pathway frees beds and reduces boarding.
- Connect patients to the next step: Safe discharge depends on follow-up planning and community resources.
Article Highlights
- Psychiatric patients can spend hours or days waiting in ERs without active mental health treatment.
- EmPATH provides rapid specialist care in a calmer, living room-style setting.
- Bloomberg profiles M Health Fairview Southdale Hospital’s unit in Edina, Minnesota.
- The model can reduce unnecessary admissions while freeing emergency-department capacity.
Original Reporting
Read John Tozzi’s complete reporting, interviews and context from Bloomberg Businessweek.