MUSC Health Chief Sees Promise in EmPATH Model
MUSC mental-health chief Lalithkumar Solai, MD, explains how EmPATH units can open emergency-department capacity, stabilize patients in a therapeutic setting and reduce avoidable psychiatric admissions.
Original reporting by Ella Ruder, Becker’s Behavioral Health • February 24, 2026
What makes the EmPATH model promising for health systems?
EmPATH moves appropriate behavioral-health patients from the conventional emergency department into a calmer, open therapeutic setting. MUSC sees the model as a way to begin treatment sooner, return more people safely to the community and preserve medical ED space for patients who need it.
For Lalithkumar Solai, MD, the opportunity begins with the environment itself. As MUSC Health’s chief of mental health, he views EmPATH—emergency psychiatric assessment, treatment and healing—as a different front door for psychiatric emergencies.
Instead of waiting in a high-stimulation medical ED, eligible patients can receive observation, medication management, therapy, coping-skills support and help reconnecting with outpatient care. MUSC allows stays of up to 72 hours, giving clinicians time to stabilize and reassess patients before deciding whether inpatient admission is necessary.
The EmPATH opportunity by the numbers
Up to 72 hrs
MUSC’s window for observation, treatment and reassessment in EmPATH.
80% home
Community-return benchmark reported by University of Kentucky’s EmPATH program.
20% admitted
Share of patients admitted in the University of Kentucky comparison cited by MUSC.
50 / 50 baseline
MUSC’s conventional ED split between admission and return to the community.
A therapeutic space can begin treatment before evaluation
The medical emergency department is designed for urgent physical care, not psychiatric recovery. Noise, bright lighting and prolonged isolation can compound distress for people already in crisis.
An EmPATH unit replaces that experience with an open, calmer environment organized around engagement. Dr. Solai said the setting itself may help patients settle before a psychiatrist or other clinician completes the formal evaluation.
1. Free medical emergency beds
Moving suitable behavioral-health patients into EmPATH can quickly return beds to the medical emergency department. For crowded hospitals, that capacity benefit is central to the model’s value.
Dr. Solai encouraged systems with the ability to create an EmPATH unit to consider it, especially where psychiatric boarding occupies scarce ED space.
2. Use time to stabilize and reassess
MUSC can keep patients in EmPATH for as long as 72 hours. That window gives treatment time to work and allows the care team to make a more informed decision than may be possible during a brief crisis evaluation.
Some people who initially appear to need inpatient care may stabilize enough to leave safely with a community-based plan.
3. Build coping skills and reconnect outpatient care
The stay is intended to be active treatment, not another form of waiting. Patients can participate in therapy, practice coping strategies and receive support reconnecting with outpatient clinicians and services.
Those interventions can address the immediate crisis while strengthening the plan patients will rely on after discharge.
4. Match patients to the appropriate setting
EmPATH is not the right environment for every presentation. Patients who are actively violent or too severely psychotic to engage may require a more secure setting and a different level of care.
Separating patients according to clinical need can protect the therapeutic environment while allowing more appropriate patients to stabilize and return to the community.
MUSC hopes to shift the admission balance
In MUSC’s conventional emergency-department pathway, approximately half of behavioral-health patients were admitted and half returned to the community. Leaders want EmPATH to move that balance toward community discharge.
Dr. Solai pointed to the University of Kentucky, where the comparison he cited was roughly 80% returning to the community and 20% being admitted. That experience offers a direction for MUSC, not a guaranteed local outcome.
The model needs leadership and infrastructure
Creating an EmPATH unit requires more than repurposing a room. Health-system leaders must commit physical space, operational support and a clinical pathway that connects the ED, psychiatric services and community care.
Dr. Solai also noted that EmPATH has not yet been established as a universal gold standard through the level of scientific validation leaders may prefer, even though versions of the model have been implemented across many regions.
Therapeutic programming is part of the design
The environment needs structured ways for patients to regulate, participate and recover. Dr. Solai identified music, relaxation, group activities and group therapy as examples of the programming an EmPATH space should support.
These elements distinguish the unit from a psychiatric holding area: the goal is to create conditions for active healing throughout the stay.
Staffing determines whether the model works
A sustainable program needs licensed counseling support, nursing care and a psychiatric prescriber—either a psychiatrist, psychiatric nurse practitioner or another qualified provider—to evaluate symptoms and manage medication.
The right mix lets the unit deliver therapy, observation and medical decision-making rather than functioning only as a change of location.
Payment determines whether the model lasts
South Carolina Medicaid reimburses care delivered through the model, an important foundation for MUSC. Dr. Solai emphasized that payer participation is essential if health systems are expected to sustain the staffing, space and programming EmPATH requires.
- Start with capacity: EmPATH can release medical ED beds while psychiatric care continues nearby.
- Treat during observation: Use the stay for stabilization, therapy and discharge planning—not passive boarding.
- Define the clinical fit: Maintain other pathways for patients who cannot safely engage in an open milieu.
- Build the full program: Therapeutic space, structured activities and multidisciplinary staffing work together.
- Secure payer support: Reimbursement is a prerequisite for long-term sustainability.
Article Highlights
- MUSC can observe and treat patients in EmPATH for up to 72 hours.
- The model can free medical ED beds and reduce avoidable psychiatric admissions.
- MUSC hopes to improve on its conventional 50/50 admission and community-return split.
- Dedicated therapeutic programming, clinical staffing and payer support are essential.
Original Reporting
Read Ella Ruder’s complete interview with MUSC mental-health chief Lalithkumar Solai, MD, in Becker’s Behavioral Health.