Medicine:EmPATH unit

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Short description: American psychiatric emergency unit

EmPATH unit (Emergency Psychiatric Assessment, Treatment, and Healing) is an acronym for a specialized hospital-based emergency department or outpatient medical observation unit dedicated to mental health emergencies. Unlike standard emergency departments, EmPATH units gather their patients in chairs in a central room called a milieu.[1][2][3] EmPATH units were developed as a response to United States emergency department overcrowding as large numbers of mental health patients were waiting for hours or days until they could be transferred to an inpatient psychiatric facility.[4][5]

Moving psychiatric patients to a separate area for specialized emergency care opens emergency department beds for patients with medical emergencies and avoids the more confined structure of a standard emergency department which has been cited as a potential cause of worsening psychiatric patient symptoms.[6] The open design of the EmPATH unit allows patients to move about freely, helping reduce stress.[7][8] A study of the EmPATH unit at the University of Iowa Hospitals and Clinics has shown that patients need shorter stays, less inpatient care, and return to hospital less frequently.[9] Other hospitals' EmPATH units have reported fewer than 25% of psychiatric emergency patients still require inpatient care after an EmPATH stay.[10][11][12][13]

In their "Roadmap to the Ideal Crisis System", The National Council for Mental Wellbeing stated that there should be at least one EmPATH unit in every mental health system.[14]

History

The concept of EmPATH units was developed by Scott Zeller. For his work on EmPATH units, Healthcare Design magazine named him one of the "Top 10 People in Healthcare Design” in 2020[15] and the California Hospital Association awarded him the Ritz E. Heerman Memorial Award in 2019.[16]

References

  1. Gorman, Anna (March 25, 2019). "She Was Dancing On The Roof And Talking Gibberish. A Special Kind Of ER Helped Her". Health News Florida. Kaiser Health News (WUSF). https://www.cnn.com/2019/03/21/health/psychiatric-ers-mental-health-partner/index.html. 
  2. Ojeda, Hillary (April 12, 2019). "University of Iowa Crisis Stabilization Unit challenges convention". Iowa City Press-Citizen (Gannett Co.). https://www.press-citizen.com/story/news/2019/04/12/new-psychiatric-crisis-unit-iowa-city-creating-improved-outcomes/3446650002/. 
  3. Lockwood, James (13 October 2020). "EmPATH Units: Improving Psychiatric Emergency Care". BWBR Architects. https://www.bwbr.com/empath-units-improving-psychiatric-emergency-care/. 
  4. Amy Ellis Nutt (2021-10-26). "Psychiatric patients wait the longest in emergency rooms, survey shows". The Washington Post (Washington, D.C.). ISSN 0190-8286. OCLC 1330888409. https://www.washingtonpost.com/news/to-your-health/wp/2016/10/18/sickest-psychiatric-patients-wait-the-longest-in-emergency-rooms-survey-shows/. [please check these dates]
  5. D, Kelengabor; M, Millsangela; A, Sternsusan; C, Wadmanmichael; E, Sokolovepeter (September 28, 2021). "Emergency Department Crowding: The Canary in the Health Care System". NEJM Catalyst Innovations in Care Delivery. doi:10.1056/cat.21.0217. https://catalyst.nejm.org/doi/full/10.1056/CAT.21.0217. 
  6. Nicks, B. A.; Manthey, D. M. (March 8, 2012). "The impact of psychiatric patient boarding in emergency departments". Emergency Medicine International 2012: 360308. doi:10.1155/2012/360308. PMID 22888437. 
  7. Picone, Linda. "Empath: A new approach to mental health crisis" (pdf). Minnesota Medicine (September/October 2021). https://www.mnmed.org/getattachment/news-and-publications/mn-medicine-magazine/Past-Issues/Past-Issues-2021/Sept-Oct-2021/Feature_Picone-SeptOct.pdf.aspx?lang=en-US. 
  8. "One mental health solution: a kinder, gentler emergency department for people considering suicide". The Globe and Mail. July 19, 2020. https://www.theglobeandmail.com/canada/article-one-mental-health-solution-a-kinder-gentler-emergency-department-for/. 
  9. Kim, Allison K.; Vakkalanka, J. Priyanka; Van Heukelom, Paul; Tate, Jodi; Lee, Sangil (February 8, 2022). "Emergency psychiatric assessment, treatment, and healing (EmPATH) unit decreases hospital admission for patients presenting with suicidal ideation in rural America". Academic Emergency Medicine 29 (2): 142–149. doi:10.1111/acem.14374. PMID 34403550. 
  10. Holmen, Kenneth. "Your Turn: Pandemic innovation in mental health and addiction care must not stop". https://www.sctimes.com/story/opinion/2022/04/11/your-turn-innovation-mental-health-addiction-care-must-continue/9503347002/. 
  11. "Beth Heinz: What M Health Fairview is learning from its new emergency mental-health unit". January 28, 2022. https://www.twincities.com/2022/01/28/beth-heinz-what-m-health-fairview-is-learning-from-its-new-emergency-mental-health-unit/. 
  12. Marian Huber (2021-07-23). "Virginia's mental health hospitals must be restored". The Washington Post (Washington, D.C.). ISSN 0190-8286. OCLC 1330888409. https://www.washingtonpost.com/opinions/2021/07/23/virginia-mental-health-hospitals-restore-services/. [please check these dates]
  13. Gray, Callan (October 13, 2021). "M Health Fairview's new approach to mental health crises shows reduction in hospital admissions". https://kstp.com/kstp-news/top-news/m-health-fairviews-new-approach-to-mental-health-crises-shows-reduction-in-hospital-admissions/. 
  14. "Roadmap to the Ideal Crisis System". https://www.thenationalcouncil.org/roadmap-to-the-ideal-crisis-system/. 
  15. "The HCD 10: Scott Zeller, MD, Clinician - HCD Magazine". September 17, 2020. https://healthcaredesignmagazine.com/trends/the-hcd-10-scott-zeller-md-clinican/. 
  16. "CHA Awards". https://calhospital.org/about-the-california-hospital-association/cha-awards/.