Mental Health Crisis Centers Offer an Alternative to the ER
Mental health crisis centers and EmPATH units are giving patients faster access to psychiatric care in calmer, more therapeutic environments while helping hospitals reduce emergency department boarding.
Based on reporting by Grace Rubenstein for STAT • April 26, 2024
What are mental health crisis centers?
Mental health crisis centers are specialized facilities where people experiencing acute psychiatric distress can receive rapid assessment, stabilization, medication, peer support and discharge planning outside a traditional emergency room. Hospital-based EmPATH units provide a similar treatment-first model for patients who require medical clearance or closer hospital integration.
Mental health crisis centers are emerging as a practical alternative to emergency rooms for many psychiatric emergencies. Traditional emergency departments remain essential for overdoses, serious injuries and medical instability, but they are often noisy, restrictive and poorly equipped for prolonged behavioral health treatment.
Why emergency rooms struggle with mental health crises
Emergency departments have become the default entry point for acute psychiatric care even though many hospitals have limited or no on-site psychiatric services. Patients may wait in hallways or small rooms for hours or days while a psychiatric bed becomes available. This practice, known as behavioral health boarding, can intensify fear, agitation and loss of control.
The pressure also affects hospital capacity, staffing and safety. Emergency clinicians interviewed by STAT described a system overwhelmed by demand and unable to provide the therapeutic attention many patients need.
Nearly 6M
U.S. adults visited emergency rooms for mental health emergencies in 2021.
3× longer
Psychiatric patients wait in emergency departments compared with medical patients.
60–70%
People treated at Arizona crisis centers can return home rather than enter inpatient care.
How mental health crisis centers change the care environment
Dedicated crisis centers replace the emergency room’s high-stimulation environment with open spaces, recliners, natural light, food, beverages and direct access to psychiatric professionals. Patients may participate in coping-skills groups, art activities and peer-support conversations while clinicians monitor symptoms and develop a plan for continued care.
The goal is not simply to hold a patient until another bed opens. The goal is to begin treatment immediately and stabilize the person in the least restrictive appropriate setting.
How EmPATH units support hospital-based crisis care
EmPATH stands for Emergency Psychiatry Assessment, Treatment and Healing. These units work closely with hospital emergency departments but are designed specifically for psychiatric stabilization. Patients can move around, rest in recliners, speak with clinicians and maintain more autonomy than they typically would while boarding in the ER.
For health systems evaluating new behavioral health models, Inflect Advisory connects clinical expertise with operational strategy. Inflect’s broader healthcare innovation ecosystem is also described through Inflect Studio.
Evidence supporting mental health crisis centers and EmPATH units
Research cited by STAT found that patients at the original EmPATH unit boarded for an average of 1 hour and 48 minutes, compared with a California average exceeding 10 hours. Only about one-quarter were transferred to inpatient psychiatric care, while the remainder were stabilized and discharged.
STAT also reported that a Virginia hospital reduced behavioral health length of stay, psychiatric inpatient referrals and sitter expenses by approximately 20% during the first six months of its EmPATH program.
National data and crisis-care resources are available from the Substance Abuse and Mental Health Services Administration and the National Alliance on Mental Illness.
The role of 988 and mobile crisis response
The national 988 Suicide & Crisis Lifeline creates a dedicated entry point for behavioral health emergencies. Crisis systems can pair 988 call centers with mobile response teams, walk-in receiving facilities and hospital-based EmPATH units.
Arizona’s coordinated model illustrates how these components can work together. Most calls are resolved by phone, many remaining cases are handled in the field, and a majority of people who reach a crisis center can return home rather than enter inpatient treatment.
Why police and emergency medical services matter
Police officers and ambulance teams often decide where a person in crisis receives care. Crisis centers can offer faster drop-off procedures and a treatment setting that is better aligned with psychiatric needs than jail or a crowded emergency department.
Successful programs involve law enforcement and emergency medical services early in planning so transportation, intake and safety protocols support the new pathway.
What health systems can learn from crisis care models
- Design for treatment rather than containment. Calmer settings can support de-escalation and patient trust.
- Provide rapid psychiatric evaluation. Early assessment and medication can reduce agitation and unnecessary admission.
- Connect every stage of the crisis continuum. Phone support, mobile teams, receiving centers, EmPATH units and outpatient follow-up should operate as one system.
- Build sustainable payment models. Coverage for crisis services and transportation is essential for national expansion.
- Measure patient and operational outcomes. Length of stay, hospitalization, restraint use, follow-up and cost should be tracked together.
Mental health crisis centers can reshape emergency care
Mental health crisis centers and EmPATH units offer a more humane and operationally effective response to psychiatric emergencies. They do not eliminate the need for emergency departments or inpatient hospitals, but they can ensure that more patients receive specialized care quickly, retain greater dignity and return safely to their communities.
Read Original Article
Read Grace Rubenstein’s complete reporting on crisis centers, EmPATH units and the future of psychiatric emergency care.