CT hospitals are redesigning ERs for behavioral health crises
BEHAVIORAL HEALTH CRISIS CARE Behavioral Health Emergency Rooms: How Connecticut Hospitals Are Redesigning Crisis Care Behavioral health emergency rooms are replacing chaotic, high-stimulation settings with calmer spaces designed to stabilize adults, children and adolescents experiencing a mental health crisis. Based on reporting by Katy Golvala for CT Mirror • July 28, 2026 What are behavioral health emergency rooms? Behavioral health emergency rooms are specialized hospital spaces created for people experiencing psychiatric crises. Models such as EmPATH units provide rapid medical screening, psychiatric assessment, stabilization and discharge planning in a quieter, less restrictive environment than a conventional emergency department. Behavioral health emergency rooms are changing how Connecticut hospitals respond to mental health crises. Griffin Health, Stamford Hospital and Yale New Haven Hospital have created specialized units that emphasize natural light, open space, psychiatric expertise and continuity of care. Why traditional emergency rooms can worsen a mental health crisis Busy emergency departments are designed for rapid medical triage, trauma care and acute physical illness. Crowds, alarms, bright lights and limited privacy can increase anxiety, confusion and agitation for people experiencing psychiatric distress. Safety procedures may also require patients to surrender their belongings and change into paper clothing. While these precautions can reduce immediate risk, they can feel impersonal and punitive during an already vulnerable moment. How Griffin Health redesigned emergency psychiatric care Griffin Health’s 12-person EmPATH unit in Derby is physically separate from the main emergency department but remains part of hospital operations. Patients receive a brief medical assessment before moving into the psychiatric treatment space as quickly as possible. The unit includes natural light, recliner chairs and open areas rather than conventional emergency-room bays. Behavioral health specialists work to stabilize patients within 12 to 48 hours and connect them with outpatient services. Health systems considering similar models can explore strategic and operational guidance through Inflect Advisory and healthcare innovation programs through Inflect Studio. 3 hospitals Griffin, Stamford and Yale New Haven are opening or operating redesigned crisis units. 12–48 hrs Griffin’s EmPATH team aims to stabilize patients and connect them to outpatient care. 50% increase Griffin reported growth in psychiatric crisis arrivals since 2019. 1,500 yearly Estimated patients to be served by Yale New Haven’s pediatric crisis center. Behavioral health emergency rooms for children and adolescents Stamford Hospital and Yale New Haven Children’s Hospital have opened specialized crisis units for younger patients. Both systems designed their programs around the growing number of children and adolescents arriving at emergency departments with depression, suicidal thoughts and other urgent behavioral health needs. Stamford’s EmPATH-based unit will stabilize children, connect families with community services and continue behavioral health support for as long as 12 weeks after discharge. Why pediatric follow-up is essential Provider shortages often leave families without timely outpatient care after an emergency visit. Stamford’s extended follow-up model is intended to close that gap, support families and reduce the chance that children return to the emergency department before receiving ongoing treatment. Yale New Haven’s Children’s Crisis Intervention Center similarly emphasizes continuity of care. Hospital leaders expect the program to serve approximately 1,500 patients each year. Connecticut’s broader crisis care network Connecticut also supports four privately operated Urgent Crisis Centers in Hartford, New Haven, New London and Waterbury. These programs were created as alternatives to hospital emergency departments for children experiencing serious behavioral health needs. For additional crisis-care information, families and providers can review resources from the 988 Suicide & Crisis Lifeline and youth mental health data from the Centers for Disease Control and Prevention. What the new crisis units cost Yale New Haven’s pediatric crisis center cost $4.6 million and was funded through state grants. Stamford Hospital’s unit cost $2.7 million and was financed primarily through private donations. Griffin Health did not publicly disclose the cost of its EmPATH unit. The investments reflect a growing recognition that emergency psychiatric care requires spaces, staffing and workflows designed specifically for behavioral health needs. Key design principles for behavioral health emergency rooms Reduce sensory overload. Natural light, quieter surroundings and open layouts can support de-escalation. Begin psychiatric treatment quickly. Patients should not wait for hours in a conventional emergency bay before meeting a behavioral health specialist. Preserve dignity and autonomy. The environment should feel therapeutic rather than custodial. Plan beyond discharge. Follow-up connections are especially important for children and families facing provider shortages. Integrate with the hospital. Specialized units still need access to medical evaluation, emergency services and inpatient care. A more compassionate standard for psychiatric emergencies Behavioral health emergency rooms and EmPATH units give hospitals a way to provide immediate psychiatric care without exposing patients to the most stressful elements of a traditional emergency department. Connecticut’s new programs show how hospital design, staffing and care coordination can work together to create a more humane crisis response. Read Original Article Read Katy Golvala’s full reporting on how Connecticut hospitals are redesigning emergency care for adults and children experiencing behavioral health crises. Read on CT Mirror
Mental health crisis centers and EmPATH units
BEHAVIORAL HEALTH CRISIS CARE 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. Read on STAT
How MUSC Boosted EmPATH Utilization
EMPATH IMPLEMENTATION CASE STUDY How MUSC Increased EmPATH Unit Utilization From 12% to 40% Medical University of South Carolina leaders improved EmPATH utilization by changing patient-flow defaults, expanding overnight psychiatric coverage, refining admission criteria and building staff confidence in the model. Original reporting by Ella Ruder, Becker’s Behavioral Health • July 15, 2026 How did MUSC improve EmPATH utilization? MUSC increased adult EmPATH unit utilization from roughly 12% to nearly 40% by making EmPATH the default destination for eligible psychiatric emergency patients, using its traditional holding area only as backup, extending clinical coverage overnight, loosening overly restrictive selection criteria and bringing in outside operational expertise. MUSC Health opened its eight-bay adult Emergency Psychiatric Assessment, Treatment and Healing unit in Charleston in July 2025. During its first six months, the unit operated at approximately 12% daily utilization. By July 2026, utilization had climbed to nearly 40% as leaders redesigned workflows and encouraged emergency department teams to use the therapeutic psychiatric setting more consistently. MUSC’s EmPATH utilization results at a glance 24–28 → ~4 hrs Reduction in waiting time for patients needing an inpatient bed. 552 patients Adults served from opening in July 2025 through March 2026. 12% → 40% Increase in daily EmPATH unit utilization. 20–22 → 12–13 hrs Reduction in average psychiatric ED length of stay. Why the EmPATH unit was initially underused Before EmPATH opened, clinicians commonly placed psychiatric emergency patients in a traditional holding area known as the D-pod. That established habit continued after the new unit launched. Teams also applied narrow inclusion and exclusion criteria, effectively waiting for an “ideal” EmPATH patient instead of transferring patients for assessment and then determining the most appropriate level of care. This combination of ingrained workflow, staff uncertainty and conservative eligibility decisions limited early utilization. 1. Make EmPATH the default psychiatric care setting Beginning July 1, 2026, MUSC reversed its original workflow. The EmPATH unit became the primary destination for psychiatric patients arriving through the emergency department, while the D-pod became a backup area for patients requiring seclusion or a higher level of containment. The change also allowed MUSC to return six of the D-pod’s 12 bays to the medical emergency department, supporting broader capacity and throughput. 2. Broaden patient eligibility MUSC leaders moved away from overly restrictive screening criteria. The revised approach was to place appropriate psychiatric patients in EmPATH, complete the assessment there and move only those who truly required the D-pod. The system has also considered admitting selected intoxicated patients and patients experiencing substance withdrawal when they do not have significant medical instability. This could allow patients to stabilize in a calmer psychiatric setting rather than board in the medical ED. 3. Expand overnight psychiatric coverage Under the previous staffing model, a psychiatrist and advanced practice provider were available from 7 a.m. to 11 p.m. Patients arriving immediately after coverage ended could wait seven or eight hours before receiving a psychiatric evaluation. MUSC extended advanced practice provider coverage until 3 a.m., added overnight psychiatrist availability by phone and assigned on-call residents from 3 a.m. to 7 a.m. The result was continuous psychiatric coverage for the EmPATH unit. 4. Use peer education and outside expertise Clinicians who were comfortable with the EmPATH model helped educate colleagues and normalize the new workflow. MUSC also invited Scott Zeller, MD, and the EmPATH Consulting team to review operations and identify practical improvements. This combination of internal champions and external assessment helped the health system identify operational changes while building confidence among frontline teams. How EmPATH affected psychiatric emergency department length of stay Before the adult EmPATH unit opened, patients presenting with behavioral health concerns spent an average of 20 to 22 hours in MUSC’s emergency department. After implementation, average length of stay fell to approximately 12 to 13 hours. MUSC’s stated goal is to reduce that figure further to eight or nine hours. Leaders noted that statewide shortages of inpatient psychiatric beds may make it difficult to match the two- to four-hour stay common for medical emergency patients. EmPATH also shortened inpatient psychiatric bed waits Patients who required inpatient psychiatric admission previously waited an average of 24 to 28 hours in the emergency department. As more patients moved through EmPATH and fewer required hospitalization, the average inpatient bed wait fell to about four hours. MUSC also established an inpatient discharge-identification target of 11 a.m., with a buffer to 1 p.m., to free beds earlier for patients awaiting admission. Pediatric use of the adult EmPATH environment MUSC does not have a separate psychiatric emergency space for children at this location. Pediatric patients are evaluated in the medical ED and may move into the EmPATH unit after medical clearance. Some pediatric patients waiting for inpatient beds have improved enough in the therapeutic environment to return home instead of being hospitalized. MUSC characterized this observation as preliminary rather than a formal outcome finding. Reimbursement and financial sustainability MUSC receives hourly Medicaid reimbursement during a patient’s first 24 hours in EmPATH, when the service is treated as an observation stay. The system then receives a daily payment of approximately $400 after the first day. Hospital leaders reported early signs that the model may reduce losses associated with uncompensated psychiatric boarding. However, they cautioned that reimbursement data remained preliminary because Medicaid payments can take several months to process. Lessons for health systems implementing an EmPATH unit Change the default workflow: A new care environment will remain underused when legacy pathways stay easier or more familiar. Avoid searching for the perfect patient: Assessment inside EmPATH can help determine who needs a more restrictive setting. Cover nights and early mornings: Gaps in psychiatric staffing can erase gains made during daytime hours. Develop frontline champions: Peer education can help shift culture and reinforce appropriate utilization. Track operational and financial outcomes: Utilization, length of stay, admission waits, discharge rates and reimbursement should be evaluated together. Read the Original View the complete article, supporting references, and source material on Beckers behavioral health. View Original Article
Psychiatric Boarding in Emergency Departments: A Treatable Crisis
EMERGENCY PSYCHIATRY Psychiatric Boarding in Emergency Departments: A Treatable Crisis A treatment-first approach can reduce prolonged emergency department stays, avoid unnecessary psychiatric admissions, and provide more humane care for people experiencing behavioral health emergencies. By Scott Zeller, MD • Published March 1, 2026 Key Takeaways Behavioral health emergencies make up roughly one in eight emergency department visits. Traditional boarding can worsen symptoms, increase agitation, contribute to crowding, and raise staffing and security costs. Many psychiatric emergencies can be stabilized within 24 hours when assessment and treatment begin promptly. EmPATH units provide hospital-based, trauma-informed treatment in a therapeutic environment rather than functioning as holding areas. Reported outcomes include shorter emergency department stays, fewer inpatient admissions, improved follow-up, and reduced revisits. Psychiatric boarding occurs when patients experiencing behavioral health emergencies remain in hospital emergency departments while waiting for an inpatient psychiatric bed. Instead of receiving care in an appropriate therapeutic setting, patients may spend hours or days in hallways or small rooms with limited access to psychiatric treatment. The Scope and Consequences of Boarding Growing demand for emergency behavioral health care has collided with limited inpatient capacity. The result is longer stays for psychiatric patients, reduced emergency department throughput, increased walkouts, delayed care, and added pressure on clinicians and hospital operations. 1 in 8 Emergency department visits involve behavioral health emergencies. ~70% Reduction in psychiatric ED length of stay reported by one EmPATH program. 70–80% Patients in many EmPATH programs stabilized without inpatient admission. Why Traditional Diversion Efforts Fall Short Mobile crisis teams and community crisis centers are important parts of the behavioral health system, but many cannot accept patients with severe agitation, psychosis, intoxication, withdrawal, involuntary holds, or significant medical needs. Emergency departments therefore remain the primary point of access for many of the highest-acuity cases. A Treatment-First Model The article argues that psychiatric emergencies should be approached like other medical emergencies: with rapid evaluation, immediate intervention, treatment in the least restrictive appropriate setting, and a disposition decision based on the patient’s response to care. Psychiatric crises deserve the same urgency, active treatment, and dignity as every other emergency medical condition. How EmPATH Units Work Emergency Psychiatric Assessment, Treatment, and Healing units are hospital-based extensions of the emergency department. After basic medical clearance, patients receive active psychiatric care from multidisciplinary teams that may include psychiatrists, psychiatric nurses, social workers, and peer-support specialists. The environment is intentionally therapeutic, using open spaces, natural light, calming design, recliners, private calming areas, and layouts that support safety and visibility. Care emphasizes trauma-informed treatment, de-escalation, autonomy, and recovery. Clinical and Operational Results Published findings cited in the original article associate EmPATH programs with substantially shorter emergency department stays, fewer inpatient admissions, stronger outpatient follow-up, fewer 30-day returns, reduced restraint use, and improved hospital capacity. Some organizations have implemented the model by repurposing existing hospital space. Implications for Health System Leaders Psychiatric boarding does not have to be accepted as an unavoidable consequence of rising demand. Hospital and psychiatric leaders can support treatment-first emergency care models that align patient dignity and clinical outcomes with operational and financial sustainability. About the Author Scott Zeller, MD, is a psychiatrist and a leader in emergency psychiatric care and the development of the EmPATH model. Read the Original View the complete article, supporting references, and source material on Psychiatric Times. View Original Article