Title : Crisis to hope: Transforming behavioral health with the EmPATH model
Abstract:
As behavioral health needs surge, our systems remain stuck – fragmented, overwhelmed, and ineffective at treatment or instilling hope for those in need. Patients often board for days or weeks, waiting on a local bed, with little treatment. Safety risks in the emergency department are prevalent resulting in overuse of staff and resources to ensure safety. Costs of care are exceptionally high, and stigma often adversely impacts care.
The EmPATH (Emergency Psychiatric Assessment, Treatment, & Healing) model represents a bold re-imaging of a true system of effective and efficient behavioral healthcare. In July 2024, University of Kentucky HealthCare launched Kentucky’s first EmPATH unit, marking a significant shift in how behavioral health crises are addressed in the region. The primary goals were to improve outcomes, build a system of care, decompress emergency departments, and use resources more efficiently. Intentionally located independently from emergency services, this 16-chair unit embodies EmPATH principles by offering a calm, therapeutic environment focused on rapid stabilization, meaningful engagement, and care without exclusion.
Through intensive therapeutic interaction and strong community partnerships, the UK EmPATH unit prioritizes connection over containment, ensuring patients are treated rapidly and linked with the right level of follow up care immediately following. No medical clearance is required; patients are brought directly to EmPATH from local EMS, police, and often self-present. Treatment is initiated within minutes of arrival by an experienced behavioral health provider. A comprehensive treatment plan is initiated that includes rapid therapeutic medications as indicated, social work case management, and evidence-based individual and group therapy. Peer support specialists provide perspective through lived experience and hope. The unit is an open milieu setting and patients are offered a recliner chair to move about the unit in their preferred space. Large windows and an accessible outdoor patio allow patients to choose the most calming space for their needs. An open nurses station allows for active monitoring of patients without use of sitters. Calming rooms are readily available for patients to use independently, and snacks and drinks are readily available. Patients maintain agency, choice, and engagement with staff through the duration of their visit. The overall experience is one of support, choice, and immediate access to help.
In 19 months, the unit has served more than 8,100 adults, with 76% rapidly treated returned to the community. The average EmPATH stay is 16 hours, all devoted to active treatment. With no sitters, the unit has returned 5,000+ hours of care to bedside. ED revisits for behavioral health dropped 90%, and hospital readmissions decreased 13%. EmPATH’s restraint rate is 77% lower than the EDs, with fewer than 1% of visits requiring any restrictive intervention. Community follow up rates after discharge increased from 29% to 65%. The success of the model has sparked planning for statewide implementation. EmPATH is a rapidly growing model that for UK HealthCare has resulted in reduced ED boarding, improved patient and staff safety, cost savings and operational efficiencies. More than just the numbers, the patients positively impacted by EmPATH have a common experience: hope. Community partnerships have created a robust approach to streamlining care in the region, and have reduced stigma. A vision for the future of EmPATH and a truly effective system of behavioral healthcare will be shared, inspiring others to integrate and collaborate in new ways.
