Behavioral health crises are placing growing pressure on hospital emergency departments. Yet most EDs were not designed or staffed to provide extended psychiatric care. Patients may remain in overstimulating exam rooms for hours or days while awaiting an inpatient bed or transfer, delaying appropriate treatment and limiting capacity for other emergency patients.
In a recent article for Medical Construction & Design, HMC Architects’ Principal-in-Charge Andrea Ruelas, Assoc. AIA, LEED AP, explores how purpose-built crisis care environments can create more compassionate behavioral health pathways while improving hospital operations.
Rather than relying on a single solution, healthcare organizations can consider a continuum of care tailored to their patient volumes, facilities, staffing resources, and community needs. These options range from designated behavioral health rooms within a traditional ED to dedicated psychiatric emergency departments, crisis stabilization units, and emergency psychiatric assessment, treatment, and healing, or emPATH, units.
Each model offers a different level of intervention. A behavioral health pod can separate patients from the general ED activity, while a dedicated psychiatric emergency department provides specialized assessment and treatment from the moment of arrival. Crisis stabilization units create a short-term setting for observation, counseling, and medication support, often allowing patients to stabilize without inpatient admission.
The emPATH model advances this approach through an open, therapeutic environment that prioritizes dignity, mobility, social connection, and direct interaction with staff. In place of isolated exam bays, patients receive care in calming shared spaces that support observation, reassessment, and de-escalation.
Projects at Clovis Community Medical Center, Harbor–UCLA Medical Center, Rady Children’s Hospital, and Arrowhead Regional Medical Center demonstrate how these models can be adapted for different campuses and patient populations. At Arrowhead, for example, an adolescent emPATH unit combines open observation with interview rooms, lounge seating, access to nourishment, activities, and natural finishes to create a more normalized and restorative setting.
Cost, limited space, and specialized staffing can pose challenges, but organizations can begin by studying their current crisis-care systems. Patient arrival patterns, boarding times, transfer rates, inpatient capacity, workforce availability, and community partnerships can all help determine which model is appropriate.
When operational strategy, clinical care, and the built environment work together, behavioral health facilities can relieve ED congestion while giving patients the right care in a setting designed to support stabilization and recovery.
Read the full article in Medical Construction & Design.
