Mental Health Emergencies Deserve Better — These Programs Are Leading the Way
- I4MH
- Jan 11, 2023
- 3 min read
What’s Going On?
Emergency rooms are designed to handle everything from broken bones to heart attacks—but they’re not exactly built for mental health crises. The bright lights, constant noise, and long wait times can exacerbate psychiatric distress. Traditional ERs often resort to sedation, restraints, or prolonged isolation due to a lack of appropriate resources. Enter EmPATH (Emergency Psychiatric Assessment, Treatment, and Healing) units: a transformative approach rethinking how hospitals manage mental health emergencies.
Simultaneously, cities like San Antonio are demonstrating improved methods. Through targeted mental health programs, the city has significantly reduced ER visits and involuntary hospital commitments, ensuring individuals in crisis receive appropriate care without being misdirected. Collectively, these initiatives represent a broader movement toward more effective, humane, and proactive mental health care.
What Does It Mean?
Historically, mental health emergencies often led to ER visits or, worse, law enforcement involvement resulting in involuntary hospitalization—neither serving individuals effectively. Now, cities like San Antonio are showcasing better alternatives.
San Antonio’s Program for Intensive Care Coordination (PICC) has reduced emergency detentions by over 30% since 2019, connecting individuals in crisis to outpatient services rather than subjecting them to involuntary hospitalizations. The San Antonio Community Outreach and Resiliency Effort (SA CORE) expanded from a pilot to a citywide initiative, deploying teams—including a police officer, paramedic, and mental health clinician—to address 911 calls with appropriate care. Meanwhile, the Southwest Texas Crisis Collaborative (STCC) addresses high-frequency 911 callers by providing sustained care, breaking the cycle of repeated emergency service use.
Similarly, EmPATH units offer a significant shift from traditional ER experiences. Instead of sterile, stressful rooms, patients enter open, comfortable spaces designed for de-escalation and care. Immediate access to mental health professionals in a calming, communal environment leads to faster recovery, fewer unnecessary hospitalizations, and a dramatic reduction in coercive measures like restraints and forced medication. Some units report that 75% of patients can return home within 24 hours, avoiding unnecessary inpatient stays.
Why Do We Care?
Because mental health is health. Yet, psychiatric emergencies are often treated as secondary concerns—an inconvenience to an already overwhelmed hospital system. San Antonio's success in reducing involuntary hospitalizations and emergency detentions while maintaining quality care proves that alternative approaches are effective. The success of EmPATH units further reinforces this notion—patients don't need to be confined or left waiting in an ER; they require thoughtful, specialized care.
These are not isolated successes; they indicate a larger shift. Communities are increasingly recognizing that addressing mental health needs with appropriate resources at the right time not only improves individual outcomes but also alleviates pressure on hospitals, law enforcement, and emergency services overall.
What’s Next?
San Antonio’s programs are expanding, with SA CORE aiming for 24/7 coverage by mid-2024. EmPATH units are gaining traction nationwide but are not yet standard practice. More hospitals need to invest in these units, and public awareness of these options must increase. Beyond financial incentives—one study found that an EmPATH unit increased annual emergency department revenue by over $860,000—the true value lies in patient care. Continued advocacy for better, smarter, and more humane mental health care is essential.
The takeaway? Change is possible—and it's underway. If more cities follow San Antonio's lead and more hospitals adopt the EmPATH model, we could see a future where mental health emergencies are managed with care, dignity, and effective solutions. In the meantime, it's worth considering: does your city have a plan like this? If not, perhaps it's time to start the conversation.
