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EMPATH Model Improves Mental Health Crisis Response

In the decade since an Oakland hospital created an alternative to dumping people in psychiatric crises on overwhelmed hospital emergency rooms, dozens of psychiatric emergency units following the so-called Alameda Model have sprung up around the country to offer more effective and immediate care. The approach, since renamed EMPATH – for Emergency Psychiatry Assessment, Treatment and Healing – replaces the chaos and neglect of the typical E.R., where patients will wait hours or days for a bed to become available in a psychiatric hospital, with rapid but calming interventions that lead to more outpatient care and fewer hospitalizations, the New Yorker reports.

At one of the largest EMPATH units in the country, Fairview Southdale Hospital’s unit in a Minneapolis suburb, only about 10% of the psychiatric patients end up hospitalized, down from nearly half before the unit opened. In its two years of existence, it has cared for 5,000 people. The need is much greater nationwide than the growing number of EMPATH units can handle. In the U.S. each year, an estimated 750,000 emergency-department visits for mental-health crises would require hundreds of EMPATH units, each treating thousands of patients per year. Like Fairview Southdale’s, most don’t make a profit and depend on grants and donations. Still, the costs of not providing more effective care is undoubtedly higher. Says Scott Zeller, who pioneered the approach in Oakland, subjecting people in crisis to untherapeutic conditions and denying them the counseling and medication they need until a bed opens up somewhere creats a ”therapeutic dead space – a missed opportunity” – not to mention taxing traditional hospital ERs and the local jails that end up housing people whose first encounter during a crisis is with police instead of doctors.


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