Addressing One of Today’s Fastest Growing Challenges: Behavioral Health in the Emergency Department

Sumter Armstrong , MHA

Vice President of Business Development

Published August 21, 2018

Behavioral health patient comforted by physician

This year, more than 4 million Americans will present to the emergency department (ED) with behavioral health complaints, and hospitals are struggling to keep up with this growing demand.

At this year’s American Hospital Association (AHA) Leadership Summit, I had the opportunity to kick off an Innovators Connection session with Vituity’s Vice President of Acute Psychiatry, Dr. Scott Zeller. The presentation highlighted the enormous challenges hospitals face when treating behavioral health emergencies and introduced Empath — our integrated solution for addressing this problem.

Today’s catastrophic opioid epidemic, the staggering increase in suicide attempts, and fewer inpatient psychiatric beds are among the reasons leading to this increase in behavioral health emergencies in today’s EDs.

“Psychiatric care in the ED has taken an enormous toll on hospitals across the country. Right now, close to 45 million people in the U.S. experience symptoms of mental illness each year. That’s one in six of all adults,” said Dr. Zeller.

A Growing Need Among Providers

These challenges highlight the growing need to properly equip ED providers and staff with the right resources, services, and training to meet the care needs of patients experiencing a behavioral health emergency.

Research shows that roughly 80 percent of behavioral health emergencies can be resolved within 24 hours. Yet antiquated care models result in many patients boarding in the ED as their symptoms worsen, waiting for hours or even days for a bed they may not need. Other approaches such as sedation, isolation, and restraint can also have negative effects, as these traditional methods raise anxiety levels of both patients and providers.

In turn, EDs suffer from loss of revenue, increased safety concerns, lower patient-satisfaction scores, and inefficient throughput because of the bottleneck these cases can cause.

“How are we going to help these folks if we are just going to do things the same old way?” Dr. Zeller asked during his presentation. “We need to revolutionize emergency medical care and change how we’re working with patients facing behavioral health emergencies. Behavioral health emergencies are medical emergencies and need to be treated as such.”

A Model for the Future

Our session at AHA focused on Empath, Vituity’s integrated solution to acute behavioral healthcare that arms hospitals with the tools they need to address this growing problem. By combining expert emergency and psychiatric care with formalized training and education, Vituity empowers and equips emergency clinicians to properly evaluate and treat behavioral health patients.

During the presentation, Dr. Zeller discussed the three components of this model: emergency department care delivery, psychiatric care delivery, and comprehensive training and education.

1) Emergency department care delivery: Using a mentoring, collaborative approach, Vituity provides clinical services and physician leadership that ensure the entire ED team is equipped to properly care for all emergency patients, whether patients are experiencing physical or behavioral emergencies.

2) Psychiatric care delivery: Aimed at improving behavioral health care in cooperation with the ED team, Vituity developed these services with the specific needs of the behavioral health patient in mind:

Telepsychiatry: Around-the-clock, on-demand access to board-certified psychiatrists
EmPATH units: Outpatient, hospital-based units that provide calm, healing settings for patients facing behavioral health crises
Inpatient psychiatry: Coordinated treatment planning and care provided by an in-hospital psychiatrist

3) Comprehensive training and education: Vituity offers the latest training and education for both ED teams and first responders when it comes to best practices for providing behavioral healthcare, covering topics such as de-escalation, restraint management, psychiatric and opioid medication management, and agitation management.

“[Patients facing behavioral health challenges] generally don’t respond well to the ED environment,” Dr. Zeller said. “Our model allows emergency medicine physicians, social workers, nurses, and the entire team to collaborate to find the best solution for each patient.”

Core Benefits of Integrated ED Care

Vituity’s Empath model of care in today’s EDs results in hospitals and health systems improving clinical quality, profitability, and patient satisfaction scores. Meanwhile, EDs experience fewer behavioral health admissions, achieve higher throughput, and benefit from a more engaged staff. It also gives providers a new level of confidence in their ability to heal, and it helps all patients know they’re receiving proper care with dignity and respect.

Most importantly, communities begin to recognize that their local EDs are trusted partners in dealing with any healthcare crisis — including behavioral health emergencies.

To learn more, check out Redefining Acute Behavioral Healthcare: How an Empowered ED Improves Patient Care or Dr. Zeller’s recent article in HealthLeaders.

Partnering to improve patient lives

Vituity branding orange wave pattern background