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Meeting the need: UK HealthCare will open a mental health crisis emergency department

Lexington Herald-Leader - 6/10/2024

University of Kentucky HealthCare is working to give patients in mental crisis hope.

Kentucky emergency rooms are overrun and not the right environment to address mental health needs, Eastern State Hospital Chief Administrative Officer Lindsey Jasinski said.

“You don’t leave a traditional emergency department feeling a sense of hope,” she said in an interview with the Herald-Leader. “Hope is one of the most important things that keeps people alive in crisis.”

UK HealthCare is opening a dedicated behavioral health emergency room in Lexington at Eastern State Hospital.

The Emergency Psychiatric Assessment Treatment and Healing (EmPATH) unit will expand psychiatric emergency care and lessen the strain on traditional emergency rooms.

Eastern State is an inpatient psychiatric hospital owned by the state government but managed by UK HealthCare, but the EmPATH unit will be fully owned and operated by UK.

The unit is to open July 30 and will have a 12-patient capacity. Patients can stay for up to 23 hours. If a patient stays that entire time, they will be referred to another program for further treatment.

Deviating from the traditional emergency room set-up, the EmPATH model doesn’t have individual patient rooms, but employs an open concept to create a quiet welcoming space for patients in crisis. Patients will notice the large open room also swaps out traditional hospital beds for recliners.

The EmPATH model, which started in California and is now recognized as a national best practice by the Joint Commission, has been shown to reduce hospitalizations by 60%. There are over 30 units across the U.S.

Dr. Scott Zeller founded the EmPATH model and is consulting with UK to start its own.

UK’s department will be 11,000 square feet and cost about $750,000 to renovate for use. UK also will pay Eastern State $200,000 annually to rent the space.

The unit will be open to patients of all mental health needs, ranging from substance abuse disorders, to anxiety and depression or suicidal ideation. Even if the room is full when a patient arrives, they won’t be turned away.

“Crisis has to be defined by the individual,” Chief Nursing Officer Marc Woods said. “If that person is struggling through the day, their daily routine is significantly hampered or their work is significantly impacted. The individual plays a huge role in defining what a crisis is.”

Mental health has seen a decline across the nation, Woods said, and Kentucky is no different. Nationally, about one in five adults have a mental illness. Here in the commonwealth, one in three Kentuckians have an anxiety or depression diagnosis.

Before the COVID pandemic, Eastern State had an average daily patient count around 100. Now, that number sits closer to 160.

Woods said there is a gap in mental health care, and the new emergency psychiatric unit will help meet a demonstrated need.

Chief Nursing Officer Andy Cooley said having a dedicated mental health assessment unit will help move people out UK emergency rooms faster - which are often overflowing.

“In the past, what’s been occurring is patch work. We’ve been trying to force a square peg in a round hole,” he said. “There could be a backlog for a patient to be seen in an emergency room. It could be six to eight hours.”

Much like a traditional emergency room, patients can bring themselves to the new mental health crisis unit or be brought in by first responders. Anyone can take advantage of the new service, unless the patient is under 18-years-old or medically unstable.

“The idea is they won’t go to any other emergency department, they’ll come directly to us and then we can help support them immediately,” Jasinski said.

“It creates capacity for us as an entire system to not only treat our behavioral health patients but treat anyone else who needs us.”

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