GRAND RAPIDS — Dr. Scott Zeller often reminds people the brain is part of the body, and just like breaking a bone and going to the emergency room, a mental health crisis deserves the right care in a timely manner.
“If you go into the emergency room and let's say you have an asthma attack and you are short of breath,” Zeller said. “If we treated you the same way we treat psychiatric emergencies, we'd say, 'OK, come back with us. Have a seat. We're going to find you an asthma hospital. Should be in just the day or so.'”
That idea, according to Zeller, is ridiculous. "There's a lot of ways you can help people in the immediate with an asthma attack. We can do the same thing with psychiatric patients. And that was the genesis of EmPATH.”
Zeller is vice president for acute psychiatry at multispecialty group Vituity and assistant professor at the University of California's Riverside School of Medicine. He created EmPATH, which stands for emergency psychiatry assessment, treatment and healing. It’s a model used for behavioral health care that can empower ERs to treat mental health emergencies better. The model is not under copyright and can be used by anyone interested.
Zeller joined the KAXE Morning Show ahead of a webinar covering the program hosted by the Grand Rapids chapter of the National Alliance on Mental Illness, or NAMI. The webinar is noon-1:30 p.m. Thursday, Jan. 11, with registration required by Jan. 9.
“Nobody’s ever embarrassed to tell you that they broke their arm. Why are they embarrassed to have a mental health issue?”Dr. Scott Zeller
Zeller said the current system in the U.S. for mental health crises is not working. When a patient goes in, there is generally an assessment, but not the other elements of the EmPATH approach. The patient waits, often sitting in a hallway or strapped to a gurney in a back corner, for what Zeller described as long hours or even days. These patients are often eventually transferred to inpatient psychiatric care.
“What we've been able to show is actually if we do the other parts of that acronym, treatment and healing, that three-quarters of those same folks don't end up needing to be hospitalized and we can get them better.”
A new model of mental health care
The EmPATH model created by Zeller was created specifically for those working in emergency rooms.
“The ER environment itself is not very conducive to healing,” Zeller said, adding that people in need of mental health care tend to wait or get stuck in ERs or are reported to law enforcement, making it seem like punishment for mental illness.
The new model includes a space for people to go that is calm and quiet. It changes the dynamic by offering a home life environment in which patients can move around freely, watch TV or play a game while they wait. In a hospital it may take hours to get a glass of water, but the new model allows patients to get their own beverages or food or anything else they might need.
These methods can reduce stress as well as the danger of a mental health emergency.
“If you give them a few hours in this environment with the right kind of immediate treatment and intervention, they get better and then we can have them change from an emergency patient to an outpatient," he said.
The EmPATH model has been around since 2016 and has already seen success. For instance, in Iowa where this new model is in use, data showed a reduction in ER stays of up to 60% in six months.
A recent article in Psychology Today described EmPATH units as calming, supportive atmospheres for even the most acute psychiatric patients. According to the article, data indicates those using EmPATH have seen up to 80% of patients achieving stability, instead of methods like physical restraints or forced medications.
Stigma of mental health
Zeller said stigma of treating mental illness still exists, even though federal laws states psychiatric emergencies are equivalent to medical emergencies and need to be treated in emergency rooms the same way. But many still don’t understand, he said.
He reminds people the brain is another organ in the body. “If there’s something that’s not working quite as well up there, we should be focusing on it in the same way we would if you were having chest pain or if you’d been in a car crash.”
“Nobody’s ever embarrassed to tell you that they broke their arm. Why are they embarrassed to have a mental health issue?” Zeller said.
Zeller reiterated mental health emergencies shouldn’t really be different than any other emergency, like a pregnant person ready to deliver a baby. In the same way a doctor can immediately assist in that situation, EmPATH provides tools for a similar response.
“The ER doc can look at you and say, 'Hey, you’re having a difficult situation. Let’s get you right over to EmPATH,” Zeller said. “It’s really about getting somebody in an emergency condition to an appropriate location.”
