Behavioral health patients often wait longer than other emergency department patients for a bed. Along the way, patients may end up receiving care in the most expensive setting available, or experiencing distress in an often-hectic environment. Now, health systems are testing several approaches to shorten those waits and route patients to the appropriate level of care.
Future demands are stark: Behavioral health emergency department visits are projected to increase by 1 million over the next decade, with adult visits projected to grow 12% and pediatric visits projected to rise 7% — outpacing physical health ED growth. Workforce shortages have also grown with more than one-third of the U.S. population — about 122 million people — living in a mental health professional shortage area.
Here is how seven health systems are diverting behavioral health patients from the ED.
1. EmPATH units
Medical University of South Carolina in Charleston launched an adult emergency psychiatric assessment, treatment and healing (EmPATH) unit in July 2025 with eight bays, but daily utilization sat around 12% for the first six months. After the health system made the unit the default space for psychiatric patients, rather than a psychiatric holding area, and overhauled overnight psychiatric coverage, utilization climbed to nearly 40%.
The change also cut average length of stay for behavioral health patients from 20 to 22 hours down to 12 to 13 hours, and reduced the time patients waited for an inpatient bed from 24 hours to 28 hours to about four hours, Lalithkumar Solai, MD, chief of mental health at MUSC, told Becker’s.
Other health systems, including Stamford (Conn.) Health and Yale New Haven (Conn.) Children’s Hospital, have taken note and brought the model to their EDs.
2. Behavioral health and substance use navigators
Navigators are helping health systems keep behavioral health and substance use patients connected to care after they leave the ED. At Norfolk, Va.-based Sentara Health, one manager and 10 full-time navigators focus on bedside consultation and connecting patients to community resources.
Since the role launched in May 2025, Sentara’s average ED length of stay for these patients dropped from 2,740 minutes to 2,090 minutes, and 30-day readmission rates fell from 14.1% to 7.3% when navigators were engaged before discharge, Tracey Izzard, vice president of behavioral health services at Sentara, told Becker’s.
At Los Angeles-based Cedars-Sinai Medical Center, which has nearly 1,000 beds and handled more than 130,000 emergency visits in 2025, substance use disorder navigators help patients identify community resources — a role designed to reduce fragmentation across the care journey.
“It takes time to engage a patient who’s been traumatized, or feels stigmatized or embarrassed and ashamed of some of their behaviors,” Itai Danovitch, MD, chair of psychiatry and behavioral neurosciences, told Becker’s. “These are roles that can help with some of the soft skills that are so important to engaging individuals who have had negative experiences with hospitals in the past.”
3. Telehealth
Renton, Wash.-based Providence has scaled a virtual behavioral health program across 42 hospitals in six states: Alaska, California, Montana, New Mexico, Oregon and Washington. The program logged 11,880 consultations in 2025 with a median response time of two minutes, connecting patients in rural EDs to an on-call psychiatrist or licensed clinical social worker who previously might have waited up to a week for an in-person evaluation.
Providence built a team-based model that pairs psychiatrists with licensed clinical social workers, each working at the top of their license, and administers a structured suicide assessment scale at every visit to standardize care across sites. The health system reports a 95% annual clinician retention rate for the program.
St. Louis-based SSM Health has taken a similar approach to reduce the effects of boarding rather than eliminate the wait itself. Because SSM carried the highest capacity of psychiatric beds in Missouri, Emergency medical services (EMS) providers often bypass other hospitals and bring behavioral health patients directly to its facilities, creating boarding pressure. Nurse practitioners and psychiatrists now evaluate boarding patients by telehealth and start medication before an inpatient bed opens up. At DePaul Hospital, SSM’s 124-bed flagship behavioral health facility, that telehealth team conducted roughly 3,700 consults last year.
4. Mobile crisis response
Charlotte, N.C.-based Novant Health Presbyterian Medical Center partnered with North Carolina’s MORES program — mobile outreach, response, engagement and stabilization — which sends clinicians trained in adolescent care and a family peer support specialist to respond within an hour to young people ages 3 to 21 in crisis, with up to eight weeks of home-based follow-up.
Behavioral health patients previously occupied 50% to 70% of Novant’s pediatric ED rooms, with at least half of those classified as unpreventable social holds, according to Courtney Cortes, MSN, RN, director of nursing for emergency services. Since the partnership began, those patients account for fewer than 10% of pediatric rooms on a given day. Average length of stay for pediatric behavioral health patients dropped from four to six weeks to about 2.11 days, excluding four outliers. Between June 2023 and the end of 2025, the program engaged with 645 children and families, and 96% of caregivers said the service met their needs.
5. Flexible, convertible ED rooms
For WellSpan’s Good Samaritan Hospital in Lebanon, Pa., the constraint on behavioral health capacity was physical space rather than staffing or process. With only five designated behavioral health beds and volume up 100% over three years, the hospital designed a set of ED rooms so staff can convert them between medical and behavioral health use in seconds. Staff are able to lock away medical equipment behind reinforced doors so the room becomes ligature-safe once a patient is medically cleared and awaiting psychiatric placement.
“There are more patients than there are safe rooms,” said hospital President Tina Citro, DNP, RN. The redesign, funded by a $1 million Pennsylvania Department of Human Services grant, expanded the hospital to nine potential behavioral health beds while preserving the flexibility to shift rooms back to medical use during high-volume periods such as respiratory virus season.
At the Becker's Fall Behavioral Health Summit, taking place November 4–5 in Chicago, behavioral health leaders and executives will explore strategies for expanding access to care, integrating services, addressing workforce challenges and leveraging innovation to improve outcomes across the behavioral health continuum. Apply for complimentary registration now.