Rural EmPATH unit decreases subjective distress levels in patients with psychiatric complaints presenting to the Geisinger Medical Center Emergency Department in Danville, PA

Background: Mental health issues, including substance abuse, are among the leading causes of emergency department (ED) visits and account for an increasing share of overall presentations. Limited psychiatric bed availability contributes to high reliance on ED boarding, resulting in extended wait times, decreased efficiency, and worsening distress. This overcrowding strains ED resources, leading to lower-quality care and increased mortality, especially in rural areas where access to acute mental health care is limited. The Emergency Psychiatry Assessment, Treatment, and Healing (EmPATH) model addresses this gap through creating a hospital-based crisis stabilization unit separate from the general ED, available to all medically cleared patients except those with violent behavior or medical instability. Staffed by psychiatrists, nurses, social workers, and psychologists, EmPATH units provide rapid evaluation, observation, and treatment. Geisinger Medical Center (GMC) ED, like many nationwide, experiences high psychiatric boarding times. In response, a GMC EmPATH unit was established to relieve ED pressure, emphasizing patient safety, emotional regulation, and social engagement. However, data on patient experiences in rural EmPATH units remains limited. Objective: The study aims to assess changes in patient-reported distress levels from admission to discharge in the EmPATH unit and compare perceived safety and calmness to experiences in the general ED/hospital, along with analyzing qualitative feedback from free-text responses. Methods: This mixed-methods study integrates quantitative data (survey scores and ratings) and qualitative data (subjective experiences), collected before patient discharge by EmPATH staff. Participation was voluntary with no exclusion criteria. Descriptive and inferential statistics were used for quantitative analysis, and thematic analysis was applied to qualitative responses. Results: Patients reported a decrease in subjective distress scores: p-value 1.78E-14, 95% C.I. (-4.58, -3.25). They also rated the EmPATH unit as providing greater safety: 9.18, and calmness: 8.60, compared to the ED/hospital (using a 1–10 scale with 1 indicating less safe/calm and 10 indicating more safe/calm). Thematic analysis of open-ended responses highlighted themes such as a therapeutic environment, feeling heard and cared for, and identifying the unit as a space for reflection. Conclusion: Our findings suggest that the EmPATH unit offers a more therapeutic and less traumatizing alternative for patients presenting with psychiatric emergencies. Patients reported significant reductions in distress and greater perceived safety and calmness. Additionally, qualitative findings revealed key themes supporting positive patients’ experiences at the EmPATH unit. However, limitations of the study include data collection at a singular point in time, voluntary participation, and limited participant diversity. Future studies should involve larger, more diverse samples and use standardized assessment tools such as the Columbia Suicide Severity Rating Scale to provide more objective measures of patient experiences at the EmPATH unit.