New care area offers psychiatric patients an alternative to ER

Medical team in clinical setting
Care in the Crisis Stabilization Unit is delivered in a large common space furnished with reclining chairs.

University of Iowa Hospitals & Clinics teams will begin evaluating and treating psychiatric emergency patients in a comfortable, home-like setting rather than in the busy emergency room.

UI Hospitals & Clinics has recently opened the Crisis Stabilization Unit (CSU), an open-concept area removed from the emergency department. Teams of psychiatrists, nurses, nursing assistants, and social workers begin prompt treatment of adults experiencing emotional crises or psychiatric emergencies in an area that looks more like a living room than a hospital room.

The new facility allows psychiatric emergency patients to be processed quickly at the Emergency Department and brought to the CSU for short-term care.

The care team will evaluate new patients and work on a treatment plan that may include medications, therapy, arranging follow-up appointments, or getting them connected to community resources. Some patients may need more care and will be admitted to an inpatient unit, but others may only need a short-term stay in the CSU. 

Addressing the state’s needs

The CSU is an important way UI Hospitals & Clinics is addressing strains in Iowa on systems for treating psychiatric patient needs. In the months leading up to the CSU opening, the UI Hospitals & Clinics emergency department has had times when as many as 10 patients were experiencing a psychiatric issue. 

“Sometimes patients are housed in the emergency room for quite some time and without a lot of interactions,” says Peg Nopoulos, MD, chair of the UI Department of Psychiatry. “This is a place that will allow them to get effective and appropriate treatment right away.”

Designed on an evidence-based model

Jodi Tate, MD, who led the effort to get the CSU at UI Hospitals & Clinics, says a lot of thought has gone into designing a space with facilities and a philosophy to promote a healthy environment for care. She and colleagues have worked closely with proponents of a recent national care movement called emPath (emergency psychiatric assessment, treatment and healing). 

“The ambiance of the unit is very important,” Tate says. “We wanted to create a welcoming, healing, patient-centered environment to help people feel better just by being in a therapeutic space.”

Studies show the emPath model, which began several years ago in California, can be effective in decreasing the need for acute psychiatric hospitalization.

What makes this unit different

The unit, which can care for 12 adults at a time, features reclining chairs, rather than beds. Patients can eat snacks in a kitchen-like setting, watch TV, even take care of laundry, while on the unit.

Tate says staff interact directly with patients, ready to provide support in a non-coercive way.

Private areas are available in the CSU for those who need space or time alone, but patients are encouraged to interact with one another and their care team, Nopoulos says.

“Sometimes interacting with others, especially others who may share some of the same stressors that you’re undergoing, can help patients heal,” she adds.