New UIHC unit will take burden off of emergency room

Starting next week, emergency room patients with psychiatric issues will be directed to the new Crisis Stabilization Unit, a space designed to better serve them.


Becca Turnis, News Reporter

The University of Iowa Hospitals & Clinics will soon open a new Crisis Stabilization Unit to better serve patients with mental-health issues who typically head to the emergency room.

Jodi Tate, the vice chair for clinical services in psychiatry, said patients who come to UIHC’s emergency room with a mental-health crisis will often spend hours, days, or even a week in the emergency department waiting for a psychiatric bed to open up across the state.

“Unfortunately, this has resulted in poor care to individuals with a mental illness and has significantly decreased the capacity of our Emergency Department to treat individuals with and without a mental illness,” Tate said.

Paul Van Heukelom, the clinical director of the Emergency Department, said his department sees 10 to 15 psychiatric patients every day.

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“The [Emergency Department] is set up to medically stabilize the patient and to determine what the patient needs at this stage in their mental-health crisis,” Van Heukelom said. “The ER is not an effective area for this stage of therapy.”

The new unit will open to patients on Oct. 15. Tate said the unit will implement emergency Psychiatric Assessment, Treatment and Healing, or emPATH. It is a cutting-edge, evidence-based approach to provide services to individuals in a mental-health emergency.

Tate said the treatment model, developed by Scott Zellar, the chief of psychiatric emergency services for the Alameda Health System in Oakland, California, has been shown to improve patient care, decrease the need for acute inpatient psychiatric hospitalization, and improve conditions throughout the Emergency Department.

Tate said this model of care features a healing environment with a large, comfortable room where all patients are situated. There is a high staff-to-patient ratio that allows for a patient-centered, proactive, noncoercive approach to care. Psychiatric evaluation and treatment occurs as quickly as possible, and treatment methods include medication, therapy, and referrals to community resources.

Peggy Nopoulos, a UI professor of psychiatry, said it has taken roughly 15 months to develop, build, and open the unit. There are currently 30 similar units across the U.S.

While current psychiatric patients in the ER have their basic medical needs met, Nopoulos said, many don’t receive a proper psychiatric assessment. She said the Crisis Stabilization Unit will provide immediate psychiatric assistance.

“[With the help of the unit], many of these patients can potentially be discharged to home with follow-up services within 24 to 48 hours,” Nopoulos said. “Some patients will begin treatment that is then finished in a hospital. In the end, it will likely decrease the need for many of the patients to [be admitted] into the hospital.”

Van Heukelom said the unit will allow for patients with a mental-health crisis to move to an area outside of the main ER. This will help to open beds up in the ER so physicians can see new patients more quickly.

Before the unit opens to patients, there will be an open house from noon to 4:30 p.m. Friday.

“The [Emergency Department] is very much looking forward to a strong partnership with [the new unit],” Van Heukelom said.