Description

Behavioral health crises are overwhelming emergency departments across the country.

In this episode of The Architecture of Healing, Chase Miller sits down with Dr. Scott Zeller, a psychiatrist and national leader in crisis care, to explore the origins and impact of the EMPATH Unit, Emergency Psychiatric Assessment, Treatment, and Healing.

Drawing from decades on the front lines of emergency psychiatry, Dr. Zeller explains how the right care model and the right environment can stabilize most patients in under 24 hours, reduce unnecessary hospitalizations, improve emergency department flow, and restore dignity to patients on the worst day of their lives.

Key Topics

• The rise of boarding in emergency departments
• What EMPATH units are and how they function in practice
• The role of environment and design in de-escalation and healing
• Emergency department throughput and operational efficiency
• Staffing models and clinician experience in crisis care
• Rural vs. urban scalability of EMPATH units
• Financial and reimbursement considerations

Key Takeaways

• Psychiatric emergency care is primarily a care model and environment problem, not just a bed shortage
• 75–80% of patients initially thought to need inpatient admission can stabilize within 24 hours in an EMPATH unit
• Therapeutic design reduces agitation, improves safety, and accelerates recovery
• EMPATH units improve ED flow while creating a better experience for staff and patients
• This model delivers better outcomes at a fraction of the cost of traditional alternatives

Why This Matters

If you work in healthcare leadership, emergency medicine, behavioral health, architecture, planning, operations, or if you care about how hospitals respond to people in crisis, this episode will fundamentally change how you think about emergency psychiatric care.

Resources & Links

• EMPATH Unit overview and implementation guidance - https://fgiguidelines.org/wp-content/uploads/2022/06/FGI-Design-of-BHCUs_2022-06.pdf
• Federal and Facility Guidelines Institute (FGI) Podcast - https://fgiguidelines.org/podcast/e5-behavioral-health-crisis-units-scott-zeller/

• Alameda Model - https://pmc.ncbi.nlm.nih.gov/articles/PMC3935789/
• Angle of Repose - https://www.goodreads.com/book/show/292408.Angle_of_Repose
• https://pmc.ncbi.nlm.nih.gov/articles/PMC8850530/
• EmPATH Summit - https://web.cvent.com/event/c9b818d9-d9af-4e75-bdbf-8edaa2d6f6e0/websitePage:0b77ccc9-e9f0-48f7-9010-45c9759b9324

About the Guest

Dr. Scott Zeller is a nationally recognized psychiatrist and leader in emergency and crisis psychiatric care, best known for pioneering the EMPATH Unit model—Emergency Psychiatric Assessment, Treatment, and Healing. With decades of experience on the front lines, including more than 20 years as Medical Director of Psychiatric Emergency Services in Alameda County, California, he has helped reshape how hospitals address behavioral health crises by aligning care models, environment, and rapid intervention to improve outcomes, reduce ED boarding, and restore dignity to patients in crisis.

Connect with Dr. Zeller - LinkedIn

Vituity -https://www.vituity.com/who-we-are/leadership/scott-zeller/

About the Podcast

The Architecture of Healing explores the intersection of healthcare strategy, design, operations, and experience—examining how environments, systems, and decisions shape care delivery and healing.

www.thearchitectureofhealing.com

Connect with Chase - https://www.linkedin.com/in/chase-h-miller/