Psychologist and Eastern State Chief Administrative Officer Lindsay Jasinski celebrates with emergency psychiatrist and Eastern State Chief Medical Officer Andrew Cooley at the July ribbon cutting for EmPATH. (UK Photo)

This story mentions suicide and mental health. If you or someone you know is contemplating suicide, please call or text the Suicide Prevention Lifeline at 988.?

Kentucky’s first psychiatric emergency unit cared for more than 150 people in its first 10 days of operation — more than half of whom were dealing with suicidality.

The EmPATH (which stands for Emergency Psychiatric Assessment, Treatment and Healing) unit is on Eastern State Hospital’s campus in Lexington, but is serving a wide-ranging population, with patients traveling from as far as Danville, Ashland and Somerset. It opened July 30, the first of its kind in Kentucky.?

There are 30 EmPATH units in the country, which have open floor plans, as opposed to individual rooms. People who seek care during mental health crises can walk around, hang out on a patio for fresh air and even talk to peer support specialists who have histories of mental health issues and can relate to patients.?

“??They can move … to an area that has sunshine and they can see outdoors, but it allows them to sort of choose their space, whatever works for them, to help decompress whatever that behavioral health crisis was,” Eastern State Chief Administrative Officer and psychologist Lindsey Jasinski said.?

Kentucky’s EmPATH unit, funded by the University of Kentucky,? is about 11,000 square feet, has a 12-person capacity and only sees patients 18 and older.?

Anyone who is experiencing a mental health crisis that is impacting their day-to-day functioning can seek help at the unit at 1354 Bull Lea Road in Lexington.?

How does the EmPATH unit work?

As soon as a patient comes into EmPATH, they’re seen “nearly immediately,” Jasinski said. The facility takes insurance, but will treat people whether or not they have it. If that is the case, Jasinski said, the unit works with that patient to develop a sliding scale payment plan based on their ability to pay, which means they won’t face a flat rate.?

The unit has three peer support specialists — employees who have histories of mental health issues and are specially certified to speak peer-to-peer with patients — who are available seven days a week from 10 a.m. to 10 p.m.?

These specialists greet patients as soon as they walk in the door. They may ask a new patient if they need food or water, sunshine or air. They are also trained in de-escalation.?

“The key part of what they provide in this environment, and this is sort of central to all of what EmPATH does, is they provide hope that things can be different,” Jasinski explained. “And I think that is a very, very powerful message for someone to leave with, not only the medications they need, not only the therapy they need, but a sense of hope that things can be different.”??

As soon as they arrive, patients receive a pillow, blanket and a recliner, which they can move around the unit as they see fit.?

Patients can stay up to 23 hours in the unit, after which they either go home or are transferred to inpatient care or substance use recovery treatment.?

If there is immediate risk the patient will hurt themselves or someone else, staff can involuntarily hold them. But that is rare, said Marc Woods, who’s worked at Eastern State Hospital for more than 30 years and is its chief nursing officer.

“Safety first,” emphasized Dr. Andrew Cooley, a UK HealthCare psychiatrist and chief medical officer for Eastern State Hospital. “We are going to protect someone who can’t protect themselves. And if that requires further inpatient admission, then that’s what we would have to do. That’s when it would convert from a voluntary process to involuntary.”?

But most — Woods estimated about 90% — of the unit’s patients go home after visiting the unit.?

In its first week and a half of operation, patients were a mix of walk-ins and outside referrals.?

Decreasing mental health stigmas?

Stigma around mental health in general and around mental health hospitalization is improving, Woods said, but it’s still present.?

“We’ve had a couple of families and patients even come in … saying that they’ve really avoided seeking help because they don’t want to go to the (emergency department), or, they’re embarrassed by having to go to the ED,” Woods said. “And they’ve come to us, they’ve expressed they were happy to have a place to come where they felt like they didn’t have to be embarrassed by some of the things they had going on in their lives.”?

Stigma is perpetuated, Jasinski said, when people and media link mental illness with violence.?

But: “Our folks with mental illness that we see are much more likely to be victims of violence than perpetrators of violence,” she said.?

She and the other EmPATH staff are keen to break through stigma around mental illnesses. They will measure success in this effort, they said, by making sure people are coming and getting help from the unit and when they see the number of deaths by suicide decrease. In 2022, at least 823 Kentuckians died by suicide, according to the Centers for Disease Control and Prevention. The suicide prevention lifeline is 988.?

“If we can treat behavioral health emergencies just like any other need, we can reduce stigma around that, and this allows folks to get very timely, effective intervention and stabilization for behavioral health crisis in a specialized setting for them,” Jasinski said.?

Part of de-stigmatizing mental health is to decriminalize it, she said, which is a goal the staff is working toward.??

“Historically, within the mental health system, there’s been a lot of involvement of law enforcement,” Jasinski said. “There’s some criminalization that has happened with mental illness. What would be great is if law enforcement never had to touch these folks.”?

Easing strain for physical health emergency rooms?

A key part of Kentucky’s EmPATH unit is to treat mental illnesses in the state and lower stigma around that care. But it also “makes an impact on the entire ecosystem,” Cooley said.?

“With this design, patients that have mental illnesses are not congesting routine emergency rooms, where … they would wait commonly for hours and hours,” he said.?

And traditional emergency rooms aren’t trauma-informed and calming places, Jasinski said.?

“If you are anxious or overwhelmed, it is not a place that’s going to make you feel less anxious,” she said. “Typically, it’s very loud. There’s a lot going on.”?

Medical providers are also going to prioritize patients with gunshot wounds or heart attacks, Woods said. At EmPATH, though, staff have a singular focus on treating the mind.?

“This is a low bar type of entry,” Cooley said. Staff will medically screen anyone who walks through the door. “In the past, emergency services — or urgency services — had high bars, and the threshold was way too high: ‘You’re too sick’ or ‘you’re not sick enough.’”?

He added: “We’re not saying no to anybody who walks in the door.”?

Even if the unit is at capacity, Jasinski said,?we would still see patients, medically screen them, and then decide the best place for them to be.”

They could also be transferred to a nearby hospital unit, if need be, she said. “Our goal is to treat every patient we can possibly serve.”

The hope for expansion?

Not yet two weeks in, “What we’ve learned is that we’re going to be busy, and we have been busy already,” Jasinski said.?

But she and others are already looking to support organizations around the state that want to open similar units.?

“We don’t want this to be the only EmPATH,” she said. “There needs to be many, many more of these.”??