2025 Is a Landmark Year for Emergency Psychiatry

Key Takeaways

• Emergency psychiatry is gaining recognition with the approval of a focused practice designation by the American Board of Medical Specialties.

• The new designation allows both psychiatrists and emergency medicine physicians to practice in emergency psychiatry settings, addressing staffing challenges.

• EmPATH units are expanding, providing patient-centric care and reducing psychiatric boarding times in emergency departments.

• SAMHSA's recognition of emergency behavioral health centers enhances access, reimbursement, and parity with physical medical care.

SPECIAL REPORT: EMERGENCY PSYCHIATRY

2025 is shaping up to be one of the most consequential years ever for the burgeoning subspecialty of emergency psychiatry. Not only are new programs and hospital departments opening seemingly on a daily basis, while even more sites begin nouveau development, there has been unprecedented ascent in the academic gravitas and clinical recognition for emergency psychiatry’s role and stature.

Perhaps most compelling is the recent approval by the American Board of Medical Specialties (ABMS) of the proposal by the American Board of Emergency Medicine (ABEM) to recognize a focused practice designation (FPD) in emergency behavioral health.1 This new designation is an enormous step toward emergency behavioral health becoming a full-fledged boarded subspecialty, long a dream of many practitioners of emergency psychiatry.

According to the ABMS, an FPD “recognizes the value that physicians who focus some or all their practice within a specific area of a specialty and/or subspecialty can provide to improving health care. Focused practice designation enables the ABMS Member Boards to set standards for, assess, and acknowledge additional expertise that physicians gain through clinical experience, and may include formal training.”

ABEM worked in tandem with the American Board of Psychiatry and Neurology to support this new designation, which, as a result, will be available to either psychiatrists or emergency medicine physicians. This expansion of the types of physicians who will be able to practice in emergency psychiatry settings in the future is a welcome development, as one of the biggest questions in the past few years, as more and more emergency psychiatry programs have been coming online, has been: How can there be sufficient providers to staff all these new 24/7 sites? Adding emergency medicine physicians to the mix along with psychiatrists might not only address these staffing questions but also help out some practitioners with a major issue in recent years for emergency medicine: burnout. Splitting shifts between the emergency department (ED) and a psychiatric ED might be a great way for some physicians to keep themselves fresh, energetic, and optimistic. With multiple emergency psychiatry fellowships currently available to emergency medicine physicians, the opportunity for them to become trained and credentialed as emergency behavioral health providers already awaits.

The timing of the new FPD could not be better, because there will be a huge demand for prescribing behavioral health providers in the coming months as dozens of new Emergency Psychiatric Assessment, Treatment, and Healing (EmPATH) units open across the US. With nearly 50 such programs already operating across the country, it is projected that more than 100 EmPATH units will be in service nationally by 2027. As described by Cooley et al in this Special Report, EmPATH units are soothing hospital-based alternatives to the medical ED where patients can quickly be moved for prompt, appropriate, noncoercive, and patient-centric care, rather than the common approach of boarding with long hours in the ED waiting for an inpatient admission. This EmPATH solution for psychiatric boarding also stabilizes most patients—even those with involuntary status—to the point of discharge home in hours, often less time than these individuals would commonly otherwise be boarding, untreated, in the ED.

Speaking of which, everyone working at, constructing, or considering the creation of an EmPATH unit now has a place to share ideas for the first time. The inaugural National EmPATH Summit is taking place May 21 to 22, 2025, in Dallas, Texas, with a packed house of speakers, experts, clinicians, health care architects, and everyone whom one might imagine would participate in the development of an EmPATH unit. It looks like it will be quite the event.

EmPATH units and other emergency behavioral health centers, in another substantial advancement that happened just this year, were officially recognized as the sites capable of working with patient populations with the highest acuity within the overall crisis continuum by the Substance Abuse and Mental Health Services Administration (SAMHSA). In January, SAMHSA published certified national behavioral health crisis care guidance and definitions, which appreciated the considerable need for multiple levels of crisis care, especially the take-all-comers behavioral emergency sites with low barriers to entry, such as EmPATH units, psychiatric emergency services in hospitals, and high-intensity behavioral health emergency centers in community settings. This imprimatur of the federal government is a huge milestone toward establishing parity of emergency psychiatry interventions with physical medical care, helping to improve access, reimbursement, and solvency of these necessary programs while reducing stigma and improving outcomes. With all this good news, it is a great occasion for Psychiatric Times to do this Special Report on emergency psychiatry.

Note: This article originally appeared on Psychiatric Times.