Robin Mitchell Bursary, Jane Grassie

I was awarded the Robin Mitchell Fellowship in 2022, when I travelled to Minneapolis to evaluate a novel US model for emergency psychiatric presentations – the EmPATH model.

EMPATH stands for ‘Emergency Psychiatric Assessment Treatment and Healing’. These are in essence dedicated psychiatric emergency departments, co-located with ‘traditional’ EDs. There are now dozens in the US, with more internationally in Canada, Mexico and Singapore. I spent 4 weeks in the unit, which is staffed by mental health nurses, psychiatrists, peer workers, substance use experts and crisis social workers. The fellowship opened my eyes to an entirely new way to manage those presenting in distress to EDs, with close collaborative working between the ‘main’ ED and the EmPATH. The environment of the unit played a huge part in the care of these patients – with soft lighting, comfortable furniture, access to warm blankets/ food/ drink and diversions like books, magazines and jigsaws. Patients could spend up to 48hrs in the space, allowing time and space for de-escalation, assessment and treatment initiation. Crucially, nobody leaves the EmPATH unit without a follow up appointment, and the unit co-ordinators have links to a huge range of community resources for ongoing care. Evidence for the units shows shorter ED boarding, fewer psychiatric inpatient admissions and fewer return visits.

The Fellowship afforded me the opportunity to see how care can be so much better for those presenting in distress. I now work as the Mental Health Lead for my ED, looking to bring similar principles to the care we provide locally, as well as nationally. Last year our department hosted a visit from Scott Zeller MD, the pioneer of the EmPATH model, to promote the model among clinicians, policy makers and academics in Scotland.

The Robin Mitchell Fellowship has shaped how I work and my career in a way I could not have imagined prior to seeing this alternative model of care, and I would encourage resident doctors in Scotland to apply for this wonderful opportunity.