Improving Behavioral Health Care in the Emergency Department and Upstream

Improving Behavioral Health in the Emergency Department and Upstream White PaperThroughout the United States, individuals with mental health conditions or substance use disorders frequently present to the hospital emergency department (ED) for care, yet many ED teams lack the capacity to adequately support these individuals.

In addition to making improvements in the emergency department, it is integral for health systems to also partner with community-based organizations that provide supportive services for individuals before a crisis brings them to the ED.

This IHI White Paper provides actionable guidance for hospital emergency departments and their community partners to create a compassionate, seamless, and effective system of care that is respectful of and works with patients with mental health conditions and substance use disorders who present to the ED.

The paper includes:

  • A framework for a better system of care that comprises four key components: Processes, Provider Culture, Patients, and Partnerships
  • High-leverage changes and specific change ideas
  • Suggested measures
  • Practical tips and examples
  • Resources and tools

Related Content:

  • Improvement Stories: Present the experiences of seven health systems and some specific changes they tested in their EDs
  • Excerpted Framework, Changes, and Measures: Content extracted in abbreviated format from the IHI White Paper


How to Cite This Paper: Schall M, Laderman M, Bamel D, Bolender T. Improving Behavioral Health Care in the Emergency Department and Upstream. IHI White Paper. Boston, Massachusetts: Institute for Healthcare Improvement; 2020. (Available on

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