MGH launches Psychiatric Emergency Zone to improve mental health and substance use care for patients in Emergency Department

This week, Michael Garron Hospital (MGH) opens its Psychiatric Emergency Zone (PEZ), a new model that will improve mental health and substance use care for patients in the Stavro Emergency Department (ED). 

A six-bed zone, the PEZ is located in the ED’s Purple Zone, which was formerly known as the Mental Health Emergency Assessment Zone.  

This change marks a critical transformation in how MGH is delivering mental health and substance use care in the ED. Across Toronto, demand for psychiatric care is at an all-time high, and many patients with significant complexities must wait in emergency departments before being admitted. 

“Like other hospitals, MGH is seeing an increase in the number of patients showing up to our ED with mental health needs,” says Dr. Jennifer Russel, Chief of Psychiatry and Medical Director of Mental Health and Substance Use Services at MGH. “The launch of this new care model is a direct response to these higher patient volumes and the increasingly complex mental health needs of our community.” 

Some of the key improvements in the new PEZ care model include:  

• Increased staffing and specialized care: The zone is staffed by a larger and more specialized interdisciplinary team including additional psychiatrists, RNs and RPNs with mental health and substance use expertise, along with administrative and security support. Having dedicated psychiatric and medical care will improve the standard and quality of care in this dedicated space.
• Capacity to accommodate children and youth: The PEZ is now able to accommodate child and youth patients, so that care is provided in the right space and across patients’ lifespans.
• Improved patient flow: The PEZ team will work closely with MGH's ED and inpatient mental health teams to ensure a smooth flow of patients between the ED and inpatient units.
• Enhanced spaces for patients and staff: These changes include a renovated nursing station, the addition of a meeting space and lounge for staff and a new shower that will soon be available for patient use. 

PEZ will accommodate short stays for patients in need of stabilization  

In addition to assessing patients before admission, the PEZ will accommodate shorter stays of up to 72 hours for patients who may not need admission but could benefit from shorter-term stabilization.  

“Short stays in the PEZ will support patients who need stabilization from substance use or following a situational crisis,” says Ifat Witz, Director, Mental Health and Substance Use Services at MGH. “After stabilization, these patients are discharged with supports and resources, such as referrals to outpatient programs and follow-up psychiatry appointments.”  

Enhanced support for Emergency Department patients with secondary mental health concerns 

The launch of this new model includes improving care for ED patients outside of the PEZ.  

Not all ED patients with mental health concerns are located in PEZ, as their primary health concern may fall under a different area of care.  

Despite not being located in the PEZ, these patients will still be supported by PEZ staff and psychiatrists, who will collaborate with clinicians in the general ED and provide consultations, assessments and care planning. 

“This approach ensures that all patients receive equitable, consistent and specialized mental health care, regardless of their physical location in the department,” Dr. Russel says.   

Click here for more information on MGH’s Mental Health and Substance Use programs.