Virginia is facing a mental health crisis affecting patients across all age groups and communities. For hospital leaders, this presents both a challenge and an opportunity: How can health systems adapt to the growing need for behavioral health services while maintaining quality care and sustainable operations?

We spoke with Jay Taylor (Chief Growth Officer) and Jenny Ryan (Chief Clinical Officer) of Backpack Healthcare to learn how Virginia hospitals can respond to the growing mental health crisis. Our team outlines key factors to consider when building effective services and provides three examples of effective tactics Virginia hospitals have incorporated to improve patient care.

To work with Backpack Healthcare or any of our proven healthcare solutions partners, connect with us at VHHA Solutions. We source top organizations in data analytics, patient safety, and finances to help Virginia hospitals and healthcare systems streamline their practices. Book a call to learn how we can help you scale.

The Key Takeaways: 

• Hospitals should consider three (3) factors when addressing mental health needs: provider diversity trained to represent or understand the population served, early intervention through quick response times, and technical optimization through centralized platforms.
  
• Integrating telehealth solutions like the Backpack Healthcare Program can expand access to behavioral healthcare providers in areas that lack adequate resources, especially for pediatric mental health.
  
• Dedicated EmPATH Units can alleviate emergency department (ED) congestion by diverting patients experiencing behavioral health crises. This increases bandwidth for traditional staff and decreases response time.
  
• Interprofessional training for the greater healthcare workforce to recognize behavioral health signs early can help mitigate condition escalations. Integrate regular screenings into primary care visits and set up a protocol for assessment, treatment, and referral.

Understanding Virginia’s Growing Need for Behavioral & Mental Health Services

Demand for behavioral and mental health services in Virginia is rapidly outpacing the available resources as people become more willing to acknowledge and address issues such as anxiety, depression, and substance use disorders. This is further compounded by a national behavioral health workforce shortage and uneven distribution of service providers between rural and urban areas.

Key Mental Health Statistics From the 2024 State of Mental Health in America Report:

• Virginia ranks 12th in the U.S. for overall mental health, a significant improvement over the previous year at 38th. This suggests ongoing efforts to increase access to mental health resources are effective.
  
• Virginia ranks 17th in the U.S. for youth mental health, again, a stark improvement over the previous year at 48th.
  
• 93 out of 133 localities in Virginia are designated as Mental Health Professional Shortage Areas, which affects about 37% of Virginians (approximately 2 million people).
  
• Only 4 counties in Virginia have sufficient pediatric psychiatric providers to meet demand.
  
• Only 5% of Virginian youth with suicidality-related ED (emergency department) visits had a primary care visit within 7 days prior, indicating missed opportunities for early intervention.

While access to behavioral health services has expanded in some areas, many hospitals still experience increased strain on multiple fronts. Primary care physicians are often the first line of defense to address mental health issues, but they may lack robust referral channels to find a provider. Without interventional care, a patient’s condition could escalate, making emergency departments the de facto resource in times of crisis.

“Rising ED Utilization for behavioral health is wreaking havoc across the state,” Taylor shares. “Emergency departments are not meant to support behavioral health crises from a long-term care perspective and often lack adequate staffing to meet needs.”

Addressing this crisis requires hospitals to adopt scalable, inclusive, and forward-thinking behavioral health strategies.

What Hospitals Should Consider When Integrating Behavioral Health Services

A thoughtful, system-wide approach to expanding behavioral health services involves more than adding staff for acute crises. Virginia hospital leaders will need to think about compounding factors that affect patient care.

1. Diverse Behavioral Health Providers

Whether growing referral channels or hiring in-house, hospitals must incorporate a diverse list of behavioral health providers who are culturally competent. Working with providers who represent or understand the communities they serve can build trust, especially for historically underserved populations. This can also help mitigate biases and improve patient outcomes.

Providers should stay updated on socioeconomic factors that contribute to behavioral and mental health conditions, as well as the challenges community residents face.

2. Early Intervention & Response Time

Early detection and intervention are key to managing behavioral health episodes. The earlier a patient can see a behavioral health provider, the less likely the condition will escalate into a crisis, which reduces strain on EDs.

Some hospitals integrate psychiatric support into primary care visits. This new model incorporates universal screening for depression with each visit, starting with a self-administered two-question survey. If the screening is positive, patients will receive a follow-up survey, which will determine if the patient needs a psychosocial evaluation from a social worker or psychiatrist. 

3. Incorporating Technology to Optimize Capacity

Telehealth can dramatically expand access to behavioral health specialists, particularly in rural and underserved areas. One of the main benefits of virtual models is the consolidation of several services into an easy-to-use system.

“We want to shift away from the traditional model of limited in-person care to telehealth,” Ryan says. “With technology fueling support, patients can access different specialties between therapy, psychiatry, and psychological evaluations as needed. It’s a more well-rounded approach to care.”

3 Hospital Strategies to Expand Behavioral Health Services in Virginia

1. Partner With Backpack Healthcare

Backpack Healthcare is a pediatric-focused behavioral telehealth program offering integrated therapy, psychiatry, and psychological evaluations. While initially specializing in pediatric mental health, the program has since expanded to support adults.

Backpack Healthcare is designed to work alongside care management workflows, creating a seamless hospital-to-outpatient behavioral health transition while reducing service escalations. Hospitals and provider systems that lack the in-house behavioral health expertise or need more clinicians rely on the program’s resources to improve patient care.

At a high level, there are two (2) ways Virginia hospitals and healthcare systems can leverage Backpack Healthcare:

• Informal Referral Relationship – Healthcare systems can refer outpatients to the Backpack Healthcare Program as a resource. Their network of clinicians will work with patients to provide behavioral health services quickly and effectively.
  
• Formal Partnerships – Hospitals and provider groups can contract Backpack Healthcare clinicians to address patient behavioral health needs. These clinicians are credentialed under the hospital or provider group, billing through the hospital’s IT systems. However, they are managed by Backpack Healthcare. This is a revenue-share model between the hospital and Backpack Healthcare with clear mutual benefits.

Both arrangements greatly increase a hospital’s behavioral health capacity without additional stressors such as staffing overhead and clinician management. This allows health system leaders to easily refer patients to the right resources, reducing the strain on hospital staff and ED wait times.

Additionally, Backpack Healthcare’s platform encourages users to engage with content and practice care goals between psychiatry sessions. Clinicians leverage the engagement to inform future sessions and monitor progress in addition to continuing treatment outside formal sessions.

Taylor notes, “We’re trying to change the behavioral health care paradigm with our Care Companion app. Being able to break that loop of care then gap with a continuous model enhances what you would get with a clinician alone.”

2. Develop an EmPATH Unit

Emergency Psychiatry Assessment, Treatment, and Healing (EmPATH) Units are dedicated spaces near emergency departments that provide short-term, intensive psychiatric care in a calm, therapeutic environment. Hospitals rely on EmPATH units to divert patients experiencing a mental health crisis from the ED.

It’s a multidisciplinary approach that involves social workers, case managers, behavioral health experts, physicians, and advanced practice providers working to provide holistic mental health care.

The Benefits of an EmPATH Unit:

• Behavioral health staff are trained to recognize patient needs quickly and stabilize patients in a safe space. As the patient’s condition changes, they receive tailored levels of care.
  
• Traditional ED staff now have more bandwidth to focus on other patients, increasing capacity while reducing ED wait times.
  
• EmPATH Units that accept walk-ins improve service accessibility. Providing timely therapeutic and psychiatric intervention prevents further escalation.
  
• Combining outpatient services, family support, and community resources is key to helping patients safely return home within 24–48 hours.

Currently, there are three EmPATH Units in Virginia. The first was established in 2022 at Centra Health, Lynchburg General Hospital. Following the unit’s success at lowering ED boarding times, Valley Health launched its own unit at Winchester Medical Center in 2024. Inova Health System followed suit the same year with an EmPATH Unit to address rising emergency psychiatric visits.

Watch a tour of Centra Health’s EmPATH Unit below.

3. Invest in Staff-Wide Behavioral Health Training

Equipping all hospital staff—not just behavioral health teams—with the skills to recognize and respond to mental health crises can significantly enhance patient safety and outcomes. Knowing where and how to refer patients for screening is vital for effective assessment and treatment. Key training elements include:

Recognizing Warning Signs:

• Verbal indicators of distress, hopelessness, or self-harm
• Agitation, confusion, withdrawal, or erratic behavior
• Non-verbal cues like pacing, clenched fists, or crying

De-escalation Techniques:

• Use a calm, non-threatening tone and body language
• Maintain a safe distance and avoid sudden movements
• Offer simple, empowering choices to help patients regain control
• Listen actively and validate the patient’s experience

Interprofessional training should be incorporated into onboarding and continuing education, with tailored modules for high-risk areas such as emergency departments and labor and delivery units.

VHHA Solutions Helps Virginia Hospitals and Healthcare Systems Grow Mental Health Services

Mental health needs are rising across Virginia, and hospitals must lead the way in developing responsive, inclusive, and sustainable care models. By investing in virtual care solutions like the Backpack model, creating EmPATH units, and empowering all staff through training, health systems can better support their communities while relieving pressure on existing infrastructure.

Hospitals don’t have to do this work alone. VHHA Solutions is here to help. Contact us today to learn how we can support your efforts to expand behavioral health services and improve patient outcomes across Virginia.