Providing compassionate care for individuals with behavioral health issues has been at the core of Pennsylvania Hospital’s mission since the hospital first opened its doors. By the early 1800s, behavioral health patients outnumbered patients with physical illnesses and injuries two to one, prompting the early realization that patients with psychiatric and behavioral conditions often need their own safe, secure spaces to recover.

While treatments have advanced and the standard of care has greatly improved over time, PAH maintains its commitment to meeting these unique patients where they are and providing them with a safe haven. The newly relocated PAH Crisis Response Center (CRC) aims to do just that.

Supporting a Unique and Vulnerable Population


The CRC — one of five in Philadelphia County — provides 24/7 emergency psychiatric services to individuals who are experiencing crises, such as severe depression or anxiety, episodes of psychosis or self-harm, substance use, or suicidal ideation. Often, these issues are further complicated by poverty, housing insecurity or homelessness, unemployment, legal problems, or emotional distress caused by a physical illness.

Rather than going to an emergency department, patients are able to work with CRC staff who are highly trained to meet the needs of this vulnerable population. Whether they walk in or are admitted involuntarily, each patient is evaluated by a team of nurses, physicians, advanced practice providers, and crisis clinicians who work together to stabilize the patient and determine next steps. The CRC serves as the admissions base and entry point for additional medical care, outpatient counseling, or inpatient treatment at PAH, PPMC, or external facilities.

“A CRC offers a safe, secure environment in which patients can obtain the necessary resources to ensure a smooth transition to the appropriate level of care — depending on the specific needs of each individual,” said John Brennan, MSN, RN, CNHA, clinical director for Clinical Services and a key member of the CRC design team.

Integrating Care into the Design


While the CRC’s original location at Hall-Mercer Community Behavioral Health Center was effective and accessible to patients, its relocation to the recently renovated Spruce Building ensures more streamlined care, improved patient flow, and a better patient experience.

“The new space illustrates PAH’s commitment to behavioral health — investing significant capital into a superior design allows us to deliver compassionate and safe care,” said Juliette Galbraith, MD, medical director for Emergency Psychiatry Services for UPHS and attending physician at the CRC. “By placing the CRC in a main hospital building, there’s easy access to hospital-based services, such as pharmacy, laboratory, emergency medical care, and nutrition services. Because the CRC is now in the same building as our inpatient psychiatric units, it also minimizes unnecessary transport delays and costs.”

The design process was intensive given the need to create a safe environment for both patients and staff. For Jeff O’Neill, AIA, ACHA, CHFM, senior director of Facilities, the relocation presented challenges ranging from transitioning from a non-hospital location to a fully modernized clinical space, to ensuring the needs of this patient population informed the architectural and design elements. Removing all safety risks to protect patients from harming themselves or others was of particular importance, and PAH worked with the state to get clearance to create rooms that are larger than standard ED rooms to ensure all necessary staff could fit in the room while also eliminating blind spots.

“Everything we learned from Spruce 4 and 6, our inpatient units, we’ve implemented down in the CRC,” O’Neill said. “We’ve updated everything from the computers to the furniture; set up two points of entry to ensure that individuals who might be highly emotional and potentially violent can be given the attention and support they need; created a driveway so emergency vehicles can pull up without blocking streets or the sidewalk; and even put down rubber flooring that will be easier on staff members’ feet and backs. It’s been a long time coming, and I think these small but important elements will go a long way.”

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