HN Summary

•Specialized Emergency Mental Health Care: The Purple Zone, launched in March 2024, provides 24/7 interdisciplinary care for mental health and addictions emergencies in a therapeutic, patient-centered environment.

•Improved Access and Outcomes: Over the first year, patients received faster physician assessments, psychiatric consults more than doubled, and the model reduced pressure on the broader Emergency Department

•Community-Focused Support: The program emphasizes personalized discharge planning with partnerships for housing, addictions services, and peer support, while addressing ongoing challenges like follow-up care and systemic barriers.

Embedded in the heart of North York General’s (NYG) bustling Charlotte & Lewis Steinberg Emergency, a dedicated healing space is transforming how emergency mental health and addictions care is delivered. Opened in March 2024, NYG’s Mental Health Emergency Services Unit (called “Purple Zone” internally) provides around the clock care for those experiencing mental health or substance use emergencies – all under one roof. 

The innovative, interdisciplinary model brings together emergency medical and mental health care in a compassionate, therapeutic environment. From the start of their visit, patients are supported by a team of emergency physicians, mental health nurses, peer support, and case managers. Together, they work closely with community agencies to safely discharge and support each patient with personalized wrap-around services in the community.

“The care provided by our multi-disciplinary team has helped us streamline how we provide emergency mental health and addictions support and provide comprehensive discharge planning,” says Sandy Marangos, RN and Clinical Director of NYG’s Mental Health Program. “The impact has been clear – since opening, the Purple Zone has provided immediate medical and mental health assessments during the most vulnerable stage of crisis care.” 

This special zone includes individual treatment rooms, carefully selected furniture, colours and other features which create a calming and healing environment for patients. Made possible by the generosity of more than 6,000 donors, the Purple Zone is also part of NYG’s vision of delivering World Class Care, 24/7 and commitment to deliver connected and integrated health care that extends into the community.

A Measurable Impact

Over the past year, the Purple Zone has strengthened the delivery of emergency mental health and addictions care in the Emergency Department (ED). 

Patients receive initial physician assessments when most in need within a little over an hour instead of the almost two hours it took previously. 

Psychiatric consultations have also increased significantly with over 2,000 consults provided after the first year of opening compared to just over 1,200 consults in the previous year, highlighting improved access to specialized support. 

Mental health and addictions patients typically stay in the ED longer than others. But since the Purple Zone opened those extended stays are happening where they are most appropriate. This shift has eased pressure on other areas of the ED—with non-Purple Zone patients now spending up to 30 minutes less time in the ED than before. 

Mental Health hospital admissions are also now mostly concentrated to the Purple Zone with those patients requiring hospitalization more likely to be seen and admitted through the Purple Zone. 

“This tells us the model is working,” says Andrea Ennis, RN and Director of the Emergency Services Program at NYG. “By concentrating resources to support high-acuity and complex emergency mental health cases in a therapeutically calming and private space, we are better caring for patients with more complex or acute mental health needs.” 

Systemic Barriers

An important part of the Purple Zone model is to discharge patients with comprehensive care plans that connect them to wrap around services in the community tailored to their individual needs. Much of this work is made possible by a grant from the Slaight Family Foundation that has allowed North York General to build on partnerships with community agencies Eva’s Initiatives for Homeless Youth, Addictions Services Central Ontario and COTA Health, whose case managers will visit patients to help them access housing and other services to assist with their recovery. 

An additional partnership with the Krasman Centre provides a peer navigator with lived experience who is embedded with the Purple Zone’s clinical team to help patients navigate their recoveries.

Work is also underway to develop an Artificial Intelligence (AI) tool that will help the Purple Zone team best match patients with appropriate community resources.

However, systemic issues including limited affordable housing and long wait lists for community-based therapy and other supports are challenging recoveries after discharge, not just for Purple Zone patients but for other mental health patients seen elsewhere in the ED. 

Between March 2024 and March 2025, 16% of discharged patients from the Purple Zone returned within 30 days compared to 15% for other patients.

“Although we are effectively managing acute cases, our current revisit rates show we need to continue looking at ways to strengthen follow-up care in the community and address some of those gaps,” says Dr. David Koczerginski, Chief of Psychiatry and Medical Program Director of Mental Health at NYG. “This includes growing partnerships and expanding resources within the housing and addiction services sector.” 

Next Steps

Other ways NYG is exploring to build on the Purple Zone’s early successes includes collecting more feedback from youth, racialized and equity-deserving populations, further training ED team members working outside of the Purple Zone who may have to manage psychiatric emergencies, and allowing Purple Zone nurses to consult or support outside the unit when capacity allows during high acuity moments elsewhere in the ED. 

“We’re proud of what we’ve achieved in our first year,” says Marangos. “We’re committed to building on this momentum and growing to meet the evolving needs of our communities.”