Peer-Enhanced Agitation Code Team
Testing whether peer support specialists with lived experience of mental health recovery can transform how emergency departments respond to behavioral health crises.
Compassionate, Recovery-Oriented Crisis Care
Behavioral health emergencies in emergency departments (EDs) can be stressful and potentially unsafe for both patients and healthcare workers. Current approaches often rely on security involvement, physical restraints, or medications, which may negatively affect patient experience and outcomes.
Patients, families, clinicians, and health system leaders have identified the need for more compassionate, recovery-oriented approaches to behavioral crisis care. The Peer-Enhanced Agitation Code Team (PACT) study will evaluate whether adding trained peer support specialists with lived experience of mental health recovery to emergency department behavioral crisis response teams improves patient and staff outcomes.
Using a pragmatic stepped-wedge trial across multiple emergency departments, the study will compare PACT to usual care, measuring outcomes including patient experience, use of physical and chemical restraints, workplace violence incidents, staff well-being, healthcare utilization, and implementation outcomes.
What PACT Adds to the Response
Peer support specialists work alongside clinicians during behavioral health emergencies to promote engagement, de-escalation, and recovery-oriented care — combining a multi-professional crisis response team with someone who has lived experience of recovery.
Scope of Work for Recovery Support Specialists
Recovery Support Specialists (RSS) bring lived experience directly into the ED, working one-on-one with patients in distress, building trust, and connecting people to ongoing care.
Study Design
A pragmatic stepped-wedge trial across multiple emergency departments compares PACT to usual care, with patients, family partners, peer support specialists, clinicians, and health system leaders engaged throughout to ensure the intervention fits real-world settings.
- Patient experience
- Restraint use
- Workplace violence
- Staff well-being
- Healthcare utilization
- Implementation outcomes
- Pragmatic trial
- Stepped-wedge design
- Multi-site EDs
- Stakeholder-engaged
Why This Research Matters
These principles shape how we design, evaluate, and implement the PACT model.
Dignity & Compassion
Replacing security-led, restraint-first responses with engagement that treats patients with respect during their most distressing moments.
Lived Experience
Peer support specialists bring firsthand recovery knowledge into the ED, building trust that clinical teams alone often cannot.
Safety for All
Reducing restraint use and workplace violence while protecting the well-being of the healthcare teams delivering crisis care.
Health Equity
Improving the quality, safety, and dignity of emergency care for individuals experiencing behavioral health crises, regardless of background.
Stakeholder Engagement
Engaged throughout the study to ensure the intervention addresses real priorities and can be implemented in real-world settings.
Interested in the PACT study?
We welcome collaborators, clinicians, community partners, and trainees who share our commitment to improving behavioral emergency care.
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