Emergency departments are experiencing sustained growth in behavioral health–related visits, often resulting in prolonged lengths of stay, boarding, and increased safety and staffing pressures. For healthcare systems, this trend is no longer episodic—it represents a structural shift in demand that directly impacts capital planning, infrastructure systems, and long term emergency department performance. Leaders are now challenged to invest in environments that can safely and efficiently support behavioral health care while maintaining throughput and adaptability across a broad range of acuity levels. This session examines how health systems are responding through targeted planning and design strategies that align clinical operations with physical infrastructure. Behavioral Health Emergency Units (BHEU) are reviewed as a capital investment approach that relocates behavioral health care from high cost ED treatment rooms into purpose built, lower acuity therapeutic environments—freeing ED capacity while improving patient and staff outcomes. BHEU’s, include four distinct proximity typologies – from directly adjacent to Emergency Departments to freestanding in the community and often encompass the EmPATH (Emergency Psychiatric Assessment, Treatment and Healing) model of care. The physical layout and composition of these units vary based on population, physical location and the primary goals of the organization but are unified in their desire to create healing environments that provide the right care and the right time for those experiencing mental health crises. In contrast, behavioral health pods embedded within the emergency department are explored as a space efficient solution that leverages existing infrastructure, staffing models, and adjacencies to support behavioral health patients without requiring stand alone units. The discussion also includes flexible acuity zones and hybrid models, which enable systems to dynamically adjust space use, staffing, and observation levels in response to fluctuating volumes and mixed medical behavioral presentations. Using case study examples from pediatric, adult, and mixed use emergency departments, the presentation highlights how different organizations have evaluated tradeoffs related to capital cost, infrastructure upgrades, staffing efficiency, and long term adaptability. Case studies will examine key decisions involving room typologies, visibility and supervision strategies, ligature risk mitigation, mechanical and electrical systems, acoustic control, and phased implementation—demonstrating how early alignment between clinical leadership, facilities, and design teams supports better return on investment. By comparing these models through a capital planning and operational lens, this session provides decision makers with practical insights into which strategies are best suited to their organizational goals, physical constraints, and patient populations. Attendees will leave with a clearer framework for making informed, forward looking investments that strengthen emergency department resilience while addressing the growing and persistent demand for pediatric behavioral health care.