NORTHWEST REGION

1. NORTHWEST REGION CHILDREN�S SERVICES

2. WESTERN MO MENTAL HEALTH CENTER Child and Adolescent Unit Designed for 10 beds, but staffed for fewer Acute psychiatric inpatient Front Door � Emergency Room typically, frequently Central or Regional Office recommendation

3. WMMHC Stats Approximately 200 admissions in a year Mood Disorder, Not Otherwise Specified by far the most frequent diagnosis (7x more frequently given than the next diagnosis which was Psychotic Disorder, NOS) Approximately 45% referred by family/relatives Approximately 25% referred by courts/law enforcement 10% were involuntary commitments

4. WMMHC Stats 17% had dual diagnoses of MI/DD Payor Sources 38% Medicaid 33% MC+ Managed Care 17% �guest of the state� 12% private insurance

5. WMMHC Statistics Average Length of Stay 11.5 days with a range from 2-126 days (10% exceeded 30 days) Of the 10%, the classic presentation was Dually diagnosed with MI/DD Extreme Behavioral Presentations (typically aggression) Co-occurring medical conditions Multiple admissions to inpatient services

6. Complicated Medical Conditions One youth had the following medical conditions on Axis III HYPOTHYROIDISM UNSPEC OBESITY UNSPEC TEAR FILM INSUFFIC UNSPEC ALLERGIC RHINITIS UNSPEC ESOPHAGEAL REFLUX UNSPEC CONSTIPATION ACUTE DERMATITIS SOLAR RAD OBSTRUCTIVE HYDROCEPHALUS STEVENS-JOHNSON SYNDROME OTHER CONVULSIONS OTHER DRUG ALLERGY

7. NW Region Inpatient Bed Capacity for Children and Adolescents Crittenton 41 Research Psychiatric 25 Heartland �St. Joseph 0 St. Luke�s Northland 6 Two Rivers 20 ___________________________ Total Beds 102 Royal Oaks 33

8. Capacity Development Based on model developed by Robert Friedman out of Southern Florida in 1987 � updated through discussions in 2003 Balanced system of care � excess or deficit in any area, impacts all other areas Does not include services for prevention or early intervention Public mental health services and funding, so would include schools, juvenile courts, child welfare and Medicaid

9. NW Region Capacity Development