1 / 19

Metrowest Medical Center

Metrowest Medical Center. Mental Health Assessment, Treatment and Discharge Process Mary Mullany, APRN-BC. Introduction. Psychiatric screening process Who, when and where Options for treatment Outpatient, partial hospital program or inpatient unit Course of treatment

janna
Download Presentation

Metrowest Medical Center

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Metrowest Medical Center Mental Health Assessment, Treatment and Discharge Process Mary Mullany, APRN-BC

  2. Introduction • Psychiatric screening process • Who, when and where • Options for treatment • Outpatient, partial hospital program or inpatient unit • Course of treatment • Discharge planning process

  3. First Contact • Evaluation and Referral Team is located at MWMC in Natick • (508) 650-7380 • Coordinator, Tina Marian R.N. • Licensed mental health clinicians, licensed social workers, dual diagnosis specialist and graduate student interns • Psychiatrist

  4. Referral Process • Call (508) 650-7380 to speak with mental health clinician • Referrals come from a wide geographical region • Give clinical information about current crisis • Provide insurance information • Different options with different insurers: MBHP, Tufts, Blue Cross, UBH.

  5. Next Steps • Initial telephone screening with referring people, schools, parents, self • Directed to come to Emergency Department • Framingham ER covered by Advocates in a contractual arrangement with MWMC • Natick ER is covered by MWMC staff clinicians

  6. Emergency Room Process • ER medical staff will provide medical clearance, physical exam and labs as needed • Immediate safety assessment • If there is concern about safety to self or others, patient will be maintained on constant observation with trained staff

  7. Decision Process • Mental health clinician and psychiatrist will evaluate and determine disposition • If hospitalization is required clinician must seek authorization from insurance company • Medicaid insurance requires PES Team (Advocates) to evaluate and determine disposition

  8. Inpatient Child Development Unit (CDU) • 12 bed licensed DMH unit located at Leonard Morse Hospital in Natick • Multidisciplinary team • Psychiatrist, nurses, social workers, psychologist, on-site teacher, counselors, recreational therapist, nurse practitioners and pediatrician

  9. Diagnosis • Ages: 3- 18 • Length of Stay: 7-10 days • Diagnosis : Depression, mood disorders oppositional defiant disorder, school phobia, psychosis, ADHD

  10. Behaviors • Multiple forms of risk behaviors: • Substance use • Violence • Sexual activity • Suicide thoughts and behaviors • Bullying • Cutting

  11. Treatment • Milieu treatment, groups, recreational activity, setting daily goals, mood monitoring journals • Classroom • Pet therapy program • Adolescent groups • Psychopharmacological evaluation • Diagnostic assessment • Collateral Contact with out patient providers , therapist, psychiatrist, pediatrician

  12. Partial Hospital Program • Day program located at LMH, MWMC Natick • Hours: 8:30 a.m. - 3:00 p.m. • Ages 15 years old and up • Must have transportation available • Good treatment program for depression, substance abuse or dual diagnosis • Step-down from inpatient hospital • Alternative to hospitalization

  13. Treatment Modalities: PHP • Groups • Psychopharmacological assessment • Psychosocial and family assessment • Staff: • Coordinator: Kathy Natale, OTR • Psychiatrist : Annette Hanson, MD • Social workers • LMHC • Psychiatric APRN

  14. Discharge Planning • Essential contact from day ONE: • Parental/guardian involvement • Contact with school staff • Engagement with social service agencies, e.g. DCF • Outpatient treatment team, psychiatrist, therapist • DMH referral • Residential

  15. Clinical Illustrations • 17 year old female • Acute suicidal thoughts and history of binge drinking • Disclosed extent of her depression and suicidal thoughts to guidance counselor when talking about college application process • Parents in denial and minimizing risk

  16. Clinical Illustrations • 17 year old male • Difficulty with impulse control • Mood disorder • Precipitating behaviors: physical altercation with school personnel; verbally abusive to substitute teacher

  17. Clinical Illustrations • 15 year old female • ADHD and PTSD • History of cutting/gauging arms • Precipitating behavior: engaged in physical altercation (punching) with mother in school setting

  18. Rewards and Challenges • Staff are dedicated and committed to making a difference in the lives of the children who we serve • We welcome ongoing involvement from the staff in the schools • HIPAA may limit what we can share but we still recognize that we are all in this together • It takes a village…

  19. QUESTIONS ? • QUESTIONS ?

More Related