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'The need is critical': Inpatient psychiatric unit for teens set to open this month

Spokesman-Review - 2/5/2020

Feb. 5--Inland Northwest Behavioral Health held a ribbon-cutting Tuesday for a new inpatient adolescent unit for teens experiencing mental health emergencies.

The 25-bed unit on West Fifth Avenue and Browne Street is set to open in mid-February. It will serve adolescents ages 13 to 17 with mental and behavioral health needs that require hospitalization, adding to the region's system of mental health care.

"We're so thrilled to have this access point that has not been here," Dorothy Sawyer, CEO of the for-profit psychiatric hospital, said at a ribbon-cutting ceremony on Tuesday.

The adolescent unit is the last of four units to open at the hospital, which opened its doors to adults in October 2018. In 2019 alone, the hospital, which is operated by United Health Services, served nearly 1,400 adults requiring inpatient care for mental and behavioral diagnoses and conditions in its three units with 75 total beds.

Community leaders, health care stakeholders and elected officials, including Spokane Mayor Nadine Woodward, celebrated the unit opening Tuesday afternoon.

Woodward said she thinks the beds will fill up fast and the unit will have far-reaching benefits.

"If you want to work upstream, you have to start with young people," Woodward said.

The goal of treatment at INBH is stabilization, doctors said, and coordinating other services, like counseling or other treatment, when they leave.

"We treat the most acute, severe patients for as short as possible," said Dr. Dirk Dhossche, the psychiatrist and director of the adolescent unit.

Teens can be referred by themselves or their family or by health care providers. Once they arrive, they are assessed for the level of care they need.

The private psychiatric hospital will admit teens who are a threat to themselves or others or experiencing a mental health emergency, which is all determined in the assessment process with a clinician. INBH takes most health insurance plans, including Medicaid.

"We're determining if this person needs to come inpatient or not, so if they don't meet criteria for inpatient, we will link them with services in the community," said Julie Hall, director of admissions at INBH.

If a teen is admitted, there is no timeline on how long they can stay, but typically a stay lasts seven to 10 days, Hall said.

"It's all based on their presentation, level of acuity, so we would never put a date or time on it," Hall said.

The teenagers will not interact with adults also staying at the facility. The youth unit will be on a staggered schedule from the adults to use the cafeteria and gymnasium. Teens get group therapy sessions and other recreational opportunities during their stay, and within 72 hours of admission, there will be a family session to help plan for the youth's treatment and discharge. Hospital staff can help connect teens to further treatment, follow-up appointments and outpatient services.

Staffing changes based on the acuity and number of patients on the wing, but at a minimum the staffing ratio requires one staff member to five patients. There is always a resident nurse on the floor, however, and at capacity, there would be two resident nurses and more mental health technicians as needed.

Teens will be separated by gender in their rooms, but the wing will be open to both young men and women. The teen will meet with a psychiatrist or clinician every day.

The new adolescent unit will help alleviate local emergency departments as well as add to the system of inpatient mental health beds for teens already operating.

In Spokane, Providence Sacred Heart Medical Center has a 24-bed inpatient unit for youth between the ages of 12 and 17. Most inpatient stays there are between seven and 10 days, Tamara Sheehan, director of behavioral health, said in a statement. Their unit is often full, but like most inpatient units treating emergencies, the census can vary.

Across state lines, Kootenai Health also has an inpatient unit for youth ages 6 to 17 who are experiencing mental health crises. Kootenai can usually accommodate about 24 beds in their unit, although they are licensed for 32. The average length of stay there is about a week.

Two local nonprofits also provide inpatient beds for youth experiencing mental health crises.

Daybreak Youth Services currently has six beds open for teenage girls ages 12 to 18. Excelsior operates 14 beds for teenage boys ages 13 to 17. Both programs have reported being at capacity before, and representatives from both nonprofits expressed excitement about Inland Northwest opening its doors to local teens.

"People coming to take part in this effort is welcomed," said Andrew Hill, CEO of Excelsior. "The need is critical -- it's there."

Ultimately, the adolescent unit will be able to offer more emergency-based mental health stabilization to local teens, but the entire system of mental health care remains crucial.

"It is essential to realize that we are just a link in a chain of mental health care for young people," Dhossche said.

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