| September 18, 2008 | Media contact: Kara Gavin E-mail: kegavin@umich.edu Phone: 734-764-2220 |
U-M to renovate & expand hospital psychiatric facilities & programs
$3.8M project approved today includes specialized treatment areas, more private rooms and innovative new treatment approach
The proposed floor plan of the expanded unit. Bed use can be flexible according to patient needs.
ANN ARBOR, Mich. — More than 100 years ago, the University of Michigan opened the doors to one of the nation’s first inpatient psychiatric facilities that aimed to truly treat and study mental illness.
Now, a new $3.8 million project will take that legacy into the 21st century, with renovations and expansions to the U-M facilities and programs that serve adult patients during their most severe psychiatric episodes.
The University’s Board of Regents today approved a project that will remodel, and add the capacity for three additional beds to, the existing 22-bed inpatient psychiatric unit within University Hospital, allowing more patients to have private inpatient rooms. The project will also improve and expand facilities for patients who come to the hospital to receive electroconvulsive therapy (ECT), which can now be given on an outpatient basis.
At the same time that the physical space is overhauled, U-M has embarked on an innovative new approach to caring for hospital patients with psychiatric issues – both those in the inpatient unit, and those in other areas of University Hospital who have been hospitalized for physical health reasons, but also have mental health conditions.
The new approach, which has been tried at few hospitals around the country, centers on a team of “hospitalist” psychiatrists who specialize in treating only hospitalized patients with mental health issues.
The new efforts complement the outpatient care available at the U-M Depression Center, and at U-M’s outpatient psychiatry and addiction treatment center. All of these are based at the Rachel Upjohn Building on U-M’s East Medical Campus.
The inpatient unit also links closely with U-M’s Psychiatric Emergency Services, located at University Hospital, which is one of only two 24-hour emergency rooms in southeast Michigan for people in mental health crisis. U-M also has a 14-bed Child and Adolescent Psychiatry inpatient unit at C.S. Mott Children’s Hospital.
“This project represents a major commitment on the part of the U-M Health System to caring for the mental health needs of our community, and continuing our mission of improving care for patients everywhere through research and innovative practices,” says Gregory Dalack, M.D., interim chair of the Department of Psychiatry.
“Ultimately, this simultaneous overhaul of our physical space and our programs will allow us to truly provide a seamless continuum of high-quality care, from emergency to inpatient to outpatient,” says David Knesper, M.D., director of the Hospital and Community Psychiatry Section of the Department of Psychiatry. “This is especially noteworthy at a time when the number of psychiatric beds in our region has shrunk."
The programs provided on the inpatient unit have been developed along subspecialty lines including:
- those with mood disorders such as severe depression and bipolar disorder;
- those with thought disorders such as schizophrenia and psychosis; and
- older adults who have both severe mental and physical illnesses and need special geriatric-oriented inpatient care that can address all their needs at once.
In each of these focus areas, the physical renovation and programs are aligned, with care given by specialized teams that include psychiatrists, nurses, social workers and activity therapists.
The new “hospitalist” model for patient care means that the psychiatrists staffing these specialized areas will be able to spend more time focusing on the needs of patients with specific types of disorders. Part of their year will be spent treating patients on the inpatient unit, and part will be spent consulting with other doctors around University Hospital to treat mental health issues in patients who have been hospitalized for other reasons, such as heart disease or diabetes.
Patients experiencing other severe mental health episodes — for instance, related to personality disorders, eating disorders and obsessive compulsive disorders — will also continue to be treated in the renovated inpatient unit, as will patients who have drug- and alcohol-related problems.
The renovation will also allow a flexible number of patient rooms — up to four at a time depending on need — to be used as a secure “intensive care unit” or ICU for the most severely ill psychiatric patients. This approach will allow such patients to be hospitalized separately from other less-severely-ill psychiatric inpatients, and to receive intensive care from a dedicated team.
Physical enhancements to the inpatient unit will also include a library and computer stations for patients to use; a more welcoming and “open” feel with wood trim and fewer barriers; enhanced laundry, dining and activity rooms, informal gathering places for patients and visitors; direct access from the unit to an existing gymnasium for exercise; and larger medication preparation areas.
The renovation will also enhance safety and security, with better video monitoring and more options for managing the flow of patients, including the flexible size of the ICU area.
Meanwhile, patients who come to the hospital for a series of outpatient ECT treatments will have their own separate area, with better amenities and a separate entrance.
U-M has one of the nation’s largest and most experienced ECT programs, providing a safe and effective option to many patients who have not gotten relief from severe depression despite trying numerous medications and psychotherapy sessions. Vagal nerve stimulation is available for severe situations where ECT does not provide relief. U-M is also heavily involved in research involving transcranial magnetic stimulation and deep-brain stimulation.
Beyond the physical enhancements to the hospital space, Knesper predicts that the new model for caring for patients will enhance each patient’s experience, reduce the amount of time they need to stay in the hospital, and reduce the risk of future psychiatric crisis, rehospitalization and suicide.
Another improvement aimed at enhancing continuity of care for patients is a new Transition Clinic. When the most appropriate continuity of care plan cannot be achieved in a timely manner at the time of discharge, the clinic provides immediate, interim care until more permanent outpatient providers become available. According to Knesper, keeping recently discharged patients from "falling through the cracks" is one major means of preventing suicide.
For more information on the project and all of U-M’s psychiatric care, visit www.psych.med.umich.edu.
Donations are now being accepted to help pay for amenities in the inpatient unit, including computers and exercise equipment; visit www.psych.med.umich.edu to give online.
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