Mental Health Services

ACUTE UNIT
The Acute Unit is a 30 bed locked inpatient unit which treats patients with acute psychiatric problems. The goals are accurate assessment and diagnosis, and a short term treatment plan designed to alleviate acute psychopathologic symptoms so that patients can return to the community or move to a less intensive setting safely.

All patients undergo a medical clearance before admission. Once admitted to the unit they are seen by an RN who completes a nursing assessment and develops a nursing plan of care. An interdisciplinary treatment team evaluates the patient within 24 hours and implements a treatment plan.

About half of the patients are admitted for detoxification from alcohol or drug abuse. These patients are monitored closely, particularly since many have other psychiatric or medical diagnoses. Nursing staff are very skilled in monitoring the need for appropriate medications and ensuring the patient's safety. There is a close working relationship with the Intensive Day Treatment Program, where many patients are referred once they have safely "detoxed".

Other patients may be referred in from community residential care homes or nursing homes because of an exacerbation of their psychiatric disorder. Again, staff are very skilled in assessing causes of exacerbation and making medication adjustments.

The unit is able to perform "restraint and seclusion" for very agitated patients. This happens rarely but is sometimes necessary for the safety of all on the unit.

The interdisciplinary team consists of a nurse manager, 7 RNs, 1 LPN, 10 PNA;s, a 0.5 time nurse practitioner, 2 psychiatrists, a social worker, recreational therapist, chaplain, dietitian, consulting psychologist, and a ward administrative clerk.

The unit provides the patients with a safe, structured milieu. As soon as the treatment team thinks that the patient is safe they are allowed to leave the locked unit.

GEROPSYCHIATRY UNIT
The Geropsychiatry Unit is a locked 35 bed inpatient geropsychiatry unit. The goal is to provide ongoing care and rehabilitation for chronic psychiatric patients in a secure and therapeutic environment. The interdisciplinary team consists of a psychiatrist, nurse manager, registered nurses, licensed practical nurses, nursing assistants, nurse practitioner, social worker, recreational and occupational therapists, and a nutritionist.

Patients are transferred to this unit either from acute psychiatry or one of the nursing home care units. Very occasionally patients are admitted directly from residential care homes or other VA hospitals. Candidates for admission to the Geropsychiatry Unit will not be suicidal, homicidal, or so acutely psychotic that they will disrupt the milieu. The unit does not have the capacity to do seclusion and restraint, and does not provide oxygen or intravenous therapy.

Most of the patients on this unit have some combination of schizophrenia, bipolar affective disorder, organic brain syndrome, and dementia. The age ranges from 40 to 101 years old. About two thirds of the patients are elderly. Many of our patients have chronic medical problems, such as chronic obstructive pulmonary disease, diabetes, hypertension, and seizures. Length of stay is usually several months to several years.

Treatment planning is done by the interdisciplinary team with the inclusion of the patient, at least every 90 days. If possible family members are also included.

The goals of treatment are to improve and maintain level of functioning and quality of life. Placement options include residential care, community nursing homes, or the VA nursing home care unit.

Supportive weekly small meetings are held to encourage patients to share their concerns. Patients are also encouraged to attend other activities in the hospital, such as the CSP program and the CWT program. Some of our patients see individual therapists as well.