health issues , for the benefit of both the individual and the community at large . The Adverse Childhood Experiences Study — a widely regarded collaborative research project — has linked childhood trauma with lifelong health and social consequences . Connecting those children with care is the tricky part : the U . S . Department of Health and Human Services reports that less than half of adolescents with psychiatric disorders received any kind of treatment in the past year .
Rady Children ’ s mental and behavioral health services are designed to meet the varied needs of patients . Within its framework are outpatient clinics , inpatient care , individual and group therapy programs , emergency and crisis intervention , school-based mental health services , autism services , and sleep disorder assessments .
When a child requires inpatient psychiatric care for conditions including depression , psychosis , anxiety disorders , and substance abuse , they ’ re referred to Rady Children ’ s 24-bed inpatient unit , known as Children and Adolescent Psychiatry Services ( CAPS ).
Ben Maxwell , MD , medical director of CAPS , says patients who are referred to the locked unit are considered a danger to themselves or others , and that a considerable number of them are suicidal . Patients typically spend five to seven days there working to stabilize their situations , whether through family dynamics , medications , or placement in the next level of care .
“ We work to take away whatever obstacles they might have ,” Dr . Maxwell says .
Working with children and adolescents requires a different approach to treatment . While a doctor treating an adult would rarely involve that patient ’ s family or workplace in the process , Dr . Maxwell says it ’ s vital to look closely at a child ’ s psychosocial considerations .
“ Kids are so dependent on their environment — their parents , their school , their community ,” he says . “ Kids are so influenced by all these aspects , it ’ s very important to engage all of these in treatment .”
Charles Wilson , MSSW , is a senior director in the hospital , overseeing a range of behavioral health departments including the Chadwick Center . The Chadwick Center for Children and Families is a component of Rady Children ’ s that serves children traumatized by child abuse , domestic violence , or neglect . He says that even when the ideal therapy for a child is identified , the demand for services can outpace available staffing and resources . For example , there ’ s often a four-month waiting list for trauma counseling , he says .
Philanthropy and a contract with the County of San Diego ’ s Health & Human Services Agency extends the reach of the Chadwick Center ’ s services , which include evidencebased medical , social , and therapeutic approaches .
Getting children the mental and behavioral health services they need is ultimately an investment in their future , Wilson says .
“ We ’ re on the front lines and if we do our job right , we can break the cycle . We can help change their life trajectory . We ’ re in the business of making nightmares go away .”
PILOT PROGRAM
Rady Children ’ s puts Crisis Stabilization Unit to the test
Every month in 2014 , the Sam S . and Rose Stein Emergency Care Center at Rady Children ’ s saw more than 150 children with acute mental health needs . The scarcity of available inpatient psychiatric beds creates a limbo for these young patients . Not immediately eligible for admission to a facility and not safe enough to return home , the patients must be held in an overstimulating emergency department until their symptoms are better managed . To add another layer of support for these patients , Rady Children ’ s has approval from the state for a one-year pilot of a Crisis Stabilization Unit ( CSU ) for children experiencing a mental health emergency . Patients can be kept here on a short-term basis to be assessed for further placement or intervention . The outpatient unit is staffed by a registered nurse , a psychiatric technician , a social worker , and an on-call psychiatric attending physician . The CSU frees up space in the emergency department while allowing the patient and their family a quieter place to develop a plan for care , according to Ben Maxwell , MD , medical director for Rady Children ’ s 24-bed inpatient psychiatric unit . “ They are generally calmer , and we ’ re able to spend a little more time with them ,” says Barent Mynderse , LCSW , director of the hospital ’ s behavioral health services . So far , the CSU has just four “ beds ”— in this case , four reclining chairs . Hospital executives hope to expand the unit to accommodate up to 10 patients . Ideally , an expanded CSU would include artwork , games , and electronics to help the children relax , and additional clinical staff support . The hospital estimates the expansion cost at $ 1.5 million , with additional funds needed annually to sustain the unit . To that end , the CSU will be the beneficiary of The 107th Anniversary Charity Ball , “ Heart of Gold ,” set for Feb . 20 at the Hotel del Coronado . More information about the charity event is available at charityball-sd . org .