As the need for mental health services continues to increase for every age group, Anne Arundel Medical Center has been taking steps to ensure patients in the region get the tools they need to better understand and cope with their conditions.
Behavioral health programs are an important part of patient care at AAMC. “There have been advances in psychological, medical and physiological research that have led to new ways of thinking about health and illness,” said Dawn Hurley, executive director of behavioral health. “(We) know more and more about the understanding of the mind-body behavior relationship as it dramatically changes medical assistance and practices.”
Mental health conditions are one of the most common leading causes of disability in the country. “It is estimated that 1 in 4 individuals are affected by one or more mental health conditions at any time in their life,” she said.
Last year, the Annapolis-based facility opened up a psychiatric day hospital — an intensive treatment program run during regular business hours for adults and adolescents ages 13 and up featuring clinical, diagnostic and mental health services. Designed for patients that are either transitioning from inpatient care or stabilizing a condition to prevent hospitalization, the program offers multiple services, including group and individual therapy sessions and medication management monitoring.
A majority of the cases thus far have been depression and anxiety disorders, but staff has also treated patients with bipolar disorder, schizophrenia and obsessive-compulsive disorder.
Donna Phillips, the hospital’s clinical director, believes the number of cases continue to rise because the stigmatization around mental illness has decreased over the years while environmental stressors such as social media, bullying and school and work issues and other factors have increased.
Hurley noted the medical/behavioral health profession has improved over the last decade in screening and diagnosing issues earlier. “Being able to screen people early on for this disorder shows an increase in the rise of this condition,” she said. “I don’t think (a mental health issue) is something new. Thirty years ago people still had mental illness. I think we are just better now at documenting it.”
The psychiatric day hospital takes referrals from a variety of different providers such as inpatient, medical and psychiatric. Two teams, one for adults and another for adolescents, look over the referrals, which can be lengthy. “We want to know as much as possible about that patient,” Phillips said.
Additional information may be collected and a patient assessment is scheduled. “We try to make it as quick as possible,” Phillips said. “It is usually within the first two days (of receiving the referral).” During the first meeting, patients are seen by the lead clinician for a psycho/social assessment, a nurse for a medical assessment and Phillips and the appropriate psychiatrist for a diagnostic evaluation.
Patients rate themselves from 1 to 10 on a depression and anxiety scale during admission, a week into the program and at discharge. “Each person develops a treatment plan where there are specific goals that are associated with the problems they came in with and so we work with them on those goals on a daily basis,” Phillips said.
The average length of stay for adolescents is usually about 10 days while adults average about six to eight days. “It does vary depending on the acuity of symptoms so it is very individualized,” Phillips said.
The hospital can serve up to 12 adults and 12 adolescents at a time. Thus far, it has operated at about 70 percent capacity. “I’ve been surprised at how underutilized the program has been,” Hurley said. “…It is a very intensive program more so than your typical out-patient program.”
Because a majority of patients first turn to their primary care doctors for treatment, AAMC has started embedding some of mental health clinicians into a few of their primary care settings around Annapolis area so they can be the first point of contact.
The focus on behavioral health programs has taken place under the leadership of AAMC CEO and President Victoria Bayless, who has held both those jobs since 2011 and has led the hospital through a period of great growth.
AAMC also has Pathways — a substance abuse and addiction recovery program for teens and adults. This year marks its 25th year of service to the community. The center has also filed a Certificate Of Need to the Maryland Health Care Commission in the hopes of building a 16-bed inpatient adult mental health hospital.
Hurley said a reviewer has been assigned and officials hope to hear in the fall if the certificate will get a hearing or be approved. The hospital will be built near the Pathways location. “Our goal is to have a one-stop shop campus there,” Hurley said. “A whole mental health campus where there is just no wrong door. That is our motto. Where one patient can come through one door and get all the treatments they need for their behavioral health concerns.”
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