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UMMC seeks approval for adolescent psychiatric unit

The University of Maryland Medical Center plans to build a 16-bed psychiatric unit for children and adolescents at its downtown campus, an application filed with the state health care commission showed.

The total cost of the project will be around $9.5 million and represents phase three of a four-phase plan for the medical center to modernize its psychiatric facilities between its two campuses.

“The University of Maryland Medical Center is committed to continuing to expand and enhance services that meet the timely needs of our community,” said Dana Farrakhan, the medical center’s senior vice president for strategy, community and business development. “These new psychiatric services will provide our young patients who need  psychiatric care the high quality and compassionate care that we value, while meeting their medical needs.”

There is a growing need for space to treat adolescents, the medical center said in describing why the new beds will be necessary. The new unit will replace a 12-bed unit for latency-aged children.

“There are not enough inpatient acute psychiatric beds for adolescent patients in the four counties (Anne Arundel County, Baltimore City, Baltimore County and Howard County) UMMC defines as its service area for adolescent psychiatry,” the application said. “The demand for services has increased. Discharges have risen by 5 percent since fiscal year 2016. At the same time, length of stay has increased 6.1 percent compounding the need for more beds. As a consequence, patients wait much too long for beds.”

In the last fiscal year, about 600 adolescents with some psychiatric need sought treatment at the UMMC children’s emergency room. Of those, the medical center said, 70 patients waited up to seven days to be admitted to an inpatient psychiatric facility. Another 45 patients waited up to 11 days for an inpatient bed before it was determined they were stable enough to be discharged for outpatient care.

The application said the children’s emergency room is not the best place for care for adolescents with acute behavioral treatment needs and such a practice could place patients and staff at risk.

“The current ‘care model’ is extremely inefficient,” the application said. “As a safety precaution, UMMC often must assign one or more hospital security officers as “sitters” for disruptive and often violent adolescent patients awaiting admission to an inpatient acute psychiatric bed.”

Physically, the project will be a gut renovation of part of a floor in the medical center’s North Hospital that was previously an adult inpatient psychiatric unit.

It has to be designed with some qualities that serve practical purposes but also can’t be a space that feels confining or institutional for the patients. Some of these qualities include: tightly controlled access to the space, surfaces that can withstand hard use and abuse, and limits on the number of hiding spaces.

The space must also provide a sense of privacy for the patients while encouraging social interaction.

This phase of the psychiatric project follows the second phase — renovating and expanding the adult inpatient unit at the hospital’s midtown campus. That phase is expected to be completed late this year.

The first phase, finished in April, involved removing or reducing ligature risks in all behavioral health areas. The fourth phase will be a renovation of the geriatric psychiatric facilities at the UMMC downtown campus.

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