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Harbor Oaks Hospital provides in-patient and partial hospitalization psychiatric care for adults and adolescences struggling with behavioral health issues. Specifically, the New Baltimore-based facility has a Specialized Inpatient Pediatric Unit (SIPU), which offers unique support for children with an autism spectrum diagnosis or a developmental disability who are in crisis and are in need of an acute short-term inpatient care.
Krystal Armstrong, Clinical Operating Officer for Harbor Oaks, says the SIPU program was designed as a safe place for kids with developmental disorders to stabilize the crisis and develop a safety plan to discharge to a lower level of care.
While some of Harbor Oak’s patients come from personal referrals, most of the kids who enter the facility have come from an emergency room, where they have had a significant incident and their available resources are no longer working.
“Our families are typically at the highest level of frustration and all other less restrictive interventions have failed,” Armstrong says. “Our plan is to stabilize the crisis and plan for discharge.”
Harbor Oaks uses a 2:1 staffing ratio on this unit. Most psychiatric units have a 4:1 or 5:1 ratio. Armstrong says the lower ratio allows the staff to provide more attention to the kids they support.
Harbor Oaks SIPU also has a Board Certified Behavior Analysts on site who provides concepts and skills of Applied Behavior Analysis therapy to the patients on the unit. Applying technique grounded on changing behaviors of social significance can help increase the level of functioning and decrease the inappropriate behaviors that have led to admission. Devising a behavioral intervention plan to incorporate replacement behaviors, providing parent training, and coordinating with providers and supports is the core of the programming on SIPU.
“We are also honored to have Registered Behavior Technicians (RBT) that have completed coursework and passed the state boards to treat the patients and collect data in the process to individualize the care for the patients,” Armstrong says. “If we have a kid that is actively aggressive, the RBT is equipped to count the frequency and measure the duration so that when it’s time to institute a behavior plan, we will have baseline data. By discharge, there should be a decrease in the behaviors that led to the admission. ”
Each day of their stay, the patients have a schedule to follow, which includes daily hygiene, breakfast and group or individual therapy with a behavior health clinician. Other activities include encounters with the behavior analyst, school teacher, and recreational/art therapy (which tends to be the most popular activity).
Family is an important part of the patient’s treatment, Armstrong says.
“We work with the parent from admission. We learn from them what the patient likes, doesn’t like, what triggers their behavior and other information. With their help, we aren’t stepping into working with the patient blindly and starting from scratch,” Armstrong says.
The behavior analysts and therapists work with the families to make sure they understand the treatment plan and can follow it, but they also provide ample opportunities for families to see their children.
“Traditional psychiatric hospitals have strict visitation policies, but our visitation is flexible. We need advanced notice that a family plans to visit, but we want to have visitation times that work for the family,” Armstrong says. Some families come from a distance, work during the day or have other circumstances that prevent them from being available at very specific times, she adds.
Armstrong says Harbor Oaks will also allow video conference visits, such as Skype, along with telephone calls if that works best for the family.
The typical length of stay at Harbor Oaks is between seven and 14 days, Armstrong says. Patients who need more assistance are placed in long-term care facilities and others, who have improved since admission, are discharged to their families – who go home with support.
“We have a 72-hour follow-up discharge call. We call the family within 72 hours of discharge with the purpose of asking questions to find out how the patient is really doing,” Armstrong says. “We identify whether or not the family needs additional resources, (has) questions about the behavioral plan, etc., ” Armstrong says.
Harbor Oaks is located at 35031 23 Mile Road in New Baltimore. For more information, call 866-258-3079 or visit harboroaks.com.