With a sick child, it’s not always only a medical issue that needs professional attention. Often, there are concurrent psychological issues that warrant treatment.
That could be a child undergoing cancer treatment who is actively suicidal, a kid with stomach ailments who also deals with anxiety, and a diabetic who doesn’t maintain personal medical care. Typically, both issues are treated separately.
The team of health care professionals at Hasbro Children’s Hospital Medical/Psychiatric Inpatient Program has addressed all of these cases. Rhode Island’s Bradley Hospital and Hasbro Children’s Hospital joined forces last year to open a new medical psychiatric inpatient program to treat both psychological and medical issues for children and adolescents. The program launched in October 2012 is housed in a newly renovated secure eight-bed unit on the sixth floor at Hasbro. The unit features private and semi-private rooms and areas for family, group and milieu therapy, according to a news release.
“We have the ability to engage multiple doctors’ care including specialty services,” says Matthew Willis, M.D., medical director of Hasbro Children’s Hospital Medical/Psychiatric Inpatient Program. “Another facility might require them to be medically cleared before they would treat them.”
A team of health care professionals treats children ages six to 18 who come in for care at the unit. That team includes a psychologist, several LISCWs, nine milieu therapists, about 20 nurses, dieticians and one M.D., with another joining the team soon, Willis says. Patients will also see pediatric specialists in the hospital if needed. “The unit as a whole is for kids who are medically stable…but have medically complex issues.”
Children admitted to the unit meet psychiatric criteria for care but it’s specific to kids with some kind of medical condition, says Kristie Puster, Ph.D., the psychologist for the unit. “We’re a great option if folks need inpatient hospital care but have kids who have chronic medical issues,” she says. For example, a child receiving cancer treatment who was actively suicidal came into the unit and received chemotherapy, was put on suicide watch and also received psychological care, according to Puster.
According to the news release, the program is the first of its kind in the region. The unit combines Bradley Hospital’s expertise in treating psychiatric issues with Hasbro providing space and medical staff, says Willis.
Puster adds that the program focuses on creating a therapeutic environment for the patient and providing family therapy services as well.
“Our program offers the ability to tease out medical versus psychiatric issues,” says Willis. “It provides clarification over time… and ultimately makes it easier for psychologists to treat patients and make (emotional and medical factors) clear to families.” He says the program gives credibility to the idea that emotional factors drive medical symptoms, which “can lend clarity for families.”
Willis says families usually understand the medical issues their child is facing, but often do not understand the emotional factor, which can “leave psychologists sometimes handicapped in treating” kids with both symptoms. The program allows the team to show families “that it can be both… that yes, your child can have specific medical pathology that we can elucidate. We want families to understand that that doesn’t explain the whole picture. There is a certain level of comfort and credibility that comes with hearing that from a pediatrician.”
By Rivkela Brodsky