VPH Child Mental Health unit stabilizes and plans continuing care - Plattsburgh (NY) Press Republican

By: Jeff Meyers Staff Writer

PLATTSBURGH — Sometimes all a kid needs is a little hope; sometimes it's a lot more complicated than that.

Inpatient services at the Child and Adolescent Mental Health Unit at CVPH Medical Center offer support for children age 6 to 18 who are experiencing any of a wide range of mental illnesses.

"What we are trying to do is get the child stabilized," said Dr. Diane Zuniga, director and lead psychiatrist for the unit. "Our job is to get the (treatment) process started and then use our outpatient-referral system to ensure continued care."

Children typically enter the unit through the hospital's Emergency Department, though some also come with referrals from pediatricians or family doctors.

"The most common thing we see is when the child is suicidal or may have made an attempt at suicide," Zuniga said.

"Another is when a child is incredibly violent with siblings or parents. We're here to keep the child and the family members safe."

The typical length of stay is between seven and 10 days, depending on how the child responds to therapy while in the hospital.

But a child is never released unless the staff believes he or she is ready to return home and has follow-up care awaiting that return.

"A lot of times, we'll get kids who have been undiagnosed for a long period of time," Zuniga said. "Once an accurate diagnosis is made, managing the child on an outpatient basis can be much easier."

When a child is admitted to the 12-bed unit, Zuniga initiates care with full physical and neurological exams to pinpoint any physical problems that may be contributing to the mental condition.

Then she works with a treatment team — which can include parents, school officials, physicians, therapists and representatives from Social Services or Probation — to develop a treatment program for each patient.

"We look at different kinds of social issues, what's keeping them from getting the care they need. We'll talk about medications, about their outpatient needs, educational needs. We'll work with the kids, see if we can identify attention problems, whether they relate well with other kids."

A lot of attention focuses on the child's schoolwork. The staff tries to keep them on task so they aren't behind when they do get back to class, Zuniga noted.

"We'll deal with anger management, with social skills, behavioral management. We try to find a way to help them become more independent.

"And we'll help families figure what they need to do" when the child does return home.

Parents do play a large role in the process, she added. For instance, there's the responsibility for making sure the child receives the right medications at the right time.

Staff members work with children individually and in group settings. Typically, younger children spend their group sessions together in one area while teens are together in another.

LIMITED ROOM
Major areas of concern include depression, attention deficit/hyperactivity disorder, bipolar disorder and anxiety issues, though the gamut of mental illness is as complicated as the treatments for each specific kind of disorder.

The unit is filled much of the time, and patients often have to be referred to other facilities in Ogdensburg or Saratoga.

But since the family is such an important part of treatment, it is always the best option to keep a child closer to home, Zuniga said.

About one-third of patients admitted to the unit eventually come back a second time, she added.

"Some don't follow up (with outpatient care) as they should, and some have severe mental illness that is going to need several hospitalizations to treat, similar to a medical illness like diabetes.

"Mental illness is not cured; it's managed."

MIND MAZE

This is the fourth of a seven-part series on children's mental illness.

Tomorrow: The cost of treatment.