Back to life: New psychiatric program helps patients get there

September 5, 2019  //  FOUND IN: Strategy & Leadership,

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Life. It’s going to work, attending school, raising children, caring for aging parents, spending time with friends and family, pursuing passions, enjoying hobbies. Life is different for everyone and, ideally, it’s filled mostly with good and meaningful things that leave individuals with a sense of purpose and happiness.

When illness strikes, life can come to a screeching halt, especially if the symptoms of that illness include negative thoughts and feelings that spiral out of control, sadness that robs you of your energy or paralyzing fear that prevents you from doing things you once loved. In the face of anxiety and mood disorders, everyday life can become a challenge.

According to the National Institute of Mental Health (NIMH), an estimated 17.3 million adults, or 7.1 percent of all adults in the U.S., had at least one major depressive episode in 2017. Of those, 11 million (4.5 percent of all U.S. adults) suffered severe impairment as a result. It is also estimated that 31.1 percent of U.S. adults experience an anxiety disorder at some time in their lives.

Unfortunately, these mental illnesses often go undiagnosed and untreated. Even with treatment, anxiety and mood disorders can escalate to a point where they disrupt life, limiting a person’s ability to perform at work, participate in relationships or focus in school.

Scheduled for success

The Adult Psychiatric Partial Hospitalization Program (PHP) at Michigan Medicine’s University Hospital was launched six months ago to help patients suffering from severe anxiety and mood disorders. PHP is an intensive treatment program that focuses on helping patients gain the skills, education and support they need to begin the healing process.

“The great thing about this program,” said Bradley Stilger, M.D., PHP medical director, “is that patients get to attend day-long treatment sessions and then go home at night to practice the skills they’ve learned in a real-life environment. This helps build and reinforce coping strategies and gives patients a chance to put new skills to work.”

Program hours are 9 a.m. to 3:30 p.m., Monday through Friday. Throughout the day, patients are scheduled to participate in different group modalities designed to enhance their coping skills. They receive process group therapy and skills-based therapies, including Cognitive Behavior Therapy (CBT) focused on goal-setting to change unhelpful thinking and behavior, and Dialectical Behavior Therapy (DBT) using mindfulness and dialogue to explore and resolve issues.

Patients receive education on nutrition, sleep hygiene, spirituality, sexual health and other topics that promote wellness. Each patient also receives individual therapy and medication management.

“Having the structure of a set place to be, with set hours and activity plans is really helpful,” said Kathi Voelkner, M.S.W., PHP clinical director.  “It’s also highly beneficial for patients to interact and work with other patients having similar experiences.”

“Each day concludes with a therapy group activity like visiting the gym or playing a game of bocce ball in the courtyard,” said Voelkner. “These physical group therapies help build confidence and encourage social interaction.”

New level of care

PHP offers patients a new level of care that falls between outpatient therapy and full hospitalization. The program is sometimes used to help hospitalized psychiatric patients transition back to life outside of the hospital. Other times, the program is used instead of hospitalization when that’s a more suitable approach for patients seeking treatment through Psychiatric Emergency Services, outpatient psychiatry practices, primary care providers and community service providers.

Stilger said patients, who must be referred by a therapist or physician to participate, typically complete the program in eight business days, but the decision to discontinue participation is a joint one between the patient and the treatment team.

“Most folks who come to us are impaired in their functional status in work or relationships,” said Stilger. “Our focus is to get them back to their pre-functioning state before they leave us.”

When patients are ready to leave the program, PHP faculty and staff take steps to ensure that their care continues.

“When a decision is made that the patient has improved to the point that they are ready for outpatient therapy, we make sure they’re connected to providers,” said Voelkner. “We want them to have a smooth transition to the next level of care.”

A need fulfilled

Michigan Medicine’s PHP was developed in direct response to a community need. According to Stilger and Voelkner, prior to the launch of the program, patients were often put on waiting lists at other facilities for as many as seven to 10 days.

“When people are in an acute state, they need to be able to get in somewhere within a couple of days,” said Stilger.

To date, PHP has served 164 patients. The average age of participants in the program is 35. On any given day, PHP faculty and staff see between 12 and 14 patients. They will strive to continue growing the program to achieve and maintain a consistent census of 18 patients each day.

“We want to offer this program to as many people as possible,” said Stilger. “We’re glad to be able to fill an important need in the community and help patients who may not have had access to these services otherwise.

“The people who come here are just like you and me,” he added. “They work, they have families. Our goal is to provide a high level of quality care to help these folks get back to their lives.”