Patient services

Adult psychiatric services

Yale-New Haven Hospital provides brief, acute inpatient care, detoxification from substances care, partial hospitalization and intense outpatient programs to adults ages 18 and over. A broad spectrum of psychiatric and substance abuse disorders are treated.

Inpatient treatment services for adults
Patients age 18 and older with psychiatric symptoms and dual diagnosis are evaluated and treated within the hospital's adult inpatient program. Children , adolescents and certain geriatric patients are treated within other programs geared to their unique needs.

General adult inpatient program
This brief, acute program treats patients who require comprehensive psychiatric evaluation and treatment to stabilize their psychiatric symptoms. Crisis intervention and individualized, structured treatment are provided to patients in need of an intensive and safe setting.

Staffing
A team model of treatment emphasizes assessment, brief treatment and crisis intervention, clinical case management and the initiation of rehabilitation. Members of the treatment team integrate biological, family systems, psychosocial and life skills approaches in treating the individual holistically and in helping patients achieve their goals.

Who is treated
Patients are admitted to this 24-bed unit for treatment of a variety of disorders, such as depression, bipolar disorder, psychotic disorders including schizophrenia, anxiety disorders including obsessive-compulsive disorder and other serious psychiatric conditions.

Clinical services may include:

• Comprehensive and multidisciplinary biopsychosocial evaluation, psychological and brief neuropsychological assessment; independent living skills assessment
• Crisis intervention and stabilization of the patient's acute psychiatric symptoms
• Psychopharmacologic evaluation and management
• Electro-Convulsive Therapy (ECT) when indicated
• Crisis-oriented family therapy and psychoeducation
• Cognitive-behavioral oriented therapy groups focused on symptom management and coping skills
• Occupational therapy interventions to promote independence
• Crisis management groups focused on acute life stressors
• Psychoeducational groups focused on psychiatric disorders, medication and recovery
• Case management and collaboration with the patient's outpatient clinician, physicians, family and community agencies to facilitate an integrated approach and establish comprehensive transition plans

Dual diagnosis and detoxification inpatient program
For patients who are diagnosed with both substance abuse disorders and psychiatric illness, Yale-New Haven Psychiatric Hospital provides inpatient treatment and detoxification.

The program is a 25-bed acute care unit providing brief treatment for patients, ages 18 and older, who require comprehensive psychiatric/substance abuse evaluation and stabilization of their psychiatric symptoms and substance abuse. The program specializes in treating patients suffering from a wide range of psychiatric disorders compounded by substance abuse.

Full attention is given to both problems. Our clinical approach is tailored to address the interaction of the substance abuse and the psychiatric problem. The programs recognize the wide range of motivation and awareness of each patient and utilize creative and flexible interventions to achieve treatment goals.

Inpatient detoxification is also provided for patients with primary substance abuse disorders who only require detoxification from substances.

Treatment model
A team model of treatment emphasizes assessment, brief treatments and crisis interventions, clinical case management and the initiation of rehabilitation. Members of the treatment team integrate biological, relapse prevention and life skills with 12-step recovery, crisis intervention and social developmental orientations to support the patient in achieving his or her goals.

Helping patients learn new and more effective ways to handle triggers is a critical function of the program. Moreover, the dual diagnosis programs assist in the coordination and development of the participant's network of community providers and available recovery-related supports.

Staffing
Psychiatrists, psychologists, social workers, occupational therapy staff, therapeutic recreational specialists, nurses and counselors staff the programs. The multidisciplinary staff is able to address the many facets of addiction and psychiatric illness using a range of services including pharmacotherapy, case management, group therapies, skill-building groups and crisis intervention.

Clinical services may include:

• Comprehensive and multidisciplinary biopsychosocial and spiritual evaluation; psychological and brief neuropsychological assessment and independent living skills assessment
• Stabilization of the patient's acute psychiatric symptoms and substance abuse
• Detoxification from substances
• Crisis intervention focused on acute life stressors
• Psychopharmacologic evaluation and management of psychiatric and substance abuse problems including alcohol and drug detoxification
• Electro-Convulsive Therapy (ECT) when indicated
• Family psychoeducation and crisis oriented family therapy to address familial problems that impact on the patient's ability to become and remain psychiatrically stable and abstinent from alcohol and drugs
• Psychoeducational groups to encourage the patient's commitment to change problematic behaviors and to teach patients about their psychiatric disorders, addictive behaviors, health concerns and risks and prescribed medications
• Activities that support recovery (12 Step meetings, religious services or supports, spirituality group)
• Psychosocial and occupational therapy promoting the teaching of relapse prevention skills
• Case management and collaboration with the patient's outpatient treaters, family, physicians and involved community agencies to (1) facilitate an integrated approach, (2) establish comprehensive transition plans and (3) promote the patient's optimal functioning

Adult ambulatory service: partial hospitalization and intensive outpatient programs
Adult patients who do not require the level of supervision and support provided by an inpatient program, but who need more intensive intervention than is readily provided in most outpatient settings, are treated within these intensive ambulatory programs. Most patients are admitted for treatment of mood disorders, anxiety disorders, chronic suicidal ideation, co-occurring disorders (psychiatric and substance abuse disorders), personality disorders and family/interpersonal conflicts.

Partial hospital program
The partial hospital program is the most intensive level of ambulatory clinical care for patients.

Patients are in treatment for four hours per day up to five days per week and become eligible for this level of care when their day-to-day stability is threatened by severe psychiatric and substance abuse problems. Partial hospitalization helps patients safely manage their psychiatric and substance abuse problems on an outpatient basis. The program helps reduce and resolve acute psychiatric symptoms.

Clinical services may include:

• Comprehensive and multidisciplinary biopsychosocial and spiritual evaluations; psychological and brief neuropsychological assessment; independent living skills assessment
• Crisis intervention focused on acute life stressors
• Group therapy to help identify and manage interpersonal problems that contribute to a higher relapse risk
• Cognitive behavioral skill-building groups focused on affect regulation, stress management and problem solving to promote independence
• Relapse prevention groups to provide psychoeducation and teach implementation skills
• Family and couple's therapy and psychoeducation
• Promotion of medication and treatment compliance
• Psychopharmacologic evaluation and management as needed
• Case management and collaboration with the patient's outpatient treaters, family, physicians and any other community agency to (1) facilitate an integrated approach, (2) establish a comprehensive transition plan and (3) promote the patient's optimal functioning
• Enhancement of the patient's commitment to change problematic behaviors and to follow up with aftercare plans

Intensive outpatient program
Designed for patients ages 18 and older, this full outpatient assessment and treatment program is for the patient who has achieved some stability but continues to need more intensive treatment than traditional outpatient therapy. Participants attend the program less than four hours a day and typically less than five days per week. The structured group therapy and case management program is for patients who are still struggling with psychiatric symptoms or co-occurring disorders and may be at risk for relapse.

Clinical services may include:

• Comprehensive and multidisciplinary biopsychosocial and spiritual evaluation; psychological and brief neuropsychological assessment
• Crisis intervention and case management to help patients safely manage their psychiatric or co-occurring disorders on an ambulatory basis with increasing self and community support reliance
• Family and couple's therapy and psychoeducation
• Cognitive behavioral groups that focus on continued development of relapse prevention, coping and problem solving skills
• Group therapy that actively addresses the interpersonal problems that contribute to the patient's ongoing psychiatric problems and co-occurring disorders
• Psychoeducational groups that strengthen the patients' commitment to change problematic behaviors
• Medication consultation to community psychiatrists and other physicians prescribing phamacologic treatments for patients and promotion of medication compliance
• Discharge planning and collaboration with the patient's outpatient treaters, physicians, family and community agencies to facilitate an integrated approach and to establish comprehensive transition plans that promote the patient's optimal functioning

Treatment tracks

• General adult track for patients with depression, anxiety and psychiatric problems
• Dual diagnosis track for patients with psychiatric and substance abuse disorders.
• Specialized Dialectical Behavioral Therapy (DBT) track for patients who struggle with chronic patterns of suicidal or other self-destructive behaviors, including substance abuse.
• DBT for substance abuse (DBT-S) is provided for patients who struggle with substance abuse and other self-destructive behaviors

Last revised: December 8, 2004 (jj)

Home page URL: http://www.ynhh.org

All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.