Clinical Care
The Child and Adolescent Psychiatric Hospital (CAPH) has been an integral part of the University of Michigan Medical Center since its founding in 1956. It provides inpatient, outpatient, and consult-liaison services that support a network of clinical training programs and psychiatric research programs. It has trained mental health professionals and produced clinical research that have shaped the field for almost 50 years.
The Child and Adolescent Psychiatry Inpatient Program serves children and adolescents in need of acute psychiatric hospitalization. The patient composition is approximately 65% adolescents and 35% children. The inpatient program has over 400 admissions a year with an average length of stay of one week. The program provides acute crisis intervention and stabilization, comprehensive diagnostic evaluation and treatment planning for initial and recurrent psychiatric disorders, and consultation by pediatric, surgical, nutritional, and other specialists. It uses multidisciplinary teams consisting of child and adolescent psychiatrists, clinical psychologists, psychiatric nurses, social workers, special educators, occupational and recreational therapists, and speech and language pathologists. The teams have expertise in assessing and managing suicidal risk, homicidal ideation, and psychotic symptoms, along with complex diagnostic and psychosocial issues. Treatment often includes individual, group, and family therapy; behavior therapy with parent guidance; pharmacotherapy, educational programs; and occupational and recreational therapy. As a tertiary care center, the inpatient program also provides specialized treatments for the most severe forms of psychopathology in children and adolescents. These include pharmacotherapy and electoconvulsive therapy for treatment resistant disorders, an eating disorders protocol involving adolescent medicine and other specialties, and a rooming in program for very young, developmentally delayed inpatients and their parents.
The Child and Adolescent Psychiatry Outpatient Program consists of a General Clinic and three specialty clinics, the Developmental Disorders Clinic and the Aspergers Syndrome Clinic, and the Obessesive-Compulsive Disorder Clinic, that together provide a spectrum of services for children and adolescents with a broad range of behavioral, emotional, and learning difficulties. Referrals are frequently made to the General Clinic for attention-deficit and disruptive behavior disorders, learning and communication disorders, and anxiety and mood disorders. Other referrals to the General Clinic include those for tic and stereotypic movement disorders, mental retardation and pervasive developmental disorders, feeding and eating disorders, alcohol and other substance related disorders, schizophrenia and other psychotic disorders, and problems related to abuse, neglect, divorce, and other stresses. Referrals to the Developmental Disorders Clinic are specifically for autistic disorder and other pervasive developmental disorders and for behavioral and emotional problems related to mental retardation, fragile X syndrome, Down’s syndrome, and chromosomal abnormalities. The Neuropsychology section and Speech and Language Pathology provide assessments of intelligence, personality, academic achievement, speech and language, motor proficiency, and adaptive functioning.
The outpatient program annually provides approximately 1150 outpatient evaluations and 11,000 return visits. Outpatient services include an array of psychosocial and pharmacological treatments. The program provides integrated services with the Huron Valley Child Guidance Clinic for children and adolescents from low-income families in Washtenaw County. Consultation for diagnostic and treatment issues is provided to pediatricians, family physicians, psychiatrists, and other mental health clinicians throughout the region. Consultation and inservice training to schools and other agencies are provided by several clinicians.
The Consultation-Liaison Program provides consultation-liaison services to pediatric inpatients at the C. S. Mott Children’s Hospital and to students at local elementary schools. Referrals are frequently made to the program for pediatric inpatients with depression and suicidal behavior, delirium and substance-related disorders, eating and feeding disorders, somatoform and factitious disorders, and psychological factors affecting a medical condition. Interdisciplinary conferences bring together clinicians from Behavioral and Developmental Pediatrics, Child Behavioral Health, Child and Adolescent Psychiatry, Social Work, and ancillary services.