What to Expect
On the day of admission, our priority is assuring that you and your child have a safe and comfortable transition into the unit. Typically, you will be asked to return the following day to attend a formal admission meeting. This provides the opportunity for you, your child, and the medical treatment team to meet each other and discuss your child’s medical history and current illness. This is a critical step as we rely on the information you and your child provide to help design an appropriate treatment plan.
On average, the formal admission meeting lasts two hours, so please plan accordingly.
Who We Treat
At the University of Michigan Child and Adolescent Inpatient Psychiatric Unit, our patients range from 4 to 17 years of age. We treat children facing all types of mental health issues, including depression, bipolar disorder, Attention Deficit Hyperactive Disorder (ADHD), autism, psychosis, eating disorders*, Post Traumatic Stress Disorder (PTSD), substance abuse, and others.
*U-M’s Comprehensive Eating Disorders Program, located within C.S. Mott Children’s Hospital, provides additional levels of treatment for individuals 8-24 years of age, including partial hospitalization and intensive outpatient treatment. Call 877-475-MOTT to learn more.
Your Child’s Medical Treatment Team
Our healthcare providers work as a team to help ensure that your child is evaluated and treated in the most effective and efficient way possible. Your child will be cared for by a treatment team made up of a number of dedicated professionals, including:
- An attending psychiatrist oversees each patient’s team and is responsible for guiding your child’s treatment and accomplishing the treatment goals.
- Psychiatric residents and fellows are medical doctors who, under the guidance of the attending psychiatrist, manage your child’s medication and treatment planning.
- Social workers are the main communication contact for the family. They facilitate family sessions and assist in helping set up your child’s aftercare program.
- Activity therapists (ATs) specializing in Occupational Therapy (OT), Recreational Therapy (RT), and Music Therapy (MT) facilitate groups that explore emotions and behaviors, teach new coping, work, and interactional skills, and coordinate fitness and leisure activities. Dialectic Behavioral Therapy (DBT) and Cognitive Behavioral Therapy (CBT), which are described later in this booklet, are some of the techniques that ATs use.
- Learning specialists interact with patients in a diagnostic classroom where individual and group instruction is provided; formal academic achievement testing is completed when indicated. Classroom behaviors are assessed and interventions are implemented. Adolescents generally work on assignments from their schools, while younger patients are provided individualized learning tasks for assessment purposes. After obtaining your consent, learning specialists will communicate directly with your child’s school staff at the time of hospital admission and at hospital discharge. In addition, they may obtain school records and school staff observations/concerns to share with the treatment team. When necessary, learning specialists will actively advocate for your child’s educational needs; in some cases, a comprehensive education evaluation containing detailed recommendations will be provided to your child’s school staff.
- Psychiatric nurses are directly involved in your child’s treatment. Trained in therapeutic crisis intervention and in maintaining safe environments, psychiatric RN’s assess and support your child’s mental health needs, provide educational and therapeutic work, and monitor for any medication side effects.
- Registered Dieticians are available to consult with patients and families needing information to make healthy food choices.
- Psychiatric Care Workers (PCWs) are trained in mental health and therapeutic crisis intervention. Under the supervision of psychiatric nurses, PCWs assist in the care of patients.
- Consultative Services — If your child has other medical conditions that need attention, your child’s doctor will consult with other medical specialists to provide a holistic approach to treatment.
Your Child’s Treatment Plan
Your child will receive an individualized treatment approach during hospitalization. Since each child has unique needs, each will receive a personalized plan for education, information, and treatment. This plan is likely to include some combination of medication and psychotherapy (talk therapy).
Medication is a proven tool in the treatment of a variety of conditions including anxiety, depression, psychosis, agitation, and insomnia. While your child is in the hospital, the medical staff will determine whether medication would be a helpful part of the treatment plan, and your child’s doctor will discuss these recommendations with you. Your consent is required before any medication is started. Your child’s doctor will provide you with a detailed description of each prescribed medication, including common side effects.
Throughout your child’s stay, you will be asked to participate in family therapy sessions to address concerns and interactions within the family. Family therapy often includes a focus on problem solving, parenting skills, and building better communication.
Two psychotherapy approaches often used on the unit are Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT):
- Dialectical Behavior Therapy (DBT) is used to treat emotional and behavioral difficulties, including self-injury and suicidal thoughts or behavior, depressed mood, and the questioning of self-worth. DBT aims to decrease certain behaviors and reactions that can increase symptoms, including: • confusion about oneself • impulsivity • emotional instability • interpersonal problems, including peer group and family issues DBT also helps patients build useful skill sets, including mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. DBT will help your child begin to learn how to view situations from multiple perspectives, accept change, and understand the dangers of “all or nothing” thinking.
- Cognitive Behavioral Therapy (CBT) takes a practical approach to help individuals change those patterns in their thoughts or behavior that make it difficult for them to feel or function well. Through CBT’s strong focus on the present rather than the past, the treatment team will help your child identify and transform distressing or nonproductive thoughts that may lead to depressed feelings. Your child will also learn to develop effective problem-solving strategies and coping skills and will be encouraged to take part in enjoyable activities.
Electroconvulsive Therapy (ECT)
ECT is a treatment for certain cases of depression and a variety of other illnesses that is performed at the main University Hospital. ECT involves applying a brief electrical pulse to the scalp while the patient is under anesthesia. The majority of our patients who receive ECT have already discussed this treatment option with a healthcare provider before their admission and planned to receive it during their stay with us. If your child will be receiving ECT treatments, we encourage you to accompany them to the treatment area, where you can meet the ECT doctor, staff, and anesthesia team, ask any questions, and help your child prepare for the procedure. You may also wait for your child there during the procedure and recovery period.
Our goal is to provide a safe environment for every child on the unit. A number of precautions have been put in place to keep the unit safe for patients and staff, including a regular schedule for monitoring patient safet, and rules to guide which items your child can bring onto the unit.
A staff member is assigned to check on patients every 15 minutes around the clock. Patients who are unable to keep themselves safe or who pose an immediate risk to others will be monitored on a one-on-one basis.
All items brought onto the unit must be checked by a staff member before you can give them to your child (see lists of safe and unsafe items at right). Please give any items to the clerk upon entering the unit.
We will also talk with you about important measures to take at home to make it a safer environment for your child after discharge.