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Harbor-UCLA Medical Center plans for state’s first teenage psychiatric ER

The center will employ doctors and psychiatrists trained to specifically address psychological issues teenagers and children face, including aggression, suicidal thoughts or actions and early signs of psychosis. (Courtesy of Ira Lesser)

By Celia Janes

Feb. 22, 2018 11:49 p.m.

Doctors at Harbor-UCLA Medical Center are working to open California’s first teenage psychiatric emergency room.

The center will employ doctors and psychiatrists trained to specifically address psychological issues teenagers and children face, including aggression, suicidal thoughts or actions and early signs of psychosis. Ira Lesser, chair of the psychiatry department at Harbor-UCLA, said the center should be ready to open in less than two months.

Lesser said after working at an adult psychiatric ER, he thought adolescent patients would benefit from a psychiatric ER tailored to their specific needs.

“We felt that teenagers and children with psychological issues could best be assessed and treated if they had a space that was dedicated for their care,” he said.

Marcy Borlik, the program’s co-director, said hospitals currently only determine whether or not a child who enters the ER should be hospitalized. The new center will provide a comprehensive psychiatric screening, followed by an evaluation with a child psychiatrist to determine the best method for long-term treatment, regardless of whether or not the child is initially hospitalized.

“We’re going to take an extra step and make sure each child receives a therapeutic intervention, whether they go to the hospital or whether they go home,” she said.

Borlik said the facility’s goal is to reduce unnecessary hospitalization and help adolescent patients receive the care they need outside of an emergency setting. By providing more comprehensive screenings early on, the patients’ families have the opportunity to seek treatment without the additional stress of hospitalization, she said.

Patrick Kelly, the unit’s co-director, said teenagers and children receive more specialized and individualized care if treated in a separate unit.

For example, an aggravated 6-year-old boy one time entered the pediatric ER in handcuffs, he said. Rather than responding with additional aggression, the pediatric nurses spoke to him in a calming manner.

Kelly said this method of dealing with children provides a calming environment that helps prepare a child to receive therapeutic intervention. A facility with staff trained to work with a younger age group will help patients feel more comfortable, he added.

Borlik said she thinks psychiatric ERs often serve as the point of entry into the mental health system for aggressive and suicidal teens. The center plans to focus on long-term therapeutic intervention in addition to emergency mental health treatment, she added.

Kelly added he hopes society’s increasing awareness of and efforts to destigmatize mental illness will encourage adolescents to reach out for help before they reach the point where they need to go to the ER.

Lesser said he wanted to help create a psychiatric ER dedicated to adolescents because teen suicide rates are rising, and suicide is the third leading cause of death among teenagers in the United States. Kelly said he thinks many factors, including the influence of social media, have contributed to the increase in teen suicide.

“Although it’s good that people are destigmatizing these issues by talking about them, if you don’t do that in a careful way, it can lead to more problems,” he said.

Lesser said the program’s directors still need to obtain a license from the state before it can open. He added he hopes other hospitals in the state follow Harbor-UCLA’s lead and replicate the program.

“We want to give these kids access to a good experience with people they can trust, and I think if we do that we’ll be doing an excellent job,” he said.

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Celia Janes
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