New CHOP Facility Expands Mental Health Crisis and Inpatient Care in Philadelphia

Every day and night, children and youth in mental health crisis come to the Emergency Department at Children’s Hospital of Philadelphia (CHOP) for help. In that setting, there is little that busy ED physicians can do. The ED social work team, in conjunction with consults from the psychiatry team when indicated, will make a level-of-care recommendation and provide referrals consistent with that recommendation. However, the number of beds in inpatient psychiatric facilities in the Philadelphia area is woefully inadequate, so the patients with the most severe problems wait in the ED’s Extended Care Unit for days, sometimes weeks, before a spot for intensive inpatient therapy becomes available.

CHOP intends to improve that scenario by opening the Behavioral Health and Crisis Center in West Philadelphia, about 20 blocks west of the Main Hospital. It provides both immediate care for kids in crisis and inpatient care for those who need a longer course of treatment.

Crisis Response Center

The Crisis Response Center is a 24/7 walk-in facility that evaluates children 5 to 17 years old with immediate mental health needs. It provides intensive, short-term interventions to support youth and their families in managing immediate stressors and provide stabilizing strategies until the youth is safe to return home and move into outpatient therapy for follow-up care.

Crisis Stabilization Unit

Within the Crisis Response Center is a three-bed Crisis Stabilization Unit for youth who need additional time and treatment to be safe. The CSU will support and provide 24/7 intensive treatment and crisis stabilization for up to five days for children who can return to the community once stabilized.

Inpatient care

Inpatient psychiatric care is delivered for youth 7 to 17 years old who need more intensive treatment. Therapy uses a strengths-based model that builds on each child’s positive qualities to help them develop appropriate coping skills, improve social functioning and decrease maladaptive behavior so they can safely return to their homes and communities and continue care in an outpatient setting. We have 46 beds over three units. In addition to spaces for individual, group and family therapy, the floors have areas for quiet activities and bigger spaces for physical exercise.

The CHOP Behavioral Health and Crisis Center (BHCC) is staffed by our own psychiatrists, psychologists, a clinical pharmacist with additional training in child and adolescent psychopharmacology, social workers, psychiatric nurses, behavioral health clinicians, pediatricians, board-certified behavioral analysts, teachers, creative arts therapists, and recreation therapists. The spaces were designed to be welcoming, open and safe.

Core principles at the BHCC

Our core principles are consistently represented throughout the Behavioral Health and Crisis Center. These include:

• Recognition that families are at the core of their child’s treatment and recovery: This can include family therapy and family education opportunities, so parents/caregivers understand their child’s diagnosis and what is needed to put their child on a path to wellness and wholeness.
• Referrals and connections to ongoing outpatient care post-discharge: Follow-up care may be with a CHOP provider or with a community provider, but all patients leave with a plan for continuing care.
• Patient, family and staff safety is paramount: This includes controlled entry, lockers for personal items, and furniture and room designs that meet highest behavioral healthcare standards.
• Strengths-based treatment model that builds on each child’s positive qualities: We use a modified version of Positive Behavior Interventions and Supports adapted for crisis and inpatient use.
• Milieu-based therapy: Milieu therapy involves the environment, a structured day of group and individual therapy sessions, and patients and staff actively engaged in a community setting. All activities, like meals and recreation time, are seen as an opportunity for treatment.

CHOP’s Behavioral Health and Crisis Center aims to change the landscape and experience for pediatric patients requiring crisis stabilization or hospitalization for mental health and psychiatric conditions, placing an emphasis on hope and healing for both children and their families.

This center’s treatment is different than what most psychiatric and behavioral health facilities tend to offer; every CHOP team member shares the goal to build upon the strengths of youth in our care and their families, and to equip them with tools to help patients successfully return to daily lives at home, at school and in their communities.