A Look Into 7 North

1
A Look Into 7 North
2
Where I Worked

• Second oldest Psychiatric hospital in the nation
  (established in 1894)
• Private
• Sits on over 200 acres and has 11 inpatient units

3
7 North

• The adolescent unit (ages 13-18)
• Full range of diagnoses

4
The Staff

• Psychiatrists, Psychologists, Social Workers,
  Nurses, Discharge Planner, Activities Director,
  Mental Health Workers, and Volunteers
• Separate responsibilities
• Team effort towards a common goal

5
My Role

• As part of the treatment team
• Along-side the Mental Health Workers
• In a unique position

6
How Someone Ends Up In A Psychiatric Hospital

• Voluntary vs. Involuntary Commitment
• Change in criteria over the past 40 years
• Can be hard to determine
• Current criteria for involuntary commitment
• Grave disability
• Danger to self
• Danger to others
• Suicide attempts as common causes of commitment
  in 7 North

7
Civil Rights

• Right to treatment
• Right to refuse treatment
• Department of Mental Hygiene

8
When Someone Is Committed

• Placed on status
• Medical examination and chart review
• Team assessment during rounds

9
Assessment

• Gather information
• Assessment tools
• Diagnosis

10
Gathering Information About Symptoms and Causes

• Current symptoms
• Recent events
• Physical condition
• Drug and alcohol use
• Personal and family history of physiological and
  psychological conditions
• Cognitive functioning
• Coping styles
• Social resources
• Self-concept
• Sociocultural background

11
Tools

• Neuropsychological tests
• Intellectual tests
• Interviews
• Behavioral observation
• Self-assessment/self-report

12
Problems With Assessment

• Age range
• IQ level
• Language
• Culture

13
Diagnosis

• Multiaxial
• Axis I Clinical Disorder
• Axis II Personality Disorder
• Axis III General Medical Conditions
• Axis IV Psychosocial Environmental Problems
• Axis V Global Assessment of Functioning
• A lot of comorbidity

14
Treatment

• Biological
• Drugs (antipsychotics, antidepressants, mood
  stabilizers, barbiturates benzodiazepines)
• Electroconvulsive Therapy
• Psychosurgery
• Psychological
• Behavioral
• Cognitive
• Humanistic
• Social Approach
• Family systems
• Preventative methods
• Biopsychosocial

15
Complications With Treating Children Adolescents

• Matching psychotherapy to the developmental level
• Effects of drugs
• Need to treat the family
• Children adolescents rarely seek treatment on
  their own

16
Health Care Plays A Role

• Managed care
• Insurance policies