Inpatient

The primary Inpatient Unit is at the Mental Health Hospital (MHH). The MHH is a 48-bed unit, serving indigent, disabled and private sector patients from a large area of many counties (referrals come from up to 3 hours away). Each day, during the Treatment Team Meeting, residents present cases, suggest diagnoses and treatment plans, and then discuss utilization review, billing, cost and community resource issues. The pros/cons of discharge, for example, depending on the acuity, availability of outpatient clinical and case management services, are thoroughly discussed. Residents receive training in diagnostic evaluation and acute psychiatric care, with the goal to get patients to a less restrictive setting. They carry a usual caseload of 5-8 patients for PGY-1 and 8-10 patients for PGY-2, all supervised by faculty, with patients from many socioeconomic, geographic and cultural backgrounds. Regarding the latter, residents use formally certified interpreters in-person or by telephone to afford patients the opportunity to speak in their preferred, primary language. Patients generally fall into three groups of severity, though all are acute: higher-functioning, working; full- or part-time working but intermittently very ill; and the severely and persistently ill.