“Many patients think that being hospitalized is the worst thing that can happen to them,” Dr. Vora says. “But sometimes it actually ends up being the thing that turns their life around.”
Stigma remains a big problem for psychiatry. Inpatient psychiatric care, in particular, has long suffered from unfair portrayal. The mere mention of an inpatient psychiatric unit conjures up images of Jack Nicholson in One Flew Over the Cuckoo’s Nest. This stigma is present not only among the public, but also among many doctors and medical providers. “There’s a certain amount of stigma and fear around the idea of being hospitalized in a psychiatric unit, but it’s a very different quality of care and treatment than what is typically portrayed in the media,” says Rajvee Vora, MD, MS, Associate Professor and Vice Chair of Clinical Affairs for the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai.
Forget the stereotypes, Dr. Vora says. The inpatient psychiatric facilities at The Mount Sinai Hospital are bright, welcoming, and beautifully designed, and patients receive high-quality care. “Patients are up and walking around, encouraged to be up and about, attend groups and sessions, and play basketball in our indoor court.”
Above all, hospitalized patients receive a range of evidence-based treatments to help them manage their mental illnesses. “Many patients think that being hospitalized is the worst thing that can happen to them,” Dr. Vora says. “But sometimes it actually ends up being the thing that turns their life around.”
An Interdisciplinary Approach to Inpatient Mental Health
In recent years, the field of psychiatry has moved most treatments to outpatient settings. Yet for some patients with severe mental illness and acute psychiatric needs, inpatient care remains critical. In fact, the need for such care has increased recently. “During COVID, many outpatient providers switched to remote services, which aren’t always accessible to people with serious mental illness,” says Danielle Campisi, LCSW, director of social work for the inpatient psychiatry service. “Now we’re seeing a big uptick in the number of patients that had been chronically well-managed, but lost access to care during the pandemic.”
The team at Mount Sinai’s inpatient behavioral health unit treats a variety of psychiatric illnesses, including:
- Mood and anxiety disorders
- Personality disorders
- Psychotic illness
“Treatment isn’t something that happens to the patient. It happens with the patient,” says Dr. Rosenthal.
Patients don’t need to be severely incapacitated to benefit from hospitalization, says Blake Rosenthal, MD, Assistant Professor of Psychiatry and Inpatient Unit Chief at The Mount Sinai Hospital. “Sometimes our patients have developed psychotic symptoms for the first time. They may have a change in their ability to perceive reality or are developing hallucinations,” Dr. Rosenthal says. “They can come in without having a complete decompensation and loss of function, and we’re able to meet those needs really well.”
Cutting-Edge Psychiatric Treatments
Inpatient treatments typically include medications and intense psychotherapy, including individual, group, and milieu therapy. As a cutting-edge research institution, Mount Sinai offers access to new and emerging treatments, including interventions such as electroconvulsive therapy (ECT) and esketamine for treatment-resistant depression. Patients also receive additional services such as art therapy, music therapy, dance/movement therapy, and substance abuse counseling. “Inpatient treatment is so much more than medication management,” Dr. Vora says. “The core of the work we do is ‘milieu therapy’ — what being in this environment does for patients.”
Patients are treated by an interdisciplinary team that includes an attending psychiatrist, psychiatric residents, nursing staff, creative arts therapists, assistive staff, and social workers. The team develops a comprehensive treatment plan for each patient, which describes the interventions and services they will receive as well as the plan for transitioning to outpatient care. That transition is important, since patients typically stay in the hospital just a week or two before being discharged to outpatient services or to higher levels of care, such as assertive community treatment (ACT).
Social workers work closely with patients to understand their psychosocial needs, connect them with appropriate services, and teach them about their illnesses. “When patients come in, they’re sometimes resistant to being treated. We do a lot of psychoeducation to improve patients’ understanding of their illness, the potential need for medications, and the importance of outpatient follow-up,” she says.
It’s a collaborative effort, Rosenthal adds. “Treatment isn’t something that happens to the patient. It happens with the patient,” he says.
Inpatient Mental Health at Mount Sinai
While Mount Sinai provides access to the latest evidence-based treatments, its biggest asset is the people delivering those therapies, Dr. Rosenthal says. “What really distinguishes Mount Sinai’s inpatient program is our team. Our treatment team almost functions as a single provider,” he says. “It sounds cliché, but everyone on the unit cares deeply about how patients are doing.”
Mount Sinai has leading experts in schizophrenia, depression, and other psychiatric illnesses, who often consult on treatment. The team mentality extends to treating a patient’s non-psychiatric medical conditions as well. The inpatient psychiatry team collaborates closely with other service lines such as OBGYN and neurology to ensure all of a patient’s healthcare needs are met during their inpatient stay.
While caring for patients is a top priority, Mount Sinai’s inpatient behavioral health team is also committed to reducing stigma and improving care for all patients with psychiatric illness. Experts from the department recently held a symposium to discuss the management of clinical challenges in inpatient psychiatry.
Most psychiatric inpatients are transferred from the emergency department, but individual cases are considered. Learn more about Mount Sinai’s Inpatient Behavioral Health Services, or contact the inpatient behavioral health admissions coordinator at 212-241-5675.