CVPH Child & Adolescent Mental Health Unit

  • By Kristin Shives

“Realistically, we’re not going to cure their problems in five to seven days, but we are going to help them develop skills the children can use in order to interact and deal with issues outside our facility,” said Sharon Schmidt-Twiss, Director of the Children and Adolescent Mental Health Unit at CVPH Medical Center.

In the U.S. today, one in every ten children suffers from a mental disorder severe enough to cause some level of impairment, according to the National Institute of Mental Health.

In February of 2001, CVPH Medical Center opened its Child and Adolescent Mental Health Unit, a 12-bed unit on 4-Main accepting children ages six through 17 to receive short-term acute care. This facility provides mental health care and counseling in a hospital clinic setting for children and adolescents.

Before this unit was constructed, children needing those services were being sent far away to anywhere in the state of New York that had an open bed. This process was extremely difficult on both parents and children. Parents struggled with the long distances to visit the child and this resulted in parents usually being unable to participate in group therapy sessions. Without total participation and involvement with parents, it is difficult to see rewarding results for children.

“The previous process was more like a band-aid for the child,” said Mary Krakowski, program director of the Child and Ado-lescent Mental Health Unit at CVPH Medical Center.

“Children do well with structure. Knowing what is expected is essential,” Schmidt-Twiss said. The children’s daily schedule, while in the CVPH nursing unit is broken down into goals groups, reading groups, group therapy, free time, school, meal times and relaxation. Parents are allowed to visit their children on weekdays from 5 to 6 p.m. and on weekends from 5 to 7 p.m.

Parents are strongly discouraged from bringing caffeinated beverages and sugared candies to their children. The staff feels that caffeine and sugar have an adverse affect on the children’s overall status.

The typical day for a child admitted to the unit follows a structured program from 7 a.m. until 8 p.m. The children are divided into two tracks. Track One is for children ages six to12, while Track Two covers ages 12 to18. Each track will participate in the var-ious programs offered throughout the day, scheduled in 30 and 60-minute blocks. During the school year, a certified teacher comes to the unit to provide two hours of education to each of the two age groups.

“A high percentage, but certainly not all, of the kids who come though our doors have been abused,” said Schmidt-Twiss. The children who have been abused are dealing with internal anger which can lead to screaming, physical abuse, emotional disturbance, and acting out of control in order to gain control.

Long-term effects of child abuse include fear, anxiety, depression, anger, hostility, inappropriate sexual behavior, poor self-esteem, a tendency toward substance abuse and difficulty with close relationships.

The most common type of mental disorder the health unit sees is Attention Deficit Hyperactivity Disorder or ADHD/ADD. Ac-cording to the Centers for Disease Control and Prevention, an estimated 4.4 million youth ages four to17 have been diagnosed with ADHD by a healthcare professional, and, as of 2003, 2.5 million youth ages four to 17 were receiving medication for the disorder.

But the brains of young children are in a state of rapid development and animal studies have shown that the developing neuro-transmitter systems can be very sensitive to medications. It is important to remember that children’s bodies handle medications dif-ferently than older individuals.

Schmidt-Twiss does not believe medication is the answer to curing the disorder. She does believe that an outline helps children to develop better.

“When they know what’s expected, they do better,” she said. For instance, if a child acts up during a session, he or she will be asked to leave the group or go to the timeout area. The timeout area is a room where the child will sit alone and reflect on his or her actions. If the child does not want to apologize for those actions or change the behavior, he or she will not be allowed to enjoy free time with the other children.

The Child and Adolescent Mental Health Unit at CVPH Medical Center offers combined treatments of behavioral therapy, psychotherapy, social skills training, support groups, and parenting skills training. Once children are discharged from the facility and are back in their own environment, they are set up with an outpatient care agency.

The responsibility falls on the parents when it comes to following up on the after care. Schmidt-Twiss says most parents she encounters are highly motivated to help their children.

Schmidt-Twiss admits there are few big rewards, but appreciates the many small rewards found in working in a mental health unit for children and adolescents. “Every day when I go home, I feel like I have made a difference in someone’s life,” she said. “It might be small, but it’s a difference. Those small things mean so much.”

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