In-Patient Mental Health Programs at Franciscan Children’s

Every year, millions of Americans face the reality of living with a mental illness. Taking care of your mental health is just as important as taking care of your physical health. That is why it is critical for everyone to join together to raise awareness of and advocate for improving our nation’s mental health care system and resources.

In recognition of Mental Health Awareness Month, Together for Mental Health, check out our incredible inpatient mental health programs at Franciscan Children’s:

Inpatient Mental Health – Unit 1 

Written by Director of Behavioral Health Nursing, Anne Barry, MSN, RN, PMHNP

Unit 1 is an inpatient unit for children and adolescents in acute mental health crisis and is a psychiatric ICU. We take kids ages three to nineteen of all developmental abilities and diagnostic categories. The focus of treatment within our unit involves restoration of safety, targeting high-risk behaviors and most frequently, reduction of suicidal behaviors.

A typical day within Unit 1 involves classroom time and therapeutic groups ranging from health and wellness to skill building to expressive therapy. We also make sure that our patients have time to go outside and as well as structured free time, like playing cards together or using the computer. Groups are run by a variety of people including mental health specialists, nurses, expressive therapists, psychology interns, teachers and members of Spiritual Care.

Something that is interesting about our unit is that we are a teaching unit for a variety of disciplines including psychiatry, psychology, social work, nursing and mental health specialists.

• Psychiatry – we are part of the Child & Adolescent Psychiatry fellowship in collaboration with with McLean and MGH
• Psychology – each year we welcome students in psychology doctoral programs for a school year-long internship
• Social work – between one to two students complete an internship in social work with us
• Nursing & MHS – while we do not currently take students, we are happy to hire new grads (even those without psych experience) and have expanded our training program over the last year to support staff training and education

Community-Based Acute Treatment (CBAT) Program

Written by McLean-Franciscan Children’s CBAT Program Director, Anne Hannan

CBAT serves patients ages four to fourteen in mental health crises. Patients are referred to the program from community-based crisis teams and emergency rooms or come to us as step-downs from inpatient hospitalization. They are typically admitted to the unit for two to three weeks. We provide trauma-informed, strengths-based care as upwards of ninety percent of the patients we serve have a history of trauma. We work off the motto of, ‘kids do well if they can’ and if they are struggling it is due to a ‘lack of skill, not will’. For example, if a patient is not doing well, we as safe and supportive adults need to help teach them the skills needed to safely manage their feelings and reactions. This helps to reframe some of the blame that society tends to put on traumatized kids who are struggling with unsafe behaviors.

We also provide short-term, intensive, skills-based therapy work and family work in order to facilitate a safe discharge home. A lot of our work surrounds helping our patients and their families communicate more effectively with each other, specifically around safety. A large part of our work also includes providing a thorough assessment (providing diagnostic clarity, recommendations for school, medication evaluation, etc.) that can be useful for the family upon discharge. Our staff does an amazing job of recognizing strengths in each patient we serve and creatively introducing new strategies to help them more effectively interact with their environment. We often provide social skills coaching throughout the day in our community-based setting, as this is something many of the patients we serve struggle with.

There is no ‘typical day’ at CBAT. Some mornings you can find our staff singing or dancing to wake patients up, other days the patients are awake and ready for the day at 7 a.m. The patients attend therapy groups, school and meet with their treatment team each day during the week. Each patient on the unit is assigned a social worker, psychiatric prescriber and sometimes a doctoral student to make up their treatment team. During less structured parts of the day we have clubs and activities available for patients to participate in that are run by our staff. Our baking club is our longest-standing and most popular club! We get creative with patients depending upon their interests, but it is not unusual to find our patients participating in a talent show, having a BINGO tournament, playing competitive card games, having Pokémon scavenger hunts and more on any day of the week!

The patients we serve at times have incredibly challenging behaviors and have often faced a lot of rejection due to this. Our staff have an incredible amount of empathy for our patients and go above and beyond to provide a safe and welcoming environment. Upon discharge, we have had patients mention that CBAT is one of the only places they have felt like they have belonged. In the end, I think this sense of belonging is one of the best ways we can serve them!