It's Where I Am with Zandra Polard

Unknown Speaker 0:00
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Unknown Speaker 0:44
Good morning Las Vegas. This is Dr. G. And you are listening to it's where I am on 91.5 FM KU nb. I am guest hosting on behalf of Zondra polearm, who continues to enjoy much needed respite after being on the air for four years. Don't worry though, if you've been missing hearing Sandra's voice, she'll be back full time and leading the way in the month of July 2024. I'm Dr. David jenis, clinical and public relations director from great mind counseling and Wellness Center. And on it's where I am I have been spotlighting different mental health programs throughout the state of Nevada. My goal has been to decrease stigma for accessing mental health services and encouraging community members to not feel ashamed or embarrassed when needing help. On this morning show I would like to engage in discussion regarding behavioral health inpatient treatment. And I'm delighted to welcome back my friend and amazing psychiatrists, Dr. Deepa Sesia. Hi, Dr. Sesia. Good morning.

Unknown Speaker 2:02
Hi, good morning, David. Good morning, Las Vegas. Thank you so much for having me back on the show. I am more than happy to share with the community what resources we have available when a family members need and then no crisis.

Unknown Speaker 2:21
Well, we're super excited to welcome you back. Dr has Sesia and of course, for me it's always a pleasure to hear your voice and to have an opportunity to engage and interact with you. So now I'm focusing this morning on desert Parkway Behavioral Health Hospital. This is a behavioral health hospital that is located on the corner of East desert and road and Maryland Parkway. And how many beds doctor has Sesia does this behavioral health hospital have?

Unknown Speaker 2:58
So this hospital has about 130 beds? Wow. 110 230. Okay, this hospital is also located right across a medical hospital.

Unknown Speaker 3:11
I'm really glad that you mentioned that because part of my role is to demystify what it's like to participate in mental health services. And so if you don't mind can, can you explain to our listeners, what is different about desert Parkway behavioral health hospital versus a med surg hospital.

Unknown Speaker 3:37
So desert Parkway is a behavioral health hospitals so we treat emergencies for mental health. When someone is in a mental health crisis, for example, they are feeling suicidal or they are not doing well mentally as far as severe aggression, trying to hurt themselves or trying to hurt other people. They cannot manage themselves. They're usually referred to by ambulance to the medical hospital, the medical hospital, some of them, they do have units that help with psychiatric care. However, most of the time, they have small units. So these patients are then referred to a psychiatric hospital where they are more specialized to help these patients.

Unknown Speaker 4:32
Okay, so if an individual or one of their loved ones is having a mental health crisis, what would be the first step what what needs to happen, I guess to get linked to desert Parkway so that an individual can be assessed.

Unknown Speaker 4:52
So when an individual is having a mental health crisis, most likely the family will call in ambulance just like you would do for a medical reason. Or you would consider calling 311. A well check on a family member if that family members not with you, the police will likely go there or the ambulance, they will assess the situation to see, is this person a danger to themselves, meaning they're so depressed, that they're thinking of ending their life? They might take this person and take them to the emergency room. At the emergency room, they will get assessed, does this patient need to stay in a hospital to get stabilized? Or can this patient be managed by an outpatient clinic? That is the process because they want to make sure their mental health and how they present is not related to a medical condition? Or if there's an existing medical condition? That's more critical? It's not missed?

Unknown Speaker 6:03
All right, so let's say now that the loved one gets transported to desert Parkway, what what can our listeners expect and anticipate what happens then.

Unknown Speaker 6:17
So when they get transported to desert Parkway, they will walk in most likely they'll fill out paperwork, if they're not able to fill out paperwork, then hopefully a family can help them fill it out. They will write down their history, if they're able to at that point about any other psychiatric issues from the past, or any medications they've taken in the past. This way, the assessor has a very clear idea on what condition they're having, and how to best kind of triage the patient and kind of decide, does this patient need to be admitted to the hospital? Or does this patient need to be referred for outpatient services?

Unknown Speaker 7:03
Okay, so just because an individual gets transported to desert Parkway, it does not necessarily mean that that person will be admitted into the inpatient side of the hospital.

Unknown Speaker 7:16
Correct. It's more for an assessment. And this way, they can decide if they need a very high level of care and getting hospitalized and staying in the hospital, they will definitely do that. And if they don't need that, then it's always better to treat them outpatient, then admit them into the hospital.

Unknown Speaker 7:38
Now, for many individuals, it is scary to be transported to any hospital. And I think more so for potentially being admitted and transported to a behavioral health hospital. Because I believe social media has really presented an image of inpatient behavioral health to be somewhat negative. And and that has informed I believe, potentially many community members perspectives, and ideas that they may hold in regards to what actually happens when a person gets admitted into a behavioral health hospital. So so let's just let's have this conversation, let's say, the level of care the level of need is determined to be inpatient. And and this person, this adult needs to be admitted into the behavioral health hospital. What can our listeners expect? What happens next?

Unknown Speaker 8:39
So if they are admitted to the hospital, they will be evaluated by a psychiatrist. And a psychiatrist will determine what medications need to be started or just asleep need to be stabilized first, because they've not slept for days and their mood is so stressed out that they're actually wanting to hurt themselves. So it depends on the individual. These hospitals also have children's unit. So they will determine does this child really need to be on medication? Or can we observe for a day and see if the sleep will help? What other measures can we take to help improve just the basic mental health and if absolutely, that cannot be helped to then they will go to medications. So

Unknown Speaker 9:34
So upon being admitted into the Behavioral Health Hospital, how long would a patient remain in the hospital for

Unknown Speaker 9:43
it depends on the situation. And I can give you some examples. I've had some children admitted to the hospital who smoked a bit of marijuana, and now we're hearing things that they've never heard before. Those children I stay at the hospital until the drug effect is gone, and they're able to come back to reality. And they know what's right from wrong and they're able to care for themselves. It truly depends on the situation, we have some situations where we start a medication at a low dose, however, it takes days for the dose to build up and the symptoms to be managed. For example, with bipolar disorder, some patients may take three four days and other patients may take seven, eight days. It depends on how the body reacts to the medications as well.

Unknown Speaker 10:37
So at Desert Parkway, you can admit both adult and children and correct okay, theatrical margin. So for a parent, a caregiver of a young child that's under the age of 18. I imagine that having their child admitted into a behavioral health hospital can be very scary. And, you know, they want to know, parents, what to anticipate how much they may be involved in treatment? And will they have access to their child? Um, can you speak to some of those things?

Unknown Speaker 11:19
Yes. First, I'm going to say that any parents having the child and as I said, recall, hospital is a very scary situation, that child may have never been away from the home and having the child especially in a new situation. And that situation is not kind of supervised by the parents is a huge deal. When children are admitted to the hospital, the nurse will sit with the parents as well try to get a lot of the medical history with the patient, lot of some of the background information. They'll also be seen by a therapist and a psychiatrist who get more information. These providers will all call the parent as well, if they don't meet the parent. When the child's horse comes in. The parent gets a call on the situation after an assessment is done. We go over what the next steps look like, how long might it take for this child to stabilize? What will it look like on the outside? Will they remain on this medication? Will they get outpatient services, will they get therapy services, we pretty much help the individual get linked to services after their current situation is more stable.

Unknown Speaker 12:43
So once the mental health crisis is stabilized, that's when the clinical and medical teams start having conversations around discharge, and then transitioning them to the next lower level of recommended care that that is underneath. Inpatient behavioral health. I think this is particularly important because parents, caregivers, stakeholders, referral agents, want to feel reassured that their person that they're their loved one is receiving the highest level of care that we have access to. And they want to feel comfortable that when they get into their car, and they go back home, and they're feeling shaken and it just upset over everything that's transpired. And now they have to leave their child. They want to feel good about who they're leaving their child with and who will be providing care to their child. So can you speak a little bit in terms of the philosophy of care?

Unknown Speaker 13:43
So the parents do have phone numbers to the hospital and the nursing stations specifically? So if they have the patient code, they can call the particular unit and get details on how their child is doing. The providers? Are there 24 hours a day nursing station had the nurse there all day who can answer and give you an update on how the child is doing okay.

Unknown Speaker 14:09
All right. So in terms of like, what would for a child under the age of 18? What What does clinical services in the hospital look like?

Unknown Speaker 14:21
So there are therapists in the hospital who will sit with the child and also call the parent and get a lot of background information to understand the circumstances and the situations involved that led to the hospitalization and to make sure that they have a plan to discharge the patient home that is safe. So they will come up with the safety plan before the child goes home and also connect the patient to services. While they're in the hospital. They do have multiple group groups on Nursing where they talk about medications and what medications do for you. They also talk about the sleep and how important sleep is and mental health. They have other groups as far as activity group, and an activity group could be an art therapy group, which helps with coping skills to deal with the stress that they're facing. Or it could involve going to the gym, or involve stretching, yoga type exercises. So there's many groups that go on there is that individual time, if the patient wants to talk to someone privately, they will get an opportunity to do that. But mainly keeping patients safe. And teaching them a structure and a schedule that is kind of needed to bring things in balance again,

Unknown Speaker 15:54
so So one of my mission statements and stepping in for Zondra, while she's out on respite, and, and guest hosting on on the show is to really provide psychoeducation information to listeners so that they have the information, they become informed to make good decisions about mental health care for themselves or for a family member. And so I really want to make sure that I'm having questions answered and information provided that I think is most helpful for our community members. Now, when a child goes back from when they get taken into desert Parkway Behavioral Health Hospital, say from an ambulance, and they're in the admissions triage area where they get assessed, what are they allowed to take with them back into the actual hospital where they will be receiving clinical services.

Unknown Speaker 16:58
So they will be able to take things that are safe, meaning psychiatric hospitals like to not have clothing with any strings in it that the patient could use to harm themselves. So any shoelaces or anything sharp jewelry that can be misplaced. Cell phones should most likely go home, they do have a locker, but you know, it's better to have the least items that are needed for the stage, just like with any hospital, in psychiatric hospitals, the telephones are definitely not allowed. And it's so the patient can focus just on the mental

Unknown Speaker 17:42
health. And I'm getting well. And so I think this is a point, though, that is is important because kids moreso adolescents, they like their clothing, they they like their makeup, they like their cell phone. And so these are things that are very, very limited in regards to what they will have access to. And this can cause sometimes conversation that's unnecessary, between caregivers and hospital team members. So another another point that I really want to highlight is that for children and adolescents that are admitted into inpatient behavioral health services, now, let's say the medical team, the clinical team, come together for treatment planning meeting, which the caregiver the parent should be involved in. And the decision is made that the adolescent the child is ready for discharge. And the parent the caregiver, like whoa, like, we're not ready, though. Because of you know, everything that has transpired leading to the child being admitted into a behavioral health hospital. How do we handle that type of situation doctor has seizure.

Unknown Speaker 19:10
So those situations, I mean, some of the situations are scary and to have, you know, concern and a rightful concern. And I would say, you know, we're gonna attempt this, we're not gonna say it's 100% gonna work. I mean, there are signs of improvement. That's why we're considering the discharge. We would like to try it out how it works out at home, but if there are safety issues, the parents are always welcome to bring the child back. We also put in services like step down services, so there's partial hospitalization programs, which mean the kid can come to us in the daytime, however, they go home to sleep, so they're still learning skills on the house. to identify their triggers, and how to identify ways to cope with those stressors. So we explain the type of services we have. And we attempt, there's no way for us to tell, is this going to be successful, but we see the behavior for days, if they're improving, and they're not trying to hurt themselves not trying to hurt other people, they appear stable. And they've looked that way for days, that's when we are going to discharge home and attempt.

Unknown Speaker 20:37
So you and I are both parents. And so we carry with us a lot of empathy when we're working with other caregivers. And so we understand their parents fear, and water could have shut up. Now, we get it. And so we're very sensitive around these caregivers fears and their thinking. However, clinically, medically, we, as the clinical providers cannot make decisions though, on woulda, coulda, shoulda, because we can't predict what may happen outside of the hospital. And so you as a provider, you know, we work with the families, medical insurance that reimburses pays for services that we provide. And and when the decision comes down, where the team believes, okay, this kid's doing really, really well now and inpatient, he or she needs to be stepped down, it's time for discharge. And the parents are still dragging their feet and just not ready yet. But the insurance company is saying, Okay, well, you know, we're not going to pay you any more. Because you know, this child is doing great, you guys did a good job, it's time to discharge to a lower level of care. What could happen doctor has seizure if the parents decide not to pick up their child. So

Unknown Speaker 22:01
that's like any other situation, David, it's kind of like saying, I dropped my child off to school. And, you know, the teacher says, okay, the school is only from nine to three, and you're supposed to come pick up your kid, the ultimate responsibility is the parents responsibility. So, you know, if the child is stable, and experts believe the child is stable, and they're acting on their best judgment, then they do have to come pick up that child. Okay,

Unknown Speaker 22:34
so I just again, so I feel like it's my responsibility to educate community members on the process involved in mental health services and how to access it and to anticipate what services should look like. So that listeners, community members can make educated informed decisions about what they believe is best for their family members or for themselves. So parents caregivers out there, and this situation and and this, it's a tricky situation. And, you know, providers are working and doing their best to to keep your loved one safe to keep you safe. And connecting you to the most appropriate resources in the community where you can continue on doing the work that needs to get done, moving forward to to heal, and to be safe and to hopefully, ultimately be happy. But I want caregivers and parents to know that sometimes though, in these situations, if you refuse to pick up your child, a phone call could be made to Child Protective Services. And then that entity might become involved because your child is languishing and a level of care where they're receiving treatment that they no longer need. And so I just feel like you know, this is an important information for caregivers to know. So Dr. Sesia, if individuals wanted to contact desert Parkway Behavioral Health Hospital and, you know, engage in conversations to determine if some of the services that desert Parkway provides would be appropriate for themselves or for a family member? How would they go about contacting desert Parkway.

Unknown Speaker 24:18
So they can call that the parkway, the main number. And that's easily available on Google or it's 702-776-3500. Or they can go to the website. There's also email access on the website that parents can email and get some information. Most often I say call the main number and ask for the intake department. This way they can help them you know figure out the right service,

Unknown Speaker 24:52
as always. Dr. Sesia I appreciate you so much. Just just remaining to be Be a provider here in Las Vegas and, you know, continuing to be involved in improving the practice of Psychiatry and Behavioral Health Services and being most importantly, being my friend. So thank you again for being on the show.

Unknown Speaker 25:18
Thank you, David. And I feel the same way about you, thank you for helping our community. And you've done it for more years than me and everyone I meet that knows you speak very highly of you and how you've contributed to changing their family. I

Unknown Speaker 25:38
appreciate hearing that because, you know, I feel the same way about all those families that I've had the privilege to be a little part of their journey. Las Vegas listeners and beyond. I am really excited to be ending the show today by playing a song for all of you. It is by the artists Whoa, a tree. And the song is called any means. And I'm very proud to say that the artist is my son. So I hope you enjoy the song and it's been a pleasure to bring to you. It's where I am on 91.5 FM, K, u and v. Until next time, I'm Dr. G. See you then

Transcribed by https://otter.ai