“Adults with mental health [disorders] don’t just [develop them] all of a sudden,” said Dr. Hoang “Wayne” Nguyen, medical director of Children’s Hospital of Orange County’s new mental health inpatient center, which is scheduled to open this week. He said the center plans to receive its first patients in mid-April.
Research suggests the seeds of psychological problems are planted early in childhood, and even before birth—potentially brought about by factors such as infections and maternal stress during pregnancy, at least in part, according to the American Psychological Association. Yet there are few facilities dedicated to serving the group.
“For the first time, Orange County children younger than 12 experiencing mental health crises will have a place for care close to home,” said CHOC Chief Executive Kimberly Cripe.
The center, which broke ground in 2016, is intended to turn the third floor of the hospital’s research building into “an environment of healing,” according to the hospital.
The 12,000-square-foot, 18-bed facility will target patients ages 3 to 17.
Cripe said that while the hospital recognizes mental health is as important as physical health, it believes that “health is health.”
CHOC consulted with the Samueli Institute and others with the intention of creating a space that’s “beautiful and healing,” said Clinical Director Dani Milliken, who joined CHOC in September.
The center has three pods of six patient rooms, each with an activity area that can be used at night for winding down or for programming and interventions. The “Neighborhood” is where treatment takes place during the day.
A veteran psychiatric nurse, Milliken said she’s seen plenty of facilities with an institutionalized atmosphere, including barbed wire fences. “You don’t get a lot of people opening new [mental health inpatient centers], and those who do don’t make them pretty, just focused on safety,” she said.
Features include a 3,000-square-foot outdoor area—more than quadruple the size required by the California building code, according to CHOC—that includes sensory-stimulation activities, curved paths for walking meditation, and a basketball court.
It’s the only center in California offering all-private rooms for children and adolescents; parents can stay overnight when appropriate.
Rooms are about 200 square feet, with space enough for only a bed and a chair. Nguyen, with CHOC since 2000 and in his new role since March, said rooms are intentionally small because treatment takes place in a group setting outside of bedrooms. “We don’t want them to stay in their rooms all the time. We want them to come out and participate in the activities.”
Furniture inside and outside the rooms is characterized by rounded design to promote relaxation and avoid user injury. Nguyen pointed to a chair in a room, saying, “It looks round and soft, but it’s actually quite heavy. [Patients] can’t just pick this up and throw it.”
Sensory rooms provide either sensory stimulation or low stimulation, depending on a patient’s condition and needs.
Walls are painted with a soothing color palette with natural elements weaved into the design. Windows in each room allow natural light into the hallway and staff areas.
CHOC executives don’t consider the center to be in a vacuum.
“We want to create a system that others can replicate and help empower health systems across the country to support children’s mental health,” Cripe said.
Safety-Focused
Patients will be transferred from the emergency department for stabilization when they’re no longer a danger to themselves or others. The typical stay will be five to seven days and be coupled with outpatient treatment planned before discharge to ensure the patient and his or her family have strong support after leaving, including therapy, primary medical care and support groups.
The space is designed to ensure patients’ safety, including features such as anti-ligature door handles and bathrooms and second entry points allowing staff to enter patient rooms if patients try to barricade themselves inside.
The interdisciplinary team—currently 68 employees—is comprised of doctors, psychologists and nurses, as well as unlicensed staff, such as child-life specialists.
Closing Care Gap
“Once we open, the state’s capacity increased,” Nguyen said. Psychiatric child-adolescent beds decreased nearly 9% from 2009 to 2015; the state had 665 beds as of 2015, according to a report from the California Hospital Association. “You can imagine the need.”
CHOC said that one in five children experiences a diagnosable mental health condition, or about 150,000 children in OC, but that the county didn’t have inpatient psychiatric services for children younger than 12, and only limited services for adolescents. It said more than half of the children in need of inpatient beds leave the county to receive that treatment.
The $13.2 million construction cost was funded via philanthropists, government funding and grants. Lead gifts were provided by C.J. Segerstrom & Sons Managing Partner Sandy Segerstrom Daniels, $5 million, and an unreleased amount given by the From My Heart/Sharon D. Lund Foundation. The Argyros Family Foundation announced a surprise $1 million gift last year at CHOC’s annual gala.
