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ACUTE AND EMERGENCY SERVICES
Central Intake Referral Line
Inpatient Psychiatry admits are coordinated through the Psychiatry
Acute Services Central Intake. The intake team is composed of mental
health clinicians, located in Psychiatry Emergency Services, who
have available and utilize consultation by the PES psychiatrists
and staff. Referring providers may contact a team staff member,
either in person or by pager, 24-hours per day, to respond to any
provider request for acute psychiatric services. This staff member
has knowledge of the openings for admission on all acute services.
All requests for acute psychiatry services are responded to immediately.
If a direct admission is appropriate and safe, the call will result
in a direct admission. If an evaluation is needed, the team will
request that the individual come to the PES for immediate evaluation,
which can then result in a direct admission.
Psychiatric Emergency Service
The Psychiatric Emergency Service (PES) provides a full range of
emergency evaluation, intervention, referral, and disposition for
adult and child patients in crisis. The services are provided 24
hours a day, and take place both on-site at the Cambridge campus
as well as through the 24-hour mobile crisis team which can go to
any location within the community including Somerville Hospital
and Alliance health centers in Cambridge and Somerville. The PES
team consists of psychiatrists, social workers, nurses, psychologists,
and licensed mental health clinicians. The PES maintains a philosophy
of referring patients to the least restrictive setting and to maintaining
individuals in the community whenever possible. The majority of
patients in crisis are referred to outpatient care or other alternative
settings. Whenever appropriate, patients receive follow up visits
by the PES staff to stabilize the crisis.
Services include:
- Immediate telephone response
- Mobile crisis evaluation capability
- Comprehensive evaluation
- Triage
- Short-term crisis intervention
- Holding bed capacity
- Follow up services
- Medication assessment and management
- Disaster response and counseling
- Immediate referral and admission to the full continuum of acute
psychiatry and addictions services
Mobile Crisis/Outreach
Mobile outreach services are provided through a team of qualified
professionals that responds and intervenes when the patient is in
crisis in the community. The mobile outreach team is trained to
assess the crisis and to stabilize the patient in the community.
Patient evaluations take place in patients’ homes, residential centers,
detoxification programs, jails, shelters, police stations, schools
and other community settings. The outreach team also accompanies
the police to emergency evaluations. The team is committed to maintaining
patients in the community and to diverting them from more restrictive
settings whenever possible.
Crisis Stabilization Holding Beds
The PES utilizes holding beds when necessary to continue to evaluate
and divert a patient from an inpatient setting. The PES provides
a comprehensive assessment, treatment plan and disposition plan.
The PES staff helps to stabilize the crisis and start resolution
within 24 hours.
Adult Inpatient Units
Cambridge Health Alliance provides intensive and short-term inpatient
services for adults ages eighteen and older.
Treatment is multidisciplinary. The treatment team is comprised
of psychiatrists, psychologists, social workers, nurses, and occupational
therapists. The goal of treatment planning is to identify the precipitants
necessitating inpatient care and supports needed for continued outpatient
treatment. A comprehensive biological, psychological and psychosocial
model is utilized for diagnosis and treatment planning. Treatment
plans focus on the areas of diagnostic assessment, re-stabilization
and after care planning.
Adult Partial Hospital Program
Patient population: 18+ years of age
Location: The Cambridge Hospital, Cahill Building
Hours: 9:00am – 3:00pm Monday-Friday
Intake: 617-665-1560
The partial hospital program is an intensive and short-term program.
The program provides comprehensive treatment for individuals with
an acute condition who do not require a locked unit. Central Intake
coordinates admissions after an evaluation in the PES or through
direct referral from inpatient units or outpatient providers.
The treatment team is multidisciplinary and includes a psychiatrist,
a psychiatric nurse clinical specialist, a psychiatric nurse, a
social worker, and an occupational/rehabilitation counselor. The
focus of the treatment is upon stabilizing the precipitating crisis
and transitioning to a less restrictive setting.
Services include:
- Comprehensive biopsychosocial evaluation
- Psychopharmacological assessment
- Daily individual monitoring of mental status and medication
compliance
- Structured group treatment in a therapeutic milieu
- Family assessment
- Family meetings
- Meetings with outpatient caregivers and other social supports
- Case management
- Aftercare planning and transition to outpatient supports
Child Acute Care Service
Child and Adolescent Partial Hospital Programs
Hours: 8:30am-2:30pm daily. Flexible programming is also available
The Child Assessment Unit at The Cambridge Hospital serves
children and adolescents ages 3-12 who are in need of acute psychiatric
care. The Adolescent Assessment Unit at Somerville Hospital
provides similar acute psychiatric care for adolescents from ages
12-19. Both units are secure and offer intensive, short-term evaluation
and treatment.
The child and the adolescent units have partial hospital programs,
which serve both as a transition from and an alternative to inpatient
services. These day programs are for children and adolescents who
need intensive evaluation and treatment, yet do not require the
containment and security of an inpatient unit at night.
The main goal of the inpatient units is to provide a comprehensive
and thorough assessment, with focus on diagnostic formulation. Evaluation
and treatment is provided in a respectful, family-centered environment,
where parents and guardians are seen as partners in care. Clinicians
work from a strength-based model of care, aiming to identify and
build on each child’s strengths and talents, and not just focus
on problems and deficiencies. The treatment team is multidisciplinary
and includes a child and adolescent psychiatrist, psychologist,
nurse, social worker and occupational therapist. A teacher who performs
educational assessments and coordinates with schools is also part
of the team. Individual, group, family and recreational therapy
are integral elements of the therapeutic program. Staff coordinates
with outside providers including schools, therapists and agencies
to complete a thorough evaluation and to create a comprehensive
discharge plan. Both units are major Harvard Medical School teaching
sites for training of child and adolescent psychiatrists and psychologists.
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