SEATTLE — About two dozen health care workers crowded around tables on a recent Thursday to troubleshoot the many ways things could go south in their new workplace.
Staffers learned what to do during a natural disaster like an earthquake. With the assistance of a computerized manikin, they also simulated how to handle a code gray (combative patient) or a code blue (medical emergency).
Getting used to a brand-new facility, staffers would need to learn “Who do I call for help? In which hallway can I see my peers and get assistance?” said Tricia Webb, a clinical nurse specialist.
Webb and her peers were on the spacious sixth floor of the University of Washington’s new 150-bed psychiatric hospital. After more than four years of planning and construction, the UW Medicine Center for Behavioral Health and Learning — a teaching hospital that will primarily serve people in need of inpatient psychiatric care — officially opened Wednesday.
The project, like many new builds, faced construction delays due to a recent concrete workers strike; it was initially supposed to open last August. By Wednesday’s scheduled ribbon-cutting, finishing touches were still underway. Employee training continues, furniture is being delivered and hospital administrators are working feverishly to recruit dozens of people to fill psychiatrist, psychologist, social work and nursing positions.
Within a few weeks, though, the hospital aims to admit its first set of inpatients: adults ages 60 and older who need acute psychiatric care, or who are involuntarily committed for longer-term treatment through a civil court process.
The hospital was designed specifically for hard-to-treat populations like this one.
Older adults with mental health diagnoses have few options for specialized care; now, an entire floor at the new hospital will be reserved for such patients. The hospital will also serve people on 90- or 180-day civil commitments, a group that used to get treatment at Western State Hospital until that state-run facility closed its civil wards and shifted its focus to people coming from jails.
Additional beds will eventually open for people with psychiatric needs who also need physical health care. And people with treatment-resistant depression and other challenging conditions will get access to a suite of neuromodulation therapies, which, in Washington, are often hard to come by.
“It really has been designed to take care of patients well from the very beginning,” said Dr. Anna Ratzliff, professor of psychiatry and behavioral sciences at UW School of Medicine and an attending physician at the hospital. “There’s been a lot of attention on trying to really make this a place that can help people who are often not able to access high-quality care.”
“Significant demand”
For years, Washington has ranked near the bottom of states for its inpatient bed capacity, though recent moves by the state have improved its standing.
The new $244 million behavioral health facility, which was funded by the Legislature, is one example of how the state’s government is expanding care.
The terra cotta-tiled building occupies a prominent footprint on UW Medical Center-Northwest’s campus in North Seattle. Its contemporary design, calming color palette, advanced safety features and integrated model of care are emblematic of a new era in mental health treatment.
Door handles are smoothed and flattened to keep patients from hurting themselves. An airy patio with planters and benches is accessible to patients via the fourth floor. Down one hall, majestic Mount Rainier is visible through a picture window on clear days.
It’s a far cry from the small, squat building across campus that houses the hospital’s existing 27-bed adult inpatient psychiatry unit.
That unit tends to treat patients who skew older, said Dr. Ryan Kimmel, chief of psychiatry at UW Medical Center. It’s a population that has traditionally had few specialized care options across the state. The current unit is, “almost always full. Or if we have a discharge, we get a new admission the same or the following day,” he said.
Come June, patients in the hospital’s existing psychiatric unit will be moved to the new behavioral health hospital.
Because of a lack of beds statewide, Kimmel said, aging adults often stay for months in short-term units that aren’t suitable for long psychiatric stays.
Older adults are at greater risk of falls, may need dialysis or have neurodegenerative diagnoses, like dementia. The new hospital is equipped for these scenarios.
A physical therapy room has parallel bars and a treatment table to help keep patients strong. Patients’ beds feature electronic lifts to help them get in and out safely. Dialysis machines are at the ready for people with kidney problems. And staff who work with these patients receive special training to track their often complex medical, neurological and psychiatric symptoms.
“There’s a significant demand as our population ages,” Kimmel said.
There’s also a growing need, he said, for medical professionals interested in working with older psychiatric patients. The hospital will serve as a training ground for UW psychiatry residents and other trainees, a move intended to help strengthen the behavioral health workforce, which has struggled to keep and attract workers.
“Part of the idea is, if you can get trainees in [to see] the care that’s provided, they might decide that’s a career they might like as well.”
Specialized services
Inside a treatment room on the first floor, assistant administrator Charity Holmes sits in a padded chair and pulls on a helmet that has the power to reset the mind.
The helmet, which sits on the head almost like a salon hair dryer hood, is fitted with magnetic coils that, when activated, can stimulate a patient’s brain.
This is a transcranial magnetic stimulation (TMS) helmet — a device used to ease symptoms of serious depression, obsessive compulsive disorder and other seemingly intractable problems, like nicotine addiction.
Down the hall, separate rooms house machines used to deliver electroconvulsive therapy (ECT), a more intense form of brain stimulation that can be lifesaving for psychiatric patients who haven’t responded to other options and have conditions like catatonia, major depressive disorder or bipolar disorder.
The new hospital’s neuromodulation suite is unparalleled in its scope: Unlike most other options in Washington, the new behavioral health hospital accepts patients enrolled in government insurance plans and offers TMS and ECT to both outpatients and inpatients.
“It’s one of the things we’re hoping is going to help decrease the length of stay of the patients and be able to get rehabilitated successfully to go back to the community,” Holmes said of the long-term patients who will receive neuromodulation therapy.
About half of the new hospital’s beds are reserved for those who are so ill they need months of care. Ratzliff, who will work on the long-term civil commitment unit, said some patients who come to her for care will have gone long periods without treatment.
Some patients, she said, might have lost “hope that things can get better,” she said.
This is one of several challenges she anticipates.
“It’s a new group of people working together. We’re creating new programming and new ways of interacting. We’re excited to have trainees there, but that also adds dimension.”
That said, she added: “This will be a really different type of place for patients to experience care, for loved ones to be supporting their family members, and for people to be learning.”
