Howard County residents who are suffering from a mental illness and need help coping with their daily lives, but who don't require hospitalization, now have a day program they can attend in Columbia.
Yesterday, the private, Ellicott City-based Oakview Treatment Center opened the county's first psychiatric partial-hospitalization program for adults at its Columbia outpatient facility.
The program comes at a time when health insurers and health-care providers are struggling to find alternatives to expensive, in-patient hospitalization to treat mental health problems and other disorders.
Taylor Manor Hospital, a private facility in Ellicott City, and Howard County General Hospital plan to start similar mental health programs later this month.
The Oakview program is for patients 18 and older who have psychiatric disorders, such as manic depression, or a dual diagnosis, such as depression and alcoholism.
These are "people who are able to function but are having problems in those areas," said Dr. Lanie Lipson, the program's clinical coordinator and family therapist.
For example, some patients may have exhausted their insurance company's limit on hospital stays, but still need intensive therapy. Others may need significant help in a clinical setting, but not full hospitalization.
Specializing in substance abuse treatment, Oakview Treatment Center operates facilities in Ellicott City, Columbia and Richmond, Va. In addition to the partial-hospitalization program, the 10-year-old Ellicott City center offers individual therapy, adult intermediate care and family therapy.
The new outpatient program is brief but intensive. During a 10- to 15-day period, patients participate in group and individual therapy and set goals. Vocational rehabilitation and crisis intervention also are available.
"The first thing we do is connect people to outside resources," Dr. Lipson said. "We don't want them to stay here." The intent is to get people out into the community and help them to function.
Once they complete the program, patients are "solidly hooked up in the community," Dr. Lipson said. They continue treatment at a community mental health center or with a local therapist.
Dr. Lipson said she also plans to conduct at least two follow-up visits with each patient, as well as meet with former patients once a month.
The Oakview program costs $285 a day. Medicaid is accepted, and those who qualify can pay on a sliding scale.
Partial-hospitalization programs are not new. However, they have grown more popular during the past three to four years as insurance companies and managed-care companies look for cheaper ways to treat patients.
"The concept is receiving new interest," said Richard Bacharach, director of the county health department's Bureau of Mental Health and Addictions.
As insurance companies restrict the number of days patients can stay
at a hospital, more people are receiving outpatient help and "you're seeing programs attempting to meet that need," he said.
Taylor Manor, for example, will open a partial hospitalization program for teens Nov. 11.
Howard County General Hospital expects to begin a similar program for adults this month and already provides follow-up treatment for people who have been discharged from the hospital's psychiatric unit.
"We're kind of functioning right now, but we hope to be fully up and open by the middle of this month," said Thomas B. King, director of Howard County General's psychiatry services.
David Heebner, administrator of Oakview, estimates that outpatient psychiatric programs can cut hospital bills by as much as one-third to a half. "That care doesn't cost us as much but it still delivers the care a person needs," he said.
Dr. Lipson, whose 22-year-old son suffers from a manic-depressive disorder, said that she wishes a day program had been available to him when he was discharged from a Prince George's County hospital in June.
"All of a sudden we expect them to take care of themselves," said Dr. Lipson, referring to psychiatric patients who are released from hospitals without follow-up care. "We need a transition, and that's what we're trying to provide."