High Intervention Program
Alireza Amisadri, M.D.
This clinical program consists of two different but interconnected programs (Crisis Center and Intensive Care Inpatient Psychiatry) in Detroit Receiving Hospital. HIP serves a unique population of patients who are high risk and suffer from wide ranges of illnesses from severe personality disorders to the ones who are highly aggressive and agitated or have acute suicidal ideation with multiple comorbid illnesses in addition to their acute or chronic social problems. Psychotic disorders, severe mood disorders with or without psychosis, and diagnosis related to substance use are among the most common illnesses assessed, treated and stabilized at HIP.
Crisis Center (Psychiatric Emergency Room)
Victor Ajluni, M.D.
Associate Medical Director
This 24/7 arm of HIP is adjacent to a very busy Trauma Center. One of the busiest crisis centers in the country, in addition to 1200 consults for the medical emergency room, serves more than 10,000 patients in a year.
Through implementation of different levels of care and assertive individualized treatment implementation, this crisis center has succeeded in reducing its inpatient admission rate to less than 30%. Patients in this service not only are treated for their psychiatric illness but their medical illnesses, social problems, and substance use issues, such as detox, are addressed in the best possible available way. Continuous best describes the relationship between this service and other medical specialties like internal medicine and emergency medicine. Patients arrive in this service via EMS, police, group home providers, lower level treatment program staff, families, etc. Patients who meet criteria for inpatient hospitalization may be transferred to any of the other hospitals in the area. Many of the patients with severe mental illness (SMI) who do not go to hospitals might be transferred to Transitional Housing Facilities secondary to being homeless.
- Treatment Team Composition
The Crisis Center has on site availability of a psychiatrist 24/7. Secondary to the volume and teaching responsibilities a second psychiatrist provides care for about 8 to 10 hours a day. In addition to nurses, social workers, mental health technicians, psychiatry residents, and medical students also take part in this team. Emergency medicine, internal medicine, dietitians, and other consultants are available on as needed basis.
- Education, training and research
Psychiatry residents and year two medical students rotate through this service. Multiple clinical or epidemiological research projects are conducted through this center by the High Intervention Program or other faculty and staff of the WSU Department of Psychiatry and Behavioral Neurosciences.
Intensive Care Inpatient
Luay Haddad, M.D.
Chief of Psychiatry
This locked unit which is located on the third floor of Detroit Receiving Hospital has 19 acute beds with private and semi-private rooms. Although most patients are voluntary a lower percentage of patients have involuntary status. Within this highly structured setting a multidisciplinary approach is implemented in different modalities such as medication management, detoxification, individual and group therapy, occupational therapy, psycho-educational meetings, family therapy as well as exercise and music groups. Spiritual counseling is also available upon request or need.
Patients 18 and older with a diagnosis of a severe psychiatric illness with higher level of intensity are admitted to this program. Although most patients come from the crisis center a good number of them are transfers from medical surgical units from Detroit Receiving, Harper University or Hutzel Women Hospitals or Karmanos Cancer Insitute and Rehabilitation Institute. Some patients are transferred from outside the system hospitals.
- Treatment Team Composition
In addition to the attending psychiatrists who have their daily rounds and conduct their treatment team meetings, members of nursing staff including social workers, occupational therapists, spiritual, dietary, pharmacy and medical consultants participate in the assessment and treatment management of patients. When available, psychiatry residents and medical students are also participants.
- Training, Education and Research
Periodically psychiatry residents, psychology interns and medical students as well as social work and nursing students have clinical rotations in this unit. Different clinical studies are under consideration for this program.