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Access to Care

Bridging the Widening Behavioral Health Gaps in Our Children and Adolescents

As one of the largest hospital providers in the state, Dignity Health has a responsibility to bridge gaps in behavioral health care and ensure that every single Californian has access to mental health services and support.

With roughly 20 percent of adolescents experiencing mental health issues—a much higher rate than adults[1]—programs for younger patients are an especially critical community support.

The staff at the McAuley Adolescent Inpatient Unit at St. Mary’s Medical Center in San Francisco, led by Medical Director Dr. Yosra El-Menshawi, are working hard to provide a growing suite of mental health solutions for children between the ages of 11 and 17.

“Untreated depression in children and adolescents can lead to potential substance abuse, to not being able to function socially, occupationally, academically, and so on. It can impact a person’s ability to be a productive individual and even provide for their own families in the future,” said Dr. El-Menshawi. “Untreated depression is also one of the greatest risk factors for completing suicide.”

Through a combination of individual, group and family services—with both inpatient and outpatient program components—Dr. El-Menshawi and her team nurture healing, growth and hope, helping children and adolescent patients navigate their own unique pathways to healthier futures with more positive outcomes.

[1]nih.gov.

The only inpatient adolescent psychiatry unit in San Francisco

“Our inpatient adolescent unit is truly a haven for kids in crisis. Oftentimes, the patients who are admitted to our unit have attempted to harm themselves or even potentially to harm others,” shared Dr. El-Menshawi. “Many have experienced acute changes in their behavior and even their ability to maintain reality. We deal with major depressive disorder, psychosis, and some kids who are also manic. This inpatient unit is a hugely important piece of the behavioral health continuum of care.”

In fact, the St. Mary’s adolescent inpatient unit is the only one of its kind in San Francisco, serving patients from all over the state—as far north as the Oregon border and as far south as Riverside. Sadly, the need for acute inpatient care among children and adolescents is much greater than the services available.

Expanding access to care through strategic partnerships

As the community need for behavioral health support grows, Dr. El-Menshawi and her staff are constantly thinking of ways to expand services and access to care for their patients.

The University of California Collaboration

Two years ago, Dr. El-Menshawi initiated a partnership between St. Mary’s and UCSF. Through this collaboration, UCSF’s psychiatry fellows rotate through the adolescent inpatient unit at St. Mary’s. The relationship has myriad benefits, increasing care touch points for patients while also providing training and an expanded view of the full range of mental health needs to doctors-in-training. This training partnership is especially important since inpatient units for adolescent mental health care are so rare, and the demand for more providers in this specialty is so great.

“Any time you have trainees, it raises the level of care that you can provide. Trainees are very inquisitive—they are curious, and they make everyone else even more curious. The UCSF fellows work quite hard to help support the staff and the treatment plans that the staff create. They also gather and share information on the latest evidence-based treatments. We have seen so many benefits, and that’s just in two years. I can’t even imagine what we’ll be able to do together down the road for these patients.”

The Counseling Enriched Education Program

The Counseling Enriched Education Program is another example of a collaboration that opens up access to support younger patients in need. Together with the San Francisco Unified School District and the department of public health, St. Mary’s runs a therapeutic day school program for children with chronic mental health issues. The program provides an individualized education plan (IEP) to support students in the public school system who are experiencing emotional disturbance or mental health impairment.

“This is a very unique program that offers intensive treatment in a school setting. The students who are enrolled are supported by a full team of psychiatrists, family therapists, recreational therapists, and others who can meet their mental health needs—in addition to the educators supporting them,” said Dr. El-Menshawi. “We see kids with histories of trauma, and also parents struggling with mental health illness and substance abuse issues themselves. These kids typically have multiple psychosocial stressors and truly benefit from the multidimensional support.”

There are very few adolescent mental health programs in California that combine counseling and education, and St. Mary’s is the only one located in San Francisco.

Together, the McAuley team embodies the mission of Dignity Health—to provide compassionate care for all Californians and provide a bridge to care when gaps exist.

Resources

McAuley Adolescent Inpatient Unit

St. Mary’s Adolescent Psychiatric Services treats adolescents whose emotional problems are impacting their safety and functioning. We provide high quality, well-coordinated mental health services in a safe, consistent, therapeutic environment.

Learn more about McAuley Adolescent Inpatient Unit