Update on new Mayo Clinic residential psychiatric treatment facility

Nov. 17, 2017

Q&A with the medical and clinical directors

Brian A. Palmer, M.D., M.P.H., psychiatrist, and Ajeng J. Puspitasari, Ph.D., psychologist, will lead Mayo Clinic's soon-to-be-open residential psychiatric facility, named John E. Herman Home and Treatment Facility.

Dr. Palmer will serve as medical director, and Dr. Puspitasari will be the clinical director for the facility, in collaboration with ClearView Communities, which will be located across from Mayo Clinic Hospital — Rochester, Saint Marys Campus, in Rochester, Minnesota.

At what stage is the new facility's building project, and when will it open?

Construction started in May 2017, has proceeded as scheduled thus far and is ongoing. Completion of the treatment facility and the north house's construction is planned for the end of January 2018 and the south house by the end of April 2018, if all goes well. We are targeting an April 2018 opening. The first phase will include eight beds for north house residents. Once the south house is finished, we will take the next eight residents.

What are your expectations for patient outcomes at this home?

  • Increased employment rate or other community participation — this may involve activities such as volunteering or education.
  • Increased daily functioning — this includes the ability to maintain habits such as a healthy diet and physical activity, the ability to independently manage medication, and the ability to maintain a living space.
  • Overall well-being — this will be monitored regularly through patient-reported outcomes.
  • Symptom reduction — while this is not the only or even main focus of treatment, we predict residents will experience some symptom reduction or stabilization, though we expect the symptom trajectory may fluctuate. We acknowledge there may be some residents whose symptoms remain high despite having made great improvements in well-being and functional and vocational recovery.
  • Improved social connections — due to the residential nature of treatment, the setting will be ripe with opportunities for residents to build healthy and meaningful social connections. Residents will be encouraged to attend regular community activities, such as weekend outings with other residents or working as a team to maintain the house and prepare meals. We also will provide support for residents' family members, since they often will be the resident's primary social support after completing the program.

How will residents successfully transition back into the community after staying at the facility?

Strong discharge planning is key to the program. Our team will work with outpatient providers and other services to ensure residents will have adequate support once discharged. We also will conduct follow-up with patients at regular intervals to assess post-discharge progress and invite them to any resident alumni events.

Previous residents may be given access to our employment specialists or other providers if they need support with re-integrating into the community, though the intensity and frequency of accessing these services will be lower than for those in residence.

How will you work with referring physicians?

We expect to work closely with all referring physicians by providing updates regarding residents' progress during their stays at the home. Before residents are admitted, we will facilitate a warm handoff from the referring physician and gather relevant information from them on residents' past histories. When residents have completed their stays at the home, our team will work closely with referring physicians and any future providers to prepare a discharge plan.

What is the referral and screening process?

You are welcome to refer a patient to the home by calling the Mayo Clinic Department of Psychiatry and Psychology appointment office at 507-266-5100 or online at https://www.mayoclinic.org/medical-professionals. We will then conduct further screening with that individual. To date, a number of people have expressed interest to be considered for the facility.

Here is a summary of the referral and screening process:

  • Physicians, the patient or the patient's family will call the Department of Psychiatry and Psychology appointment office or submit an online referral.
  • The facility's program manager will conduct a brief initial screening to ensure the patient is appropriate for further screening and discuss programming, billing and insurance.
  • If the patient meets initial criteria, the medical or clinical director will speak with the patient, family members or all parties by phone or in person for an additional screening interview to assess eligibility.
  • If the patient does not meet inclusion criteria, a referral to other treatment will be provided.
  • If the patient meets the criteria, the individual will continue with the admission process.
  • If the patient does not fully meet inclusion criteria, we will offer a trial stay, such as living at the home for three days and then completing further assessment.
  • If the patient meets admission criteria after assessment by the medical or clinical director, further evaluation will be scheduled with the patient and family members.
  • Full admission evaluation will be conducted with the facility's multidisciplinary team.

Should referring physicians have patients call their insurance companies prior to referral?

We will provide pre-certification services to help patients determine the total out-of-pocket cost and any relevant insurance coverage that may be available to them.