A new psychiatric residential treatment facility will open across from Mayo Clinic Hospital — Rochester, Saint Marys Campus, in Rochester, Minnesota, in early 2018. Named John E. Herman Home and Treatment Facility, in Collaboration with ClearView Communities, it will comprise two homes, housing eight patients each, with a treatment center and community area connecting the residences.
Brian A. Palmer, M.D., M.P.H., a psychiatrist at Mayo Clinic in Rochester, Minnesota, and the new facility's medical director, believes this home will fill a care gap for patients who need psychiatric care, especially in the region.
"There are short-stay psychiatric hospitals, but residential treatment in psychiatry is a care level not widely available," he says. "We think this type of care will be able to bend the trajectory, particularly at the start of illness and in younger patients."
Mayo Clinic's Department of Psychiatry and Psychology will begin accepting referrals to the home in October 2017, and expects to draw interest from providers and patients nationwide. Appropriate patients include those with mood disorders, psychotic disorders or personality disorders. Residents need to be stable, nonviolent and able to benefit from a longer term treatment focused on community integration and functional recovery.
The new facility's program will provide patients with a comprehensive assessment and individualized plan to help them achieve functional and vocational recovery. The facility's services will include medication management, evidence-based group and individual psychotherapy, vocational support, and family support. An employment specialist will help residents identify vocational goals, guide them as they look for jobs or volunteer work, and provide support to maintain successful employment.
Living at the home also will be part of the treatment, offering residents an opportunity to become part of a functioning community. To that end, they will make their own meals, maintain living areas and engage in healthy daily activities with staff support.
Two care tiers will be available: a higher care level, averaging a six-month stay, including intensive care with more supervision, and a lower care level for about six to eight additional months, where residents will have more autonomy, less intensive care and meaningful involvement in the community.
Staff for the home will include the medical director, clinical director, program manager, employment specialist, licensed therapists, a nurse and round-the-clock recovery coaches.
The care model is based on a collaboration with ClearView Communities, a residential rehabilitation program for adults with severe mental illness in Frederick, Maryland, founded by benefactor the Sylvan C. Herman Foundation. This model and its principles will combine with Mayo Clinic's expertise at the new facility, named in memory of Sylvan Herman's son.
"The treatment model prioritizes functional recovery — from making meals in the residence to obtaining competitive employment, school or volunteer work," says Dr. Palmer. "We believe that anchoring comprehensive biological and psychosocial treatment firmly within a framework of community integration and functional recovery can help patients build meaningful lives and relationships."
Research, as well as clinical care, is a key component. According to Ajeng J. Puspitasari, Ph.D., a psychologist at Mayo Clinic's campus in Rochester and the program's clinical director, studying the process of recovery will continually inform both patient care and program development. Dr. Puspitasari and colleagues are partnering with Mayo Clinic's Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery to measure patient outcomes and key program elements predicting outcomes, cost-effectiveness and implementation effectiveness.
"Measurement-based care is key," says Dr. Puspitasari. "We will monitor patient progress routinely to assess outcomes, inform treatment and sustain program quality. As we collect data, the plan is to feed it back to patients, families and providers."
Researchers will continue monitoring patients following program completion to improve its services and provide information for the scientific community.
Dr. Palmer explains that there has been demand for residential psychiatric treatment at Mayo Clinic for many years. "Many patients need long-term psychiatric care and want their care at Mayo Clinic," he says. "We are hopeful that we can meet this need and collaborate to further enhance high-quality residential treatment nationwide."