Dell Children’s to open new mental health unit on Monday as it expands levels of care

On Monday, the first patients will be admitted into the new Grace Grego Maxwell Mental Health Unit at Dell Children’s Medical Center of Central Texas.

The center, which was made possible by a $3 million donation and matching grant from Nyle and Nancy Maxwell and their family in January 2017, is named after Nyle Maxell’s mother, a longtime volunteer at the hospital.

“As with most families who are challenged with raising children in this complicated environment we have today, mental health is a challenge,” said Maxwell, former Round Rock Mayor and owner of the Nyle Maxwell Family of Dealerships, when his family announced their donation. “My family is not immune to this.”

Dr. Sonia Krishna, a child and adolscent psychiatrist, shows an examination room at the Grace Grego Maxwell Mental Health Unit at the Dell Children’ss Medical Center of Central Texas. JAY JANNER / AMERICAN-STATESMAN

The opening of the 24-bed mental health hospital unit means that children with mental health diseases can be treated at the same facility as children with physical diseases.

“The biggest thing is we are really destigmatizing mental illness,” says Dr. Sonia Krishna, a child and adolescent psychiatrist at Dell Children’s. “It’s on the same plane as children getting treatment for physical illness. It’s another pediatric problem.”

Previously, children needing hospitalization for mental health diseases would come to the emergency room at Dell Children’s and then be transferred to the pediatric and adolescent unit at Seton Shoal Creek Hospital or another hospital. That unit at Shoal Creek accepted its last pediatric or adolescent patient on Thursday morning. Those remaining in that hospital over the weekend will be moved to the new unit at Dell Children’s on Monday. In the meantime, patients are being referred to other mental health hospitals throughout the area.

Seton Shoal Creek will become an adult-only facility on Monday. Seton has not determined what the now-empty unit at Shoal Creek will become. The long-range plan is for a new adult hospital.

The Grace Grego Maxwell Mental Health Unit at the Dell Children’s Medical Center of Central Texas will open on Monday. JAY JANNER / AMERICAN-STATESMAN

The new unit at Dell Children’s was both an addition and a remodel of existing space. The unit has a separate entrance and waiting room that will be staffed 24-hours a day. Physicians can now directly admit patients to the unit rather than patients having to go through the emergency room.

“The emergency room is not necessarily the best environment for kids in crisis,” says Angela Nguyen, the clinical manager of behavioral health and therapeutic services at Dell Children’s. It can be a scary place, she says, and it also can expose them needlessly to germs.

Patients also previously had to transition to another space for care, which was an added expense to families as well as added time before children got the right type of care they needed.

Now, families will be able to be go to that separate entrance, be assessed in one of four consultation rooms and be either admitted for inpatient care or accepted into the new intensive outpatient program or partial hospitalization program that will be on-site or accepted into a less-intensive outpatient program such as the Texas Child Study Center, which is connected to Seton and the University of Texas.

The Texas Child Study Center is expected to move to a location either on the hospital property or nearby by the end of the year, Nguyen says. Other Seton-affliated mental health physicians and psychologists will continue to deliver outpatient care at centers throughout the community, so that families don’t have to necessarily drive to Dell Children’s for that care.

In the new mental health unit, the assessment and referral should happen within two hours of arriving at the hospital, Nguyen says. Instead of just being given a set of numbers to call if a child doesn’t need to be admitted, families will be given “a here’s where you’re going to be going,” Nguyen says.

Patients who need physical medical attention because of self-harm or who are in imminent physical danger will be admitted to the hospital until that need has subsided.

If children do need to be admitted to the mental health unit for what is typically a four- to five-day stay, they will receive a continuity of care as they step down levels of care. They will see the same group of physicians who are sharing the same records, rather than having to go somewhere else.

“We’re focusing on integrated care,” Nguyen says. “The right place at the right time.”

The unit is not expected to reach capacity during the summer, which is the slowest time of the year for mental health intake cases as well as hospital intake cases in general, Krishna says. Fall and spring tend to be the busiest times of the year for cases, she says, and when it does reach capacity, doctors will do what they currently do and find patients placement at other area hospitals, or if they know a bed is about to become available, have them stay in another part of the hospital temporarily.

The inpatient unit will be divided by age — 6-12 and 13-17. It was built with the ability to separate areas and change how many of the rooms are for each age group based on need. The unit has spaces for group therapy as well as quiet and not-so-quiet activities. All the rooms have psych-safe furniture that is bolted down, but the unit was designed to be light and airy and not feel like a bad place to be, Nguyen says.

Rooster Teeth donated the unit’s healing garden, which will have a shaded basketball court, space for noisy activities and more quieter activities as well as the potential for raised gardens for kids to plant.

The intensive outpatient and partial hospitalization side has room for two to four groups of eight to 10 kids in each group at one time.

The new center will allow Dell Children’s to also expand care in specialized areas such as substance abuse treatment and eating disorders. The needs and where to put the focus is still being assessed, Krishna says.

“It’s going to be a really great experience,” Nguyen says. “We’re all going to be here under one roof. Everyone is excited to make sure kids have a great experience.”


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