DSH - Metropolitan LA: Treatment Programs
Overview of Treatment Services
Continuum of Care
The Department of State Hospitals (DSH) - Metropolitan LA provides a range of psychiatric treatment in a continuum of care. This continuum includes acute care, Intermediate /Sub acute care, Psychiatric Rehabilitation, and a Skilled Nursing Facility. The programs were developed to respond to the identified treatment needs of the Patients served.
Psychosocial Rehabilitation Malls and the Recovery Model
DSH - Metropolitan LA implemented the Psychosocial Rehabilitation/Recovery (PSR) -Treatment Mall concept in 2003. This innovative advancement in the treatment of Patients in psychiatric institutions was the first program of its kind in the State. Each of the hospital’s five programs has at least one PSR Mall. Within this framework, Patients participate in a holistic approach to treatment that helps set goals for recovery while more closely imitating life in the community. In the PSR treatment mall, staff and Patients from multiple residential units come together to provide and receive mental health services. Similar in concept to a college curriculum, Patients select from numerous skills-based classes that meet their specific treatment objectives. The classes are designed to teach daily life skills, vocational training, education and social skills that overcome discharge barriers and prepare Patients for community placement. The PSR mall is based on a Recovery Model of mental health services that emphasizes the central role the Patient plays in their recovery through individualized evidence-based interventions, self-determination and choice, and development of a healthy lifestyle.
DSH - Metropolitan LA is committed to providing treatment that meets the highest therapeutic standards. The treatment mall concept has been shown to be an effective treatment approach for Patients with mental illness in inpatient psychiatric settings. Unlike traditional inpatient therapy, which focuses on treating disease, disorders, and deficits; the recovery model focuses on the Patient’s strengths and aspirations. The treatment team uses empirically validated interventions to enable the Patient to achieve a healthy, empowered lifestyle. The ultimate goal is for each Patient to transition into community living through utilizing of life skills learned while in the hospital.
The hospital is organized into five treatment programs. Each program is under the direction of a Program Director, Program Assistant, Nurse Coordinator and Senior Psychiatrist. The programs vary in service due to age, level of care, legal commitments and specific needs. Care of the Patient at DSH - Metropolitan LA is part of the total treatment given in partnership with County Mental Health Services, the Judicial System, and/or other State Hospitals. The populations served and the corresponding treatment units are as follows:
Division of Juvenile Justice Treatment Unit
- 109 ICF Male Young Adult
Unit 109 is an ICF program that serves Division of Juvenile Justice residents, ages 12 – 25 and is located off-campus at the Southern Youth Correctional Reception Center and Clinic in Norwalk.
Adult LPS Treatment
- 410 Acute(CMS Cert) Coed
- 412 Acute Coed
- 414 Sub acute Male
- 416 Sub acute Male
- 420 Sub acute (Spanish)Coed
Unit 410 is an acute and CMS certified admission unit. The unit accepts Patients newly admitted to the hospital as well as Patients from other treatment units who are experiencing an acute exacerbation of symptoms requiring intensive treatment and stabilization. Most of the Patients served are on LPS conservatorships.
Units 414 and 416 provide continuing treatment for Patients who no longer require acute psychiatric services. A primary treatment goal is to assist the Patient to gain self-control and reduce disabling behaviors that prevent placement in a less restrictive environment and prepare the Patient for a successful transition to community living.
Unit 412 provides continuing treatment for LPS conservatees. The unit also accepts Patients admitted from local county jails, deemed as low security risk according to pre-established screening guidelines. Only a very limited number of beds are utilized for this population. For Patients from Los Angeles County jails, the treatment goal is stabilization and preparation for return to the jail setting.
Treatment modalities within the program include: Patient and Group Psychotherapy, Family Therapy, Community Therapy, Educational Classes, Life Skills Groups, Rehabilitation Therapies, (music, dance, recreation and art), Psychological Testing, Discharge Planning, Medication Management and Industrial Therapy. Many of the staff has been trained in Dialectical Behavior Therapy. This is a very specialized treatment modality that encompasses all aspects of the treatment and living environment. Dialectical Behavior Therapy is seen as especially helpful in mitigating severe behaviors often associated with Borderline Personality Disorder. Many of the classes, groups and activities are provided in the Biopsychosocial Treatment Mall, located on Units 404 and 408.
Unit 420 has programs to addresses treatment issues in focused social and cultural milieus, Treatment is provided in Spanish and Asian/Pacific languages.
Each unit has an enclosed patio area that can be utilized for special events, exercise groups, barbecues, gardening groups and other group activities.
Adult Forensic Treatment
- 401 Acute PC Male
- 407 Sub acute Male
- 409 Sub acute PC Coed
- 415 Sub acute PC Male
Program III is a Forensic Program providing treatment to Patients who have been found Not Guilty by Reason of Insanity (PC 1026), Incompetent to Stand Trial (PC 1370), or former parolees need additional mental health treatment (PC 2972).
Unit 407 serves the PC 1026 population primarily. The treatment goal is to prepare the Patient for discharge to a less restrictive environment. The majority of placements will be through the Department of Mental Health's Conditional Release Program (CONREP). A biopsychosocial approach to treatment is used. Some of the treatment activities provided include: medication management, anger management, substance abuse education, relapse prevention and leisure skills.
Unit 401 and 409 serve Patients with PC 1026 or PC 1370 commitments, as well as PC 2972 commitments.
Unit 415 serves the PC 1370 population. Due to mental illness, the Patients have been unable to successfully complete the judicial process and have been found incompetent to stand trial. Within the larger framework of recovery and wellness, an important treatment goal is the restoration of competency and return to court to stand trial.
Some of the treatment modalities include: trial competency groups, mock court, medication education and management, substance abuse groups, relapse prevention, leisure skills, and socialization activities. All modalities have the goal of preparing the Patient to successfully complete the trial process.
The Biopsychosocial Treatment Mall, Bridge to Recovery, occurs throughout the program, utilizing all the resident units as well as patios, rehab clinics, classrooms, the dining room and the central courtyard.
- Unit 403 Sub acute PC Male
- Unit 405 Acute PC Male
- Unit 411 Sub acute PC Male
- Unit 413 Sub acute PC Female
Units 403, 405, 411 and 413 make up Program V and serve primarily the PC 1370 population. Due to mental illness, the Patients have been unable to successfully complete the judicial process and have been found incompetent to stand trial.
The Biopsychosocial Treatment Mall for these units is called New Horizons. All resident units are used for the mall classes and activities as are the patios, rehab clinics, classrooms, dining room and courtyard.
Skilled Nursing Facility
- Unit 418 SNF Coed
- Unit 419 SNF Coed
Units 418 and 419 are skilled nursing units that treat adults identified with mental disabilities and physical disabilities requiring skilled nursing care.
A focus of the treatment is on improving, retaining and/or recapturing self help skills, activities of daily living, and physical capabilities, such as ambulation, bowel and bladder control, self feeding, grooming and prevention of physical deterioration.
Admission to these units is justified when an Patient has a primary physical medical need, and a concomitant mental disorder that requires continuous skilled nursing intervention, and/or is aged/infirmed and requires supportive nursing care.
ADDITIONAL SERVICES/Central Program Services
Central Program Services has a Chief and two Assistant Chiefs. CPS supplements, supports and augments the program resources. Many of these occur off-unit throughout the hospital grounds. These include the following CPS facilities:
- The socialization program - “Oasis”
- James Hall Auditorium - for hospital-wide recreational activities
- Beauty and Barber Shop
- Industrial Therapy - providing job-training and minimum wage employment in accordance with Patient treatment plans
- Golden Vista School -providing GED, life skills and remedial education
- Volunteer Services – a large and active department that offers both direct and support services to treatment programs under the guidance of hospital staff
- Religious Center - Catholic, Protestant and Jewish chapels providing regularly scheduled religious services.
- Fashion Center - provides clothing for the Patients in a store-like setting.
- Community Store
- Arts in Mental Health Program - Community artists provide structured activities in a therapeutic setting including art, music, dance and theater workshops under the coordination of the Artist Facilitator.
- Horticultural Program – providing education and rehabilitation services in greenhouse and garden settings on the hospital campus
Other services and facilities include:
- Courtyards for intramural and Patient activities.
- Rehabilitation Therapy Clinics - provide space for cooking, crafts, fitness, music and leisure pursuits and related rehabilitation therapies.
- Medical, dental, physical therapy, podiatry and other medical ancillary services.
- Dining facilities
- Ball field and Picnic area
- The Trust Office and Cashier’s Office which handle patient financial accounts