Era of state mental treatment for youths nearing end

When Central State Hospital closed out its last hospital-based mental health unit for youths last month, it ended an era of state treatment.

All of the children and their care have been shifted to community-based crisis stabilization centers such as the new one launched by River Edge in Macon.

The changes have taken about 20 years to come and may be marked by something as basic as flowers painted on a wall. The designs at the River Edge building can deter graffiti, but also help make things more homelike.

Yvonne Nichols, whose stepson Ryan, 6, was the final patient in the state’s last child and adolescent unit, said River Edge has some advantages.

“Honestly, if I had to choose from both facilities to live in, I would pick River Edge, because it’s newer,” she said.

Shannon Harvey, chief executive officer of River Edge Behavioral Health Center, said the design of the 28-bed building, which opened about a month ago, is to mix appropriate care with a more homelike setting. The “quiet room” boasts paintings of clouds.

“You don’t want kids in an institution,” she said. “One of my guiding principles is, ‘Is this a place you would want your child served?’”

Dawne Morgan, now director of federally funded programs for the mental health division of the state Department of Human Resources, said the state used to have about 200 beds for children in seven mental hospitals and two other facilities.

The state gradually shifted that money to new community-based programs “with the premise and the notion that kids are better served in the communities, in their schools, with their families. We didn’t want kids to stay in hospital settings very long, to stay in residential services very long, because they needed to be with their families,” she said.

The way Nichols tells it, both the institutional program and the community-based program helped her stepson.

Nichols praised the staff in both locations, but especially social worker Cynthia Poole at Central State, who kept her family up-to-date. When the unit closed down, Poole moved to a different job at the Milledgeville site. Some other Central State staff started working for River Edge.

Community-based programs are supposed to incorporate families and schools for the best treatment.

Marvin Bailey, chief executive officer of Central State Hospital, said the community-based programs may be successful but will have to be monitored and tweaked to make sure they’re working well for youths.

“I think it’s better to serve kids in a non-institutional setting whenever possible, and I think the plan we’ve put in place is the right move in that direction,” he said.

Lee Johnson, director of community child and adolescent mental health services for the state, said River Edge and five other community-based centers in the state now have 112 beds to help stabilize youths who are depressed, acting out or are psychotic. Families prefer the community-based centers, which can return children home somewhat faster through improved treatments and family involvement.

“They’re more satisfied because they’re able to have their youths back quicker, and they’re more involved in the intervention,” Johnson said.

Mobile crisis teams, such as one based in Macon, were also created to try to keep youths in their homes. Sometimes that’s not enough.

“It’s a little more homelike at River Edge, as much as you can make it,” Johnson said. “It doesn’t come with the stigma of being on a state hospital grounds, either. We as a society still haven’t gotten over that.”

The interventions work, said Nichols, who is back at her Fort Benning home with Ryan. He’s been diagnosed with four illnesses, from bipolar to oppositional defiant disorder. Now, she says, he seems more relaxed, very happy — more like a kid.