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First-of-its-kind youth mental health crisis clinic opens in New London

The Day - 8/23/2023

Aug. 23--NEW LONDON -- It's not unusual for Dr. Shady Elsamra to walk into Lawrence + Memorial Hospital's emergency department on any given morning and be greeted with a line of patients both children and adults suffering from mental health issues.

"There could be 16 people waiting in crisis," said Elsamra, the hospital's vice-chairman of psychiatric services. "And that's just to start our day."

Elsamra and local child advocates are applauding the recent opening of a new urgent crisis center dedicated to addressing the immediate needs of youths suffering a mental health crisis.

The addition is expected to serve as a sort of patient pressure release valve for overcrowded hospitals.

Inside an upper-floor conference room on Wednesday at the Child and Family Agency of Southeastern Connecticut's office on Hempstead Street, a small group of caregivers broke into cheers and finger-snaps.

The exuberant reaction came after CFA Chief Operating Officer Erin Saylor got the news its new center would get its operating license from the state Department of Children and Families, or DCF, on Thursday.

The center is one of four first-of-their-kind clinics in the state created by landmark 2022 legislation aimed at addressing what child advocates are calling a behavioral health youth crisis in Connecticut.

The outpatient clinic offers wrap-around services for New London, Windham and Middlesex county clients experiencing any of a number of immediate mental health crises, including suicidal and homicidal thoughts, depression, anxiety and other high-risk issues.

"This is an intermediary place, a calm space with a multi-disciplinary approach to care that involves a registered nurse, clinician, psychiatrist, client support and discharge staff," Saylor said. "Everyone is working together to deescalate a crisis, conduct a comprehensive evaluation and send the client out with treatment recommendations and options for additional services."

Clients can call the facility's office for help or simply walk up to the group's 255 Hempstead St. offices during operating hours. Since June, the clinic has offered similar services at the group's Vauxhall Steet outpatient offices while the state licensing process played out.

The kinds of clients the facility aims to help the clinic has seen eight patients since June are likely to lack a safety plan and may come encumbered with family challenges.

"And that meant they'd be otherwise going to an emergency room for help, where they might wait for hours and become further traumatized because there were no real other options," Saylor said.

Clearing an emergency room patient jam

Jeanne Milstein, the city's director of human services and a vocal proponent of the crisis care model, said in her previous role as the state child advocate she witnessed heart-breaking scenes of children with acute mental health issues languishing in emergency departments.

"I'd see them literally in stretchers in the same hallways they'd been for days," she said. "Getting these clinics operating is one of the most important initiatives the state has approved."

Elsamra, who also serves as L+M's director of clinical psychiatry, said he saw a significant spike in the number of individuals, including children, with psychiatric issues flocking to emergency departments during the height of the COVID-19 pandemic.

"We thought that would all calm down after COVID, but we're still overloaded, many times with relatively minor issues involving children that could definitely be addressed outside the emergency department," he said.

Kathleen Ellis, a psychiatric clinician at L+M, said the new clinic operates similarly to a traditional urgent care facility a patient might visit for a relatively minor physical ailment.

"It has the ability to reduce the number of people coming here who might have to wait hours -- or even stay overnight -- to be evaluated," she said.

The clinic model also eliminates situations in which a child might be forced to share space with an adult patient, something nearly unavoidable in an emergency room setting with limited beds.

"It can be frightening to have a child in an environment where there also may be a manic adult waiting for treatment," Shady said.

'Every situation is different'

The New London clinic, along with sister operations in Hartford, New Haven and Waterbury, were initially funded with American Rescue Plan Act funding. Operators, like CFA, were selected to run the clinics through the oversight of DCF and future funding will be allotted through the normal state budget process.

The Hempstead Street facility, which has space for 12 clients, boasts 11 consultation rooms of various sizes decorated with muted colors, comfortable furniture and lots of natural light.

"Our approach is to have people walk in and feel calm," said Ashley Challinor, the clinic's behavioral health coordinator.

After medical and mental health screenings, the crisis team huddles and makes a treatment recommendation consistent with a person's symptoms. That may include calling a therapist on the spot to set up a follow-up appointment or connect with the client's current caregiver.

"Our goal is to send the client out with after-care plans within four hours," Challinor said. "Since we're not a licensed residential treatment facility, the longest an individual can stay is 23 hours."

Saylor said the treatment team works closely with a client's family, and no patient can be seen without a parent or guardian's attendance. The clinic takes all insurance plans, including the state's Husky option. Grant funding will cover the cost of treating uninsured clients.

Saylor said she expects the clinic's current hours of 8 a.m. to 4 p.m. will be expanded to 7 a.m. to 8 p.m. by mid-September.

"And as our staffing expands, we'll operate 24 hours a day," she said.

Judie Nodwell, a registered nurse at the crisis center, called the treatment process a model of efficiency that brings a host of in-house specialists quickly to bear on each case.

"Every situation is different," she said. "It might be a parent bringing in an anxious child that hasn't slept well for days or a kid riddled with anxiety. This is a safe space they can come where we can figure it out."

To contact staff at The Child & Family Agency of Southeastern Connecticut's new Urgent Crisis Center, call (860) 437-4550.


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