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Rice is set to open its new mental health unit this week

WILLMAR -- When the doors open this week in Rice Memorial Hospital's new mental health unit, patients will be gaining larger rooms, more space for specialized programming and an environment designed to be safe and calming.

WILLMAR -- When the doors open this week in Rice Memorial Hospital's new mental health unit, patients will be gaining larger rooms, more space for specialized programming and an environment designed to be safe and calming.

Hospital officials say it'll help increase Rice's ability to effectively care for psychiatric patients, especially those with medical needs.

"We didn't have this kind of room before. It's a big improvement," said Mary Kjolsing, director of mental health programs for the city-owned hospital.

The inpatient mental health unit will become the first department to open next week in the hospital's newly transformed west wing.

The Rice Institute for Counseling and Education, the hospital's outpatient behavioral health clinic, is slated to be the next new tenant; it will occupy its new space at the end of February and is hosting an open house March 3. It marks another major step in a four-year, $52 million project to expand and renovate the hospital. A new patient care wing opened last year; construction has now shifted to the west wing, which was gutted last summer and is being almost entirely rebuilt.

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By the time the entire project is complete at the end of 2006, virtually every department in the hospital will have undergone relocation, expansion or renovation.

The inpatient mental health unit will make the move into its new second-floor home on Wednesday, Thursday and Friday. "Our goal is that by noon on Friday we will be fully up and operating in our new unit," Kjolsing said.

The unit has eight beds for psychiatric patients. On average, the daily census is four to five patients, who typically are hospitalized for just under a week.

Most of the patients who are admitted have depression and are often suicidal and in need of acute care, Kjolsing said.

They often have many medical needs as well. For instance, they might be dehydrated or suffering from weight loss, or coping with a chronic medical problem.

"A lot of times these people are very, very ill when they come in," Kjolsing said.

It's the task of the staff to help stabilize these patients so they're well enough to be sent home.

"Our primary goal is to do evaluation, stabilization and medical management and to put together an outpatient aftercare program," Kjolsing said. "Our patients are with us for such a short period of time that the program is tailored for each individual client. We do a great deal of patient education and family education while the patient is on the unit."

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By locating both the inpatient unit and the outpatient mental health clinic on the same floor, it's hoped that the transition from inpatient to outpatient care will be enhanced, she said.

The soothing environment that was a key element in the design of the hospital's new patient care wing has been carried over to the new mental health unit as well.

One of the goals was to strike a balance between open space and private space, and to ensure that patients can be adequately observed, Kjolsing said.

The staff had considerable input in the design, she said. "It's a very hard thing to come up with an environment that seems warm and homey, yet does not present a lot of hazards to people who want to hurt themselves."

The rooms, all private with baths, boast large windows with upholstered window seats.

During the day, patients are encouraged to be out of their rooms, Kjolsing said. Meals are served family-style in a group dining room; nearby there's a living area where patients can watch television or sit and read.

Because patients aren't allowed outside the locked unit, opportunities for physical activity have been created with a recreation area equipped with pool and pingpong tables and air hockey. Exercise equipment also is being installed.

The unit's occupational therapy clinic, formerly housed in a cramped corner, now has space of its own. Here, patients can undergo evaluation for such things as cognitive functioning or hand-eye coordination. They also can receive therapy that helps them care safely for themselves and develop coping and leisure skills.

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It's a big improvement to have two patient rooms that'll accommodate people whose medical needs are more intense, Kjolsing said.

In the past, these patients usually had to be moved out of the mental health unit and into a medical unit, she said. Now, for the most part, they'll be able to stay where they are, she said. "It's better for the patient to stay and be cared for by folks that are familiar to them."

Safety was a priority in the design of the entire hospital project, but especially so in the mental health unit where patients and staff are particularly at risk of getting hurt, said Kjolsing and Doug Buchanan, director of environmental services for the hospital and owner's representative on the construction team.

The mental health unit was built with high-impact sheetrock and windows, Buchanan said. All the cupboards are equipped with locks. Light switches and water faucets can be controlled from outside the patient's room. Even the door hinges are specially designed.

"Everything had to be unique," Buchanan said. "This whole unit was designed for patient safety."

Historically, the unit has been a place for acute, short-term psychiatric care. People in need of longer-term residential treatment or who have been involuntarily committed to psychiatric treatment typically have gone to Willmar Regional Treatment Center or another residential facility.

It's not clear how Rice Hospital will be affected by the downsizing and eventual closing of the regional treatment center campus. The hospital has been involved for more than a year in negotiations with the Minnesota Department of Human Services about operating a mental health residential treatment unit -- separate from Rice's inpatient unit and its outpatient behavioral health clinic -- that could help fill the gap.

Another strategy might be for Rice to broaden its array of inpatient mental health services. The hospital currently has three full-time psychiatrists and is actively recruiting more.

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There's a genuine need for acute psychiatric beds in Minnesota, Kjolsing said. At times, patients from the Twin Cities have been sent to Rice Hospital's inpatient mental health unit because no hospital in the metro area has an available bed.

There's also a need for the type of longer-term residential care the regional treatment center has provided, Kjolsing said.

"Their needs are very different. That presents some real challenges. The treatment center has definitely filled a niche in this community and the surrounding area," she said. "We don't really know what kind of patients we'll be serving in the future."

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