The inpatient units in the psychiatric service at The Johns Hopkins Hospital are organized by general and specialty care units. Patients are often very ill and have family, social and occupational problems as a result of their psychiatric impairment. Each unit is staffed by a multidisciplinary team of professionals that includes a social worker. In general, social workers provide the following services on each unit, with differences of emphasis based on the type of patient and the particular illness.
ASSESSMENT - social workers conduct an interview upon admission to identify the strengths and needs of the patient and the family. Along with the psychiatrists, nurses, and occupational therapist, they help to develop treatment goals for the hospital stay and beyond.
ILLNESS EDUCATION - social workers provide information and supportive counseling to patients and families in relation to the illness itself and how it affects relationships, work/school performance, and family life.
FAMILY SUPPORT - social workers are the primary point of contact for the family. When appropriate, they provide the family with information and arrange and conduct meetings to facilitate communication among patient, family and care team members. This is often vital to the transition of the patient when discharged and to the long-term success of treatment.
GROUP THERAPY - On some units' day hospital programs, social workers run therapeutic groups to help patients with coping skills.
DISCHARGE PLANNING - social workers guide patients’ contact with agencies in the community and provide most of the information and referrals for follow-up. Planning for aftercare is a collaborative process with patient, family, the treatment team, and outside services. These may include an outpatient clinic, day hospital, a residential facility, or other type of care as appropriate.
The following General Psychiatry and Specialty Units are provided in the department with social workers as integral parts of the care teams.
General Psychiatry Unit
Patients on this unit typically have very limited resources and suffer from the full range of psychiatric diagnoses including major depression, bipolar disorder, schizophrenia, and substance abuse. In order to improve the patients’ level of functioning and to help them reintegrate into the community, social workers serve as illness educators, conduct cognitive behavioral therapy, deal with family relations and treatment compliance, and coordinate aftercare planning.
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Adult Mood Disorders Unit
Patients on this unit frequently have responded poorly to outpatient treatment in the past and have multiple family, social, and occupational issues as a result of their impairment. As specialists with patients and families coping with mood disorders, the social workers in the mood disorders unit and day hospital provide individual and family counseling, illness education, help with healthcare benefits and planning for after the hospital stay.
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Adolescent/Young Adult Mood Disorders Unit
Ranging in age from their late teens to their mid-twenties, the patients on this unit are often newly diagnosed with a mood disorder or have not adequately responded to other treatment. Because a patient’s illness can interrupt schooling, employment and family/peer relationships, the social worker often mediates in these arenas on the patient’s behalf.
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Eating Disorders Unit
Patients on this unit are diagnosed with anorexia nervosa, bulimia nervosa or other eating problems, sometimes in conjunction with mood disorders and/or substance abuse issues. The social workers on the treatment team assist with family and group therapy. Groups form around topics of self-esteem, body image, peer relationships, and family interactions. Family members usually need extensive education and emotional support to change their own behaviors to better support the patient's recovery at home.
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Patients admitted to the Geriatric Inpatient Unit need evaluation and treatment of problems of mood, memory, thinking or behavior, often complicated by chronic or acute medical issues. Many also come with housing and care-giver problems. Sometimes patients will need a higher level of care upon discharge than they were receiving before admission. This makes comprehensive discharge planning, which is led by the social worker, vital to both the patient and the family.
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Memory and Neuropsychiatry Unit
This unit is designed for patients with psychiatric symptoms in the context of various brain diseases such as Alzheimer's disease, stroke, brain trauma, brain anoxia, Parkinson's disease, Huntington's disease, epilepsy, amyotrophic lateral sclerosis (ALS), and multiple sclerosis. Proper aftercare planning, guided by the social worker, involves family members, paid caregivers, and a wide range of community supports.
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Motivated Behavior Unit
Patients on the Motivated Behavior Unit are treated for substance abuse, usually in combination with other psychiatric disorders. Treatment is focused on acute detoxification and stabilization of psychiatric symptoms to prepare them for longer term rehabilitation treatment. Along with other staff, the social worker in this setting conducts patients groups for dual-diagnosis education, relaxation training, development of coping skills, and relapse prevention.
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Pain Treatment Unit
The Pain Treatment Program is designed to treat patients with chronic, disabling pain that requires intensive rehabilitation. Treatment plans are individualized and comprehensive, dealing with a complex interaction of medical, neurological, and psychiatric issues. The social worker on the treatment team provides group and family therapy as well as aftercare planning.
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In addition to initial assessments and supportive family therapy during an inpatient stay, the social worker on the Schizophrenic Unit also conducts group therapy daily with patients in the Schizophrenia Day Hospital to increase illness understanding, problem-solving skills, and social supports. Patients typically move from inpatient care to the day hospital with the social worker key to discharge arrangements and supports.
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Short Stay Unit
The Short Stay Unit treats patients with psychiatric symptoms that can be treated and stabilized in two to five days. Their active symptoms are often accompanied by problems of substance abuse, homelessness, personality disorder, or cognitive limitations. Social workers meet with patients daily for individual counseling and discharge planning often involves follow-up and referral to substance abuse treatment, partial hospitalization, housing assistance, HIV/AIDS services, medical insurance, prescription assistance, and family/marital therapy.
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