Q&A: Introducing a donor-supported intensive day program for adolescents
Everyone is talking about mental health, especially its severe and widespread impacts on children and adolescents.
On the national stage, the U.S. Surgeon General recently issued an advisory on social media and youth mental health. At the local level, the MultiCare Behavioral Health Network is actively filling gaps across the pediatric continuum of care, with offerings like MultiCare Behavioral Health’s new intensive adolescent day program in Burien.
We sat down with the program’s medical director and psychiatrist, Lucas McIntyre, MD, to learn how six weeks of psychiatrist oversight combined with group, individual and family therapies can help prevent teens from reaching a behavioral health crisis point.
Q: Before we dive into this program, can you share what drew you to the field of youth mental health?
Dr. McIntyre: During my rotation at Harborview Medical Center, I had the opportunity to do a site visit at Lakewood’s Child Study and Treatment Center, a long-term residential facility for children and adolescents. There I saw a panel of adolescents talking about their experiences receiving treatment and the recovery process they went through, and I was really inspired.
I found I enjoy working with adolescents in particular. They’re at such an exciting time in life where they’re developing their identities — getting to know who they are and differentiating from their families. It’s also a time where we see the beginning of a lot of mental illness for people, meaning it’s a crucial time to be able to intervene.
In October 2019, I was fortunate to get my job at the MultiCare Tacoma General Adolescent Behavioral Health Unit (ABHU), which treats 13- to 17-year-old inpatients for a range of behavioral health issues over a three- to seven-day acute stay.
Q: How would you describe the adolescent Partial Hospitalization Program?
Dr. McIntyre: To clarify, these 13- to 17-year-old patients aren’t coming to the hospital and staying overnight like they do at the ABHU. Instead, the adolescent Partial Hospitalization Program (PHP) is an opportunity for youth struggling with depression, self-harm behaviors, chronic suicidality or emotional dysregulation to spend some intensive time — 25 hours per week — gaining skills to tolerate distress, regulate their emotions and improve the ways they interact with their family, peers and the community.
Specifically, we’ll be using a dialectical behavior therapy (DBT) model, which focuses — almost more than any other therapy — on the combination of acceptance and validation, along with change. It’s accepting kids where they are, but also recognizing they can get better, and they can do better. The model pulls from both cognitive behavioral therapy and Zen traditions, particularly mindfulness, to help decrease suicidality and urges for self-harm, while increasing motivation for living.
The program also features a strong family component, where parents or guardians learn about DBT and uncover their own skills to help their adolescent. By empowering families and patients to develop this skillset earlier on, participating adolescents are less likely to get to the point of crisis where they need inpatient psychiatric hospitalization. From my clinical experience, we’re in desperate need of programs like this that serve a preventive function.
Q: What’s your vision for the program?
Dr. McIntyre: It would be great to expand the program in terms of the type of PHP that’s provided. While this one is focusing on kids who are struggling with depression, self-harm or suicidality, there are models for focusing on anxiety, obsessive-compulsive disorder or first episode psychosis.
I’d love to be able to serve our patients from Pierce County as well. Once we’re established and get the program up and running, I’m interested in seeing if we could get a shuttle service from Tacoma up to Burien to overcome the limiting factor of transportation.
Q: What role has community generosity played, and what message do you have for future donors?
Dr. McIntyre: We currently have a contract with the Washington State Healthcare Authority to get the program off the ground and do the initial pilot. That being said, we used MultiCare Behavioral Health Foundation funds for some of our capital expenses like security cameras, which are really important from a safety perspective.
For me, a donation is an investment in our community and the future. For so many adolescents, they’re struggling with depression, anxiety. By helping them get through a rough patch, so many of them become stronger and more resilient. They become much more productive community members who end up helping everyone.
We’re helping people not only live engaged lives, but there’s also the pure human aspect of helping alleviate somebody else’s suffering and bringing a little joy.
