Inpatient Care for People with Neurobehavioral Syndrome
Brookhaven, an inpatient psychiatric hospital, often has patients with TBI and a history of co-morbid issues like PTSD, depression, personality disorder, and severe behavioral problems.
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Brookhaven Hospital is a little unique in the sense of its TBI population because people come to us and generally they have what's called a "neurobehavioral syndrome." and they have failed at a lot of other levels of care. The majority of people that come to us have usually a premorbid history of psychiatric issues. They also usually are from a lower socioeconomic status. They also have a lot of-- many of our patients have been removed from their homes, the families are not really involved, they have guardians, and they have significant abuse histories, probably significant neglect histories, and then they've somewhere along the line experienced a traumatic brain injury, and that also precipitates sometimes personality disorders, major depressive disorders, maybe PTSD as a part of a comorbidity for their TBI. We have--it's an inpatient psychiatric hospital, and we have a unit that focuses on traumatic brain injury as a part of a comorbid psychiatric appearance. And the average length of stay for us really has to do with one, their severity, I think, which is very, very severe-- maybe not a sense in the mild/moderate severity of TBI in general, but just severe with behavioral issues. And then I think the second part of that has to do with a lack of placement after receiving our services. I can think of a couple of cases recently where we had patients ready to go-- ready to go back to their home state, probably not their home, but probably a community level of placement. But the problem with that was there were no resources out there for them to go to. And unfortunately, one of the issues with inpatient is, if you don't get 'em out in the magic moment to where everything is good and on the upswing, there is a very big danger of regressing and going backwards. So we've experienced that on different occasions, too-- which speaks to, again, the resources available at a lower level of care that aren't out there for many states.
Posted on BrainLine November 7, 2012. Reviewed December 25, 2017.
Ron Broughton, MEd, LPC,CBIST is the chief clinical officer at Brookhaven Hospital as well as chairman of the Ethics and Performance Improvement Committees.
Produced by Victoria Tilney McDonough and Erica Queen, BrainLine, and Dan Edblom.