1. 9West: Inpatient Psychiatry
 Physical layout and structure as a locked unit
 26 beds in total; 4 female
 Day room
 Observation room
 GroupTherapy room
 Nurses’ station
 Staff composition
 Social workers
 Attending(s) and Resident(s)
 Nurses
 PsychTech

2. Patient Population
 Mostly men of color
 High rate of co-occurring disorders
 Geographically nearby, large percentage homeless
 Range in age; 16+
 Frequently unemployed due to mental illness
 Few social supports, minimal family involvement
 Acute cases

3. IsWhatYou Feel Real?
A brief overview of common diagnoses on the unit

4. Major Depressive Disorder

5. Major Depressive Disorder: DEPRESSING
 Depressed mood
 Energy loss
 Pleasure (diminished)
 Retardation (psychomotor)
 Eating disturbance
 Suicidal ideation
 Sleep; insomnia or hypersomnia
 Indecisive
 Negative thinking; feelings of worthlessness or hopelessness
 Guilt

6. Bipolar Disorder

7.  Distractibility
 Impulsiveness
 Grandiosity
(heightened sense of
self)
 Flight of ideas (racing
thoughts)
 Activity (increased)
 Sleep (decreased need
for)
 Talkativeness
(pressured speech)
DIGFAST

8. Psychosis
•Inability to distinguish inner
experience and external world
•Delusions
•Presence of hallucinations
•Disorganized behavior
•Bizarre, unpredictable
•Lacking in impulse control
•Disorganized speech
•Perseveration
•Neologisms

9. Schizophrenia
Positive Symptoms
(added/new)
 Hallucinations
 Delusions
 Bizarre behavior
 Lack of personal hygiene
 Agitation
 Thought disorder;
disorganized
thinking/speech
 Word salad etc.
Negative Symptoms
(deficit)
 Blunted affect
 Poor eye contact
 Poverty of speech
 Diminished ability to
experience pleasure
 Little interest in
relationships with others
 Difficulty beginning and
sustaining activities

10. Schizophrenia

11. Role of the SocialWorker on the Unit
 Work as part of a multidisciplinary team
 Support psychopharmacological treatment by using
biopsychosocial framework to assist patients
 Provide assessment of patient upon intake as well as over
course of admission
 Advocate for patient/ in patient’s best interest
 *Discharge planning*
 Ensure patient has a plan for discharge that is safe and conducive
to mental health
 Involve collaterals; i.e. family members, psychiatrists,ACS
workers, Intensive Case Managers,ACT teams, to name a few
 Discharge to appropriate setting when symptoms have subsided
and patient is stable (no longer a danger to self or others)

12. Obstacles our Patients Face
 Severity of symptoms
 The selectively mute patient
 The severely agitated patient
 The patient with a diagnosis of Borderline Personality Disorder
 The manic patient
 The patient experiencing auditory hallucinations
 The internally preoccupied patient
 The labile patient

13. Further Resources
 Websites:
 www.nami.org (National Alliance on Mental
Illness)
 http://www.who.int/topics/mental_health/en/(W
orld Health Organization)
 http://www.nimh.nih.gov/index.shtml (National
Institute of Mental Health)
 https://www.youtube.com/watch?v=yL9UJVtgP
ZY (Clip ofAnderson Cooper simulating life with
auditory hallucinations)
 http://www.huffingtonpost.com/2015/03/27/men
tal-illness-stigma-photos_n_6950796.html
(Regarding the photographic efforts of Anne
Betton to destigmatize mental illness)
 Books:
 An Unquiet Mind by Kay Redfield Jamison
 Prozac Nation by Elizabeth Wurtzel
 Thirteen ReasonsWhy by Jay Asher
 The Day theVoices Stopped by Ken Steele