A New Approach to Adolescent Care

The Lindner Center of HOPE is a bright, airy, modern facility in a country setting that offers both short- and long-term mental health services for adults and adolescents. Walking paths, gardens and outdoor patios on the campus offer quiet, contemplative spots for its patients and their families. The facility is located between I-75 and I-71 near Kings Island amusement park it is nestled off the main road on 36 private wooded acres. 

Opened in 2008 through benefactors Frances and Craig Lindner, the center strives to offer hope to people living with mental illness. The center was created with one goal – "becoming the top level mental healthcare delivery system in the nation with the outcomes to prove it." In addition to patient care, the center is involved with medication trials, genetic discovery, research (with grants totaling more than $3 million), and advancing new technologies and treatments, like Transcranial Magnetic Stimulation.

There are very few facilities in the country like the Lindner Center of HOPE where the staff tries to meet the constant changes in the mental health field by creating the best model of care through deep diagnostic discovery.

Since its opening, more than 23,000 patients from 45 states and several countries have been treated with the center's cutting edge approach of conducting a thorough, 360-degree evaluation to achieve an accurate diagnosis as well as including the patient as part of the treatment team.

The center includes an acute inpatient hospital outpatient services, and a diagnostic assessment and intensive treatment center called Sibcy House (all in partnership with UC Health).

The Sibcy House program for adults offers specialized assessment and short-term intensive treatment for individuals struggling with mental health and addiction issues. Its 10-day treatment program involves clinical observation, symptom reduction strategy, diagnostic assessment and long-term treatment plans. 

"The strength of the program includes a strong staff of psychiatrists and doctorate-level psychologists. Almost all of our unit staff has bachelor degrees and even support staff has extensive in-house training to help benefit our patients," says Mike Grossi, clinical manager of Sibcy House. 

Because of its success with adult patients and requests from professionals and families, the center expanded its scope in May of this year to open a comprehensive Adolescent Diagnostic and Treatment Program for patients ages 11-17 modeled after the adult program. The center serves adolescents with depression, anxiety, bipolar, obsessive compulsive, eating, addictive, and co-occurring psychiatric disorders.

Cincinnati Children’s Hospital Medical Center operates an acute care center on the campus and the Lindner Center of HOPE operates a longer-term program. Unlike other adolescent programs, the Adolescent Diagnostic and Treatment Program approach is groundbreaking because, like the adult program, it focuses on a comprehensive diagnostic assessment during a 21-day program and aftercare. 

Similar to adults, the general hospital stay for an adolescent in distress is short, just five to 10 days. This does not provide adequate time for evaluation of the underlying issue causing the distress. Typically, an adolescent in crisis is treated in the hospital, stabilized and then is sent home shortly after the crisis has passed. There is often no further assessment or treatment until the next crisis.

"Aftercare for our patients is critical," says Jennifer Pierson, director of marketing and outreach. "In our hospitals, we don't just stabilize a patient after a heart attack and send them home without any follow-up or long term treatment plan. But for some reason, with mental illness people think the issue should just be remedied immediately, without follow up care." 

The extended time frame at the Lindner Center of HOPE is beneficial because it gives the staff a chance to learn more about the adolescent and "to break down barriers the patient has built up, and it helps us build relationship with them," says Dr. Elizabeth Wassenaar, a staff psychiatrist.

During the stay, a support team of staff psychiatrists, psychologists, clinicians, and other specialists collaborate with the patient’s family and outside partners to develop a diagnostic treatment plan for further treatment. The staff works to provide this information to the patient’s team of caregivers who will assist the patients once they leave the facility.

The assessment and testing involves family interviews; life roles assessment; psychiatric evaluations; psychosocial assessment and aftercare planning; psychological and neurologic testing; health history and physical; pharmacogenetic testing to evaluate if a pharmaceutical is effective based on the patient’s genetics; clinical observations by the staff; and recreational therapy assessment.

Patient care begins immediately upon a patient’s arrival and work is done during the assessment phase. The staff immediately gets the patient involved with small support groups. The patient receives instruction on emotional skills management and learns how to apply these skills both during their stay and after their discharge.

Because they are dealing with their mental illness and the stress of family issues, the patients use these skills to manage their emotions during their stay and during their transition. The center also uses expressive therapy and meditative periods to help the patient with self-discovery.

The goal of the clinical team is to focus on the positives in an adolescent’s life. The team stress that the mental illness is just but a small factor of their entire self, that normalcy is possible, and that they are not stuck on a path of destruction. 

"We like to tell them that this trajectory can be changed and that their mental illness does not define them," says Wassenaar. "Like diabetes and other illnesses, it can be managed and that they are so much more than their illness. We help them to define the good parts of themselves. We tell them that they are not bad – there is just a part of them that is not working right."

The clinical team uses the patient’s strength-based assessment to help him or her use their strongest skills to develop positive coping mechanisms and to build a strong support network for their aftercare beyond the Lindner Center of HOPE. 

Grossi says that once the focus is shifted from coping to manageability, the illness seems less prevalent to the adolescent. However, if it's ignored, "it consumes their identity. Like any another other illness, it becomes a small part to manage and then teens can allow themselves to become who they were meant to be." 

Wassenaar believes the national dialogue needs to change. "The focus should center on mental health, not mental illness. The one-size-fits-all approach to mental health needs to change. Just as we are all unique individuals, our interventions are uniquely individual too."