Women’s Health: Inpatient Unit Specializes in Women’s Issues

Susan Van Dusen

Women's mental health clinic setting

In March 2013, UAMS did more than open a specialized psychiatric unit. It also ushered in a new era for women’s mental health in Arkansas.

Located on the fifth floor of the UAMS Psychiatric Research Institute, the 10-bed unit is the only facility in Arkansas to offer acute inpatient mental health services in a setting exclusively for women.

“The security of being among only women provides what I call ‘psychological oxygen’ that isn’t readily available in a group with men,” said Laura Tyler, Ph.D., institute administrator and a licensed professional counselor.

The security of being among only women provides what I call ‘psychological oxygen.’Laura Tyler, Ph.D.

The unit is similar in concept to a traditional intensive care unit, Tyler said, except that the patients are experiencing acute psychiatric conditions, rather than physical illnesses or injuries.

Women admitted to the unit may be experiencing severe depression, suicidal or homicidal thoughts, psychotic episodes, or other mental illnesses. The average length of stay is five to seven days, after which patients are discharged into the care of a therapist for outpatient treatment.

“When you have a setting for women only, everyone has something in common. In our group sessions, we can focus all of our attention on issues that affect women, whether it be related to pregnancy, parenting, sexuality, abuse or other areas,” said Zachary Stowe, M.D., medical director of the Women’s Mental Health Program and a nationally known expert in mental health issues affecting pregnant and postpartum women.

Stowe treats all pregnant and postpartum women in the unit, while Lou Ann Eads, M.D., and Shona Ray, M.D., see all other patients. With the exception of Stowe and rotating physicians, the unit’s entire team of providers is women.

Focus on Women

The idea for the unit came about after the Psychiatric Research Institute opened in 2008 and leaders were looking at ways to address unmet needs in the community. By focusing their efforts on a women’s-only unit, they developed a program to tackle complex mental health issues in a setting unlike traditional psychiatric units.

“We are able to give more attention to therapy throughout the day and teach coping skills that will help our patients succeed when they leave the hospital,” said Eads, who also is an assistant professor in the UAMS Department of Psychiatry.

A primary focus of the unit is on group » sessions designed to help the women develop trust, build relationships and learn from each other as well as from their group leaders. Staff members representing UAMS’ wide range of programs and services lead sessions on all aspects of a woman’s life.

women's mental health clinic

“We have group sessions led by dietitians, chaplains, occupational and recreational therapists, nurses and social workers. This environment gives us the freedom to do the therapeutic work that prepares the women to re-enter their everyday lives,” Tyler said.

She said the inpatient nursing staff also contributes to the healing, calling them “the lifeblood” of the service.

Not only does the unit have a specialized therapeutic focus, it also has a unique aesthetic quality — the walls are lavender, the beds have feminine coverings and original artwork is found in each room. “Creating a homelike environment is important and unique to this facility,” Tyler said, adding that the patients chose the paint color and a quilting guild in Benton handcrafted the quilts that are framed on the walls to serve as headboards.

Stowe said that while safety is always the main concern, the decorative elements add a special touch that isn’t found in other psychiatric units. “Our group therapy room is filled with natural light, and we have comfortable seating areas. These are all added benefits that aid in the healing process,” he said.

Expert Care

When a women who is pregnant or has recently given birth is admitted for inpatient care, her needs require special consideration that Stowe is distinctly qualified to provide. After encountering his first case of acute onset postpartum psychosis while still in his residency, Stowe has devoted his career to treating women with pregnancy-related mental health conditions, both in the outpatient and inpatient setting.

When you have a setting for women only, everyone has something in common.Laura Tyler, Ph.D.

“Dr. Stowe’s band of experience is very wide. He brings decades of experience in working with women and understanding the intricacies of how medications and therapies can improve outcomes during pregnancy and after a woman gives birth,” Tyler said, adding that pregnancy creates a level of complexity to mental health treatment that many doctors are not specially trained to handle.

“Physicians genuinely want the mothers and babies to have the best possible treatment, so they often refer to a specialist, such as Dr. Stowe, who is highly trained to understand their unique needs,” Tyler said. Stowe is a professor in the UAMS Departments of Psychiatry, Pediatrics, and Obstetrics and Gynecology.

Since UAMS has most of the state’s only board-certified physicians in maternal-fetal medicine, many women with complicated pregnancies are already referred to the university’s hospital and clinics for treatment. The women’s unit, Stowe said, is a natural outgrowth of the care that UAMS already provides.

“We have a unique advantage at UAMS of having all of the departments in place that are pivotal to a successful women’s mental health program, and they are all willing to work together in our patients’ best interest,” Stowe said.

Turning the Tide

While each woman admitted to the inpatient unit has unique needs, there is one common thread running through many of their lives: abuse.

Whether it’s verbal, physical or sexual in nature, abuse often results in trauma severe enough to warrant inpatient psychiatric treatment.

“You would be surprised by how many women have suffered some form of abuse, whether as a child or as an adult. We have the ability here to provide a secure environment for women to start addressing and dealing with these issues,” Eads said.

Although Eads admits that doctors don’t have a crystal ball to predict when a patient is ready to re-enter everyday life, she believes that the inpatient unit fills an important gap for women at the most acute stage of mental illness.

“We are set up to help women who are struggling with issues that often get swept under the rug. After we get them on appropriate medications and in group therapy sessions, they can start thinking about how to change their lives. This is a safe place to make that possible,” Eads said.

 

Research for Future Generations

 Zachary Stowe, M.D., knows that he may never see the results of his research efforts. But that isn’t stopping him from creating a resource that will undoubtedly benefit future generations.

The Transgenerational Biorepository, located at the Arkansas Children’s Hospital Research Institute (ACHRI), is designed to collect and store DNA samples from adults and children that, over time, will yield important information about which populations are more vulnerable to disease and why.

“I don’t know what tests will be available years from now, but I do know that if we have DNA samples, we will be able to use them and learn from them,” said Stowe, a professor in the UAMS Departments of Psychiatry, Pediatrics, and Obstetrics and Gynecology.

As director of the Women’s Mental Health Program at UAMS, Stowe envisions the biorepository as a source for information on why and when certain women are more prone to develop psychiatric conditions. He also sees the data as vital for other disease-related research, by revealing demographic trends and risk factors in both adults and children.

Stowe, who specializes in mental health for pregnant and postpartum women, also seeks to enroll all of his patents in research studies to examine the effects of neuropsychiatric illness and pregnancy. One of his research projects looks at the conditions that influence a mother’s ability to bond with her baby.

“We are examining whether the use of street drugs causes changes in a woman’s brain that prevent her from properly bonding with her baby, and if those changes can be reversed by removing the offending drug,” he said.