Eating disorders exact a heavy toll on individuals and families in the U.S. According to the National Association of Anorexia Nervosa and Associated Disorders, about 24 million Americans have eating disorders psychological conditions that have the highest mortality rate of any mental illness. Yet, just 1 in 10 people with eating disorders receives treatment, the ANAD Association reports.
At John T. Mather Memorial Hospital in Port Jefferson, N.Y., Susan Morin, MS, RN, NPP, PMHCNS-BC, serves as director of the hospitals adolescent and eating disorder partial hospital program, which treats people with eating disorders.
Q: Where do patients in your program come from?
A: Our patients often come from inpatient eating disorder units and residential settings as a step down from a higher level of care. They are also referred from medical units and emergency rooms.
We treat women, men and adolescents and see a combination of anorexia, bulimia, binge eating disorder and clients who have symptoms that meet criteria for our level of treatment, but may fall outside the specific criteria to meet a particular diagnosis.
On an annual basis, we treat approximately 150 individuals. We serve 10 clients at a time, which provides for very individualized and intensive treatment.
On average, a patient attends four weeks of the partial hospital program, and often then steps down to the intensive outpatient program. Upon discharge, they are connected with practitioners and services in the community.
A patient often works with us at a full-day partial hospital level for approximately four weeks, and may then continue for approximately two weeks at IOP before being reintegrated into the community with an outpatient team we arrange with the client before discharge. Each individual is different. There are times patients are with us for shorter or longer durations.
Q: Please expand on the interdisciplinary approach. For instance, what role do nurses play?
A: We are an exceptional example of how a collaborative interdisciplinary treatment team works in harmony to achieve positive patient outcomes. All of our PHP programs are interdisciplinary, and excellent communication and cooperation are key to success.
Feedback from one discipline to another is given and received with respect and professionalism. It helps us to see the biopsychosocial aspects of our clients so we can create a treatment plan and intervene in a more holistic manner.
Our program has one certified psychiatric RN for 10 clients, Kathleen Jochen, RN,C. She is very involved with our clients, which often begins at the first phone call.
Kathleen walks the client through the referral process and medical clearance process, and is often the first person conducting the initial screening.
She works closely with our psychiatrist regarding the psychiatric evaluations and medication management regimes for our patients. Kathleen also conducts many of our very successful groups, which include medication education and health awareness.
As there is much involved with maintaining a safe outpatient environment, Kathleen has many responsibilities too numerous to list that ensure sustained health and wellness while in our care. She is instrumental in working in collaboration with the medical professionals that provide the clearance for our clients to work with our outpatient team.
Q: How important is intervention in a program like this?
A: Intervention is everything. I am blessed with a most amazing team of individuals who have essentially dedicated their careers to helping those with eating disorders, and they do so with the greatest respect, compassion and professionalism.
Our outpatient teams are multidisciplinary and include nurses, social workers, psychiatrists, nutritionists, mental health counselors and administrative professionals. I have the rare privilege of working alongside real life angels, as by definition they are truly guardians of human beings who demonstrate exemplary conduct and virtue.
Q: How did you become the director of the program?
A: I have been a nurse for 29 years. My inpatient and private practice work experiences include child, adolescent and adult psychiatry. I was part of a team that launched our very successful adolescent inpatient unit at Mather, and in 2001, was recruited to fulfill the nurse practitioner role in the adolescent partial program. In 2002, I became the director of the adolescent and eating disorder partial hospital program at Mather.
In my teen and early adult years at college, I was aware of my female peers with eating disorders. I read books on the subject and provided support, information and, on several occasions, even escorts to doctor appointments and the campus health center. I was acutely aware that these amazing individuals were being consumed by an entity that appeared to not be within their control.
Q: How has the program at Mather evolved through the years?
A: The eating disorder program started in 1998 as a part-time, three-day-a-week intensive outpatient program. In 2001, the IOP was relaunched, and I joined the team in 2002. It was a slow and painful process reaching out to a population that often suffered in secrecy. With the dedication and talent of my outstanding team of professionals, we were able to share knowledge, encouragement and passion where ever we traveled.
As we continued to achieve success in outreach efforts, it became more apparent we needed to expand our hours of treatment to successfully meet the needs of our clients. With the support of my nurse AVP and hospital administration, I was permitted to expand our staffing and patient hours to provide a partial hospital level of care that meets five days a week for six hours a day.
Our IOP, unlike similar programs, provides all facets of care, including individual and family therapy and medication management, along with groups. Many similar services do not provide all modalities under one roof at the IOP level.