Feb. 16--Just a few hours after contemplating suicide, Lindsey Johnson found herself in the bright lights of a hospital mental ward, where belts and shoelaces were forbidden and doors were locked tight.
"I was terrified," she said, recalling the days after her mental breakdown this winter. "I knew I didn't belong there."
Fewer and fewer patients do, according to therapists who work with the seriously mentally ill. Even as health care costs are a growing concern, people with such conditions as severe depression and bipolar disorder are getting intensive treatment outside of hospitals.
Johnson, 28, spent three weeks in the hospital before she became one of the first patients enrolled in a new "partial hospitalization" treatment program at the Sutter Center for Psychiatry.
"It was the best thing that ever happened to me," she said.
Outpatient therapy has traditionally been reserved for the most stable patients who have less complicated mental problems. No longer, said Mare Brooks, a psychotherapist who manages Sutter's program.
"Long-term hospital stays became an economic crisis as well as a crisis of humanity. People's rights are taken away, because they are locked up," Brooks said. Programs like this are "a more respectful way to treat people with mental illness," she said.
Patients in Sutter's program, which administrators said is the only one in the Sacramento area tied directly to a hospital, attend intensive group sessions six hours a day, five days a week, for two to six weeks. Each afternoon, they go to work, or home to their families, friends and pets.
The program "teaches mind, body and soul," incorporating such approaches as "movement therapy," meditation, music and dance, Brooks said.
"Medications are involved, too," she said. "But our model is about helping individuals redefine what a meaningful life is for them. It really does help people reduce depression and anxiety."
Patients for whom outpatient care is unsuccessful, particularly those who are seriously suicidal or homicidal, can be transferred to the hospital, she said.
John Boyd, the Sutter psychiatry center's chief administrative officer, said Sutter and other programs have seen a spike in anxiety disorders.
"We are seeing plenty of business professionals, including realtors and mortgage brokers who are responding to the stress of the economic downturn and foreclosure crisis and need help," he said. The outpatient program allows them to get treatment without having to give up their jobs or employment hunts, he said.
The approach costs about half as much as inpatient care, Brooks said. Insurance companies reluctant to pay for hospital stays have embraced intensive outpatient programs, she said.
But the most convincing argument for partial hospitalization, said Brooks, is its effectiveness.
Measuring success for these kinds of programs is difficult, Brooks said, but "patients love it and on a daily basis therapists are seeing that people don't need to return to psychotherapy because they have found their strengths," she said.
Lindsey Johnson said the Sutter program was a lifesaver.
Johnson, a lifelong resident of Sacramento, had long been tormented by seesawing emotions that left her euphoric one day and depressed the next. After a series of stressful events, including the loss of a job and relationship trouble, she briefly contemplated suicide.
Her mother convinced her to go to the hospital. Doctors diagnosed her with bipolar disorder, a serious mental condition that causes extreme emotional highs and lows.
Once she left inpatient care and got the right medications, Johnson said, she began to feel better. But it was the outpatient program that truly rescued her, she said.
"I was mentally shut down in the hospital," Johnson said. The outpatient program "opened me up."
Brooks gave her tools to defuse stressful situations before they become overwhelming, she said. "I use those tools every day."
"I still get irritated and flustered, but I'm able to recognize what causes it and handle it."
Two weeks after entering the program, Johnson and Brooks decided she could stand on her own. She still attends a session a week "just to keep on track," she said.
At home, she writes herself inspirational notes and tapes them to walls and mirrors. "I am me and that is great," a typical one might read. "Remember today that you can do anything."
"I am never going into the hospital again," Johnson vowed, smiling from the sofa of an apartment that she shares with her mother Karen, cat Bailey and dog Katy. "I am confident of that."
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Call The Bee's Cynthia Hubert, (916) 321-1082.
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