Eating Disorders/
Acute Behavioral Disorders Unit

Medical West Unit 

Rady Children’s Hospital-San Diego and the University of California, San Diego have joined forces to open the only child and adolescent medical/psychiatric inpatient unit in San Diego. The unit, called Medical West, treats children and adolescents who have medical as well as psychiatric conditions. Psychiatric evaluation and treatment is supervised and directed by Chris Rich, M.D., Associate Clinical Professor of Psychiatry, UC San Diego School of Medicine, who is board certified in child and adolescent psychiatry. The Nursing Director is Erin Costa, B.S.N., M.A.S.

Medical West is staffed by a team of professionals with medical, mental health and behavioral health expertise, including specialized experience in treating eating disorders. Our staff includes nurses, social workers, licensed psychiatric technicians, dietitians, and physicians from the hospitalist, adolescent medicine and child psychiatry services.

Eating Disorders Treatment

The Medical West Unit has dedicated inpatient beds to stabilize children, adolescents and young adults with anorexia nervosa, bulimia nervosa and related eating disorders. These patients include those who have abnormal cardiovascular function or are severely underweight and require nutrition intervention under expert care.

Our understanding of the cause of eating disorders is changing. Considerable recent evidence shows that working closely with the family significantly improves outcomes and reduces relapses. As a result, after patients are stabilized, we offer them care at the UC San Diego Eating Disorders Family-Based Behavioral (Maudsley) Treatment Program, located at Rady Children’s. This program is led by world-renowned experts in eating disorders: Walter Kaye, M.D., Professor of Psychiatry, and Kerri Boutelle, Ph.D., Associate Professor of Psychiatry, both at the UC San Diego School of Medicine. Medical treatment is managed by adolescent medicine specialists Joyce Adams, M.D., and Karen Loper, M.D.

Once admitted, the eating disorders team provides:

• Family assessment, family therapy and multi-family group interventions
• Dietary assessment by a registered dietitian and an individualized meal plan to restore weight and physical health
• Fully supervised meals
• Behavioral interventions to restore weight in anorexia and stop the binge/purge cycle of bulimia
• Therapy groups using evidence-based and best-practice treatments such as Dialectical Behavioral Therapy

Medical-Behavioral Disorders Treatment

This 12-bed unit treats patients with acute medical/psychiatric emergencies, such as suicide attempts, severe depression, anxiety or other mental illnesses with significant physical complications or concurrent medical conditions. For example, patients with somatoform and factitious disorders with unclear medical symptoms that require further investigation would be treated here.

One area of special interest is the child or adolescent with a chronic medical condition who is not improving due to behavioral symptoms, such as depression, anxiety, poor impulse control or non-compliance with treatment. It is well known that a chronic medical illness affects a child both physically and emotionally, increasing psychological stress on the patient and the family, exacerbating underlying psychiatric vulnerabilities to depression, anxiety or other behavioral symptoms.

A few examples of these chronic medical illnesses include:

• Type 1 diabetes
• Inflammatory bowel disorders such as Crohn’s disease
• Sickle cell disease
• Cystic fibrosis
• Asthma
• Hemophilia

Once admitted, the psychiatric treatment team provides:

• A comprehensive psychiatric evaluation
• Coordination of care with the primary medical team and outpatient mental health providers
• Individual therapy, focusing on coping with chronic medical illness
• Education regarding the patient’s medical illness and co-morbid psychiatric issues
• Group therapy directed by Medical West social workers and licensed psychiatric technicians
• Family-based therapy, working on coping skills and how the family is dealing with their child’s overall well-being.

Following medical stabilization, patients will be referred to Rady Children’s Outpatient Psychiatry or other individualized outpatient care. In certain cases, patients will be referred to UC San Diego’s inpatient Child and Adolescent Psychiatric Services (CAPS) for continued observation and treatment of acute psychiatric disorders. Our expert team will help ensure a smooth transition to the appropriate outpatient services.

Our goal is to deliver the best medical and psychiatric care for a successful recovery.