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Medical Behavioral Unit

June 10, 2019 — The next stop on my journey was the Medical Behavioral Unit, a 14-bed inpatient medical stabilization unit in the Acute Care Pavilion for children, adolescents and young adults with eating and feeding disorders.

I attended a team meeting and learned about the important and challenging work this multidisciplinary team (which includes physicians, psychologists, therapists, psychiatrists, nurses, licensed psychiatric technicians and a dietitian) does every day.

Participating in the mindfulness exercise

Psychologist Jacqui Corvan led us in an interesting mindfulness exercise in which we wrote two sentences on a piece of paper, one with our dominant hand and the other with our non-dominant hand. We were then asked to describe what it was like to write with our non-dominant hand. For many, it was a frustrating and stressful experience. Jacqui said those feelings can be compared to the experience of patients on the unit when it comes to eating food.  It’s much more complicated than simply refusing to eat. Many of these patients’ brains are truly wired to respond to food differently than someone without an eating or feeding disorder, and it can take a lot of time to work through and adapt to a new thought process.

Learning about the unit from Walter Kaye, MD, director of the eating disorders programs at Rady Children’s and UC San Diego

I learned these patients’ cases are often complex and challenging, and require a collaborative approach with input from each member of the team. I heard about one patient in particular who has required the expertise of every team member over several years to manage their behaviors and develop strategies for improvement. This commitment to thoughtful care coordination is one reason the MBU receives referrals from outside the state, and even outside the country.

We then went on a tour of the unit, which is located on the south end of the fourth floor of the ACP. In addition to the patient rooms, there’s a meal room where patients eat all of their meals and snacks and attend group therapy. Video monitoring allows staff to keep an eye on the patients in their rooms, improving safety and compliance.

Checking out my latest passport stamp

Patients in the unit are between 6 and 30 years old, with an average age of 15.2 years. Seventy percent of patients here are being treated for anorexia nervosa, 19 percent for other eating or feeding disorders, and eight percent for avoidant/restrictive food intake disorder. On an average day, there are about 12 patients on the unit.

I left my visit with a deep appreciation for the passion the MBU team has for these special young people, and for the incredible investment every expert makes to support healing.