$48M Charleston mental health center is state’s first in 30 years

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On June 6, Trident Medical Center is set to open Live Oak Mental Health & Wellness, a $47.5 million state-of-the-art mental health hospital in Ladson, the state’s newest free-standing mental health hospital in more than 30 years.

Live Oak Mental Health & Wellness will open with 60 beds, with plans already in place to add 24 more beds at its Charleston County campus, which is located minutes from Interstate 26, about two miles from Trident Medical Center.

The facility, at 3445 Ingleside Blvd., includes a major design overhaul compared to how mental health hospitals were built in the 1990s and features large windows, courtyards and communal spaces for music and art therapy

Live Oak Mental Health & Wellness will serve adults, adolescents ages 12 to 17 and geriatric patients 65 and older in separate wings with a target 6 to 10-day stay per patient in an acute care setting to relieve overloaded emergency rooms.

In Berkeley, Charleston and Dorchester counties, “Nearly five percent of all admissions among all of the hospitals in the tri-county area are mental-health related,” said psychiatrist Dr. Harish Mangipudi, with Trident Medical Center. Trident Medical Center’s 25-bed mental health wing will move into the new facility.

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“Mental health patients are being held in emergency departments for hours and days at a time. We hear about backlogs, not just our ERs, but other ERs as well,” said David Was, chief operating officer of Live Oak Mental Health & Wellness. “Currently, our mental health unit (at Trident Medical Center) is 95 percent full with 25 beds. (Health care professionals) are having to send patients in our community as far away as Columbia and Lancaster for treatment. We can now take care of these patients in our community readily without having to transport them or have them not get the care that they deserve.”

The goal is crisis intervention and stabilization and then have patients step down to outpatient services at the facility and back home.

Live Oak Mental Health & Wellness will treat mental health issues such as schizophrenia, post-traumatic stress disorder, depression, bipolar mania, suicidal ideation and more. It will not serve as a memory care or rehab for substance abuse, but can be part of a treatment plan if a mental health patient arrives with addiction issues, Was said.

A new-look mental health facility

While not designated as an emergency room, Was said patients will be referred to and transferred to Live Oak Mental Health & Wellness from emergency rooms following a remote iPad consultation as well as be able to be transferred by the local sheriff’s department, also following remote consultations and referrals.

“We will also have a direct admission process, so patients don't have to go to the ER and can be referred to us from the private practice community, including psychiatrists’ and counselors’ offices and can come quickly to us, bypassing the emergency room completely.”

Designed in partnership with Nashville-based HCA Healthcare, Trident’s Medical Center’s parent company, Live Oak Mental Health & Wellness looks nothing like the mental hospitals built three decades ago; the design has completely changed to look like a regular hospital.

While security and safety remains paramount for both patients and staff, physical barriers have been removed between staffers and patients, large windows bring in natural light and two courtyards provide serene spaces for activities and meditation. A full-service cafeteria with a hot line resembles a food court rather than an institution.

“Smart state-of-the-art designed for the patients’ safety and the staff's safety offers dignity of the patient, security as well as privacy,” said Was. “HCA Healthcare has 65-70 behavioral health units and inpatient units (nationwide) and there is a think tank within the parent company and corporate office with a behavioral health service line division that pulls together best practices This is the latest in design.”

All staff Live Oak Mental Health & Wellness for are hired in-house, from physiatrists and therapists to activity leaders who teach yoga, music therapy, activity therapy and more.

“There is no contracted staffing,” Was said. “We have an interdisciplinary team of mental health professionals, qualified therapists, counselors, nurses, technicians, psychiatrists. There will be 24/7 in-house, on-site security, which is a differentiator,” Was said.  “The patients will have really independence. They'll be monitored at all times by our team, but we'll have games at night, TVs with big monitors.”

Live Oak will serve anyone in need

Was said Live Oak Mental Health & Wellness is 95% fully-staffed and received lots of interest from mental health professionals both in Charleston and out-of-state.

While the adult and geriatric wings will open on June 6, Was said the adolescent wing will open in August to coincide with schools reopening.

Live Oak Mental Health & Wellness will take health insurance and will also welcome uninsured patients, serving anyone in need in the state.

“We’re not taking shortcuts for quality, but will be making sure it's viable for us to be able to continue to sustainably run the place,” Was said. “Reimbursements are not as (big) as say, for open heart surgery, but insurance covers a stay and we'll operate in an efficient manner.”

The robust outpatient unit will provide a needed follow-up and wraparound services for patients once they are stabilized and go back home with individual, group and activity therapy in evening hours to accommodate working professionals and adolescent students.

“We look to step them down by way of ‘graduating’ into our outpatient program, which is four to six weeks in intensive therapy, 12-20 hours a week,” Was said. “Recidivism is important — we don't want patients to be regularly re-admitted. We want them to get better. That's the goal. To get better.”

Community input will drive outpatient services

A unique outreach for Live Oak Mental Health & Wellness are deep conversations with the business community and school districts about how to tailor outpatient services to serve at-risk populations and provide critical continuum of care.

“It could be the working professional who may be struggling with an addiction or some other issue. They're able to maintain a job, maintain family and friendships, but they're at risk of losing it all,” Was said. “It's building programs that can help meet those needs. Those are some of the intentional discussions that we're having with businesses and employers in the area to let them know that this is part of the (outpatient) plan. For our team, these conversations give us a deeper view and knowledge of the challenges that this community, and this region, has had over the years.”

School districts are also part of the conversation about how to best serve adolescent students suffering from mental health challenges.

“As we grow bed count, we're going to get into deeper subspecialties, like possibly eating disorders,” Was said, adding that the facility has the freedom to add new services based on best practices.

“You have to have the conversations,” Was said.

Deborah Parker, a registered nurse and assistant vice president of Behavioral Health Nursing Operations for three HCA Healthcare divisions, is training the Live Oak Mental Health & Wellness team in best practices as well how necessary the look and feel of the facility is compared to mental health hospitals of the past.

“When you think of mental health hospitals, ‘stigma’ immediately comes to mind. If you've never been involved in this type of care, it's easy for your mind to go to only what you've seen in the movies,” Parker said. “We want for all of our patients to feel comfortable, have an environment that's worthy of recovery and feel supported and cared about.”

Was said the 15 acres of land where Live Oak Mental Health & Wellness is located was intentionally purchased for room to grow. In July 2018 the South Carolina Department of Health and Environmental Control (DHEC) approved Trident Medical Center’s request for a Certificate of Need and mental needs have been further exacerbated during the COVID-19 pandemic.

“Absolutely, we are going from 60 beds (at opening) and then 84 beds. Hopefully our parent company will support us and building out and (continuing) to construct the space. We can construct without affecting our operations,” Was said. “Mental health is a hotter topic than ever and it's more needed than ever. This region (already) calls for more beds beyond what we're building here.”

Jenny Peterson is a contributing writer for SC Biz News.