After years of planning, Rady Children’s Hospital will soon break ground on a new behavioral health building that will double or even quadruple the number of beds available for patients who need urgent mental health care. Design of the three-story facility is nearly complete, and will be built on Rady’s Serra Mesa medical campus using a recently cleared parcel on Birmingham Way between the hospital’s Acute Care Pavillion and an existing parking structure. Construction is expected to start in July, with opening day projected to occur in late 2028 or early 2029. The new building will house Rady’s inpatient Child and Adolescent Psychiatry Services unit, doubling its number of beds from 24 to 48, with all patients housed in single rooms, a feature that has not always been possible in recent years as the demand for child and adolescent mental health care has kept beds at capacity. The plan, officials said, is to spread these rooms across two floors, dividing the patient population by age. Emergency services are expected to see an even larger expansion. Rady already has a dedicated emergency unit for psychiatric emergencies, but in the new building it will quadruple in size, jumping from a capacity of six to 24. Space will also be dedicated to serve those who do not need overnight hospital stays, with a new partial hospitalization and intensive outpatient program capable of serving about 70 patients per day. Partial hospitalization programs, also specified in plans for mental health care hubs under development by San Diego County’s behavioral health department and also UC San Diego Health, provide patients with intensive therapy for five hours per day, five days per week, for three or four consecutive weeks. Intensive outpatient programs still have patients visiting the hospital regularly, but following a less intense schedule, generally three days per week for three hours per day, but for a longer duration, usually eight to 10 weeks. Dr. Payal Beam, vice president of Rady’s Mental, Behavioral Developmental Services Institute, said the expansion originally called for 60 inpatient beds, but that number was reduced in favor of more outpatient capacity. The idea, she explained, is to provide a smoother ramp on either side of overnight treatment in locked units. Getting patients back into their regular worlds more quickly can help them make therapy more effective. “If you think about how it is now, if you’re in an inpatient bed for seven days, let’s say, where you’re spending the night, and then you’re stepping down to three weeks for half a day, and then you’re stepping down to three times a week for three hours a day,” Beam said. “The step-down model allows you to practice the skills that you’re learning in your natural environment, home, school, community. “But it also allows you to come back to your therapist the next day and say, ‘hey, I tried that, it didn’t work.’” This conceptual rendering shows an alternate angle of a new behavioral health campus planned for Rady Children's Hospital in San Diego. Elizabeth Rains, Rady’s manager of business planning who was hired in 2020 to work on the hospital’s effort to transform its mental health care services, noted that this ramp is also intended to operate in the opposite direction. “It can also be a step-up program,” Rains said. “Having partial hospitalization and intensive outpatient (programs) located within our inpatient unit may allow us, in some cases, depending on the patient’s acuity, to avoid hospitalization by placing in the daytime programs.” The design change connects to Rady’s long-term efforts around coping with what has been a large increase in demand for mental health care that started more than a decade ago. As a 2022 case study by the American Hospital Association attests, Rady saw a massive surge in children arriving in its emergency department with behavioral health concerns. From 2018 to 2022, “the number of children in their ED presenting with suicidal ideation rose by 161%.” The children’s hospital reached upstream to try to reduce the number of kids who end up in crisis. A 2023 case study published in the medical journal Frontiers in Psychiatry reported significant decreases in symptoms of anxiety and depression in children seen at 10 primary care clinics with embedded mental health care practitioners able to quickly address mental health care needs during visits for other reasons. Beam said that Rady’s decision to build what is effectively a hospital dedicated only to mental health care on Rady’s larger campus connects to the successes seen in doctors’ offices with the same desire to treat symptoms before they escalate. And there will be efforts, as is the case in most children’s hospitals, to keep the design as whimsical and unintimidating as possible. Designs call for windows that can let in natural light and fresh air in an attempt to make the building feel less confining. “Internally, we refer to it as a tree house,” Beam said. ...read more read less