BHR's Acute Psychiatric Services are located in the Thurston County Evaluation and Treatment Center to serve people with severe psychiatric issues. It is not a hospital, detoxification center, pharmacy or emergency room.

Acute Psychiatric Services will serve persons whose mental illness is so severe their symptoms present a risk to themselves or others and those who are suffering severe psychotic symptoms.

Conditions that may be accommodated:

1. Clients who have committed a misdemeanor crime as a result of acute psychiatric symptoms.
2. Clients who have a developmental disability in addition to an acute mental health crisis
3. Clients who have a pre-existing stable physical disability in addition to an acute mental health crisis that requires no more than a one-person assist for transfers.
4. Clients who do not speak English, wish to engage in religious prayer of any kind, or are of a different culture are welcomed and served to the best of our ability within the therapeutic milieu.

If such persons are admitted for care, staff may also provide routine or non-emergent nursing care such as:

• Vital signs monitoring as frequently as once an hour.
• Blood glucose monitoring
• Fluid intake and urinary output monitoring
• Maintenance of existing urinary catheters
• Prosthetic care as needed.
• Routine enterostomal care
• Simple wound care and dressing changes
• Temporary, minor to moderate pain management
• CPR and first aid
• Non-emergent laboratory tests related to mental status
• Other services as judged on a case-by-case evaluation by an ARNP or psychiatrist.

Staff is not able to provide the following services. Patients requiring these services will be diverted or referred to appropriate medical service.

• Care for children under 13 years of age.
• Medical evaluations such as for chest pain, shortness of breath,
   seizures, head injury wounds or urinary tract infections
• Medical trauma
• Vital signs monitoring more frequently than once per hour.
• Stat (within one hour) or urgent (within 4 hours) radiological exams or laboratory blood work.
• Supplemental oxygen
• Nebulizers or respiratory therapy
• Interveneous therapy
• Central line catheter insertion or maintenance
• Medical isolation
• Feeding tube insertion or management
• Initiation of bowel or bladder training
• Extensive skin care programs
• Swallow retraining
• Renal or peritoneal dialysis
• Management of pregnancy
• Telemetry
• Blood gas evaluation
• Physical therapy programs
• Radiology Services

Though Acute Psychiatric Services strives to exhibit a welcoming profile in the community, the following conditions are considered either unsafe or clinically inappropriate for initial evaluation and/or admission:

1. Needing a disability evaluation or other eligibility evaluation
2. Facing current felony charges
3. Having a level of violence that surpasses the management capability.
4. Seeking treatment primarily for domestic violence.
5. Seeking treatment primarily for sex offender behavior.
6. Showing symptoms of acute intoxification or withdrawal