Community Reintegration Unit
Short-term care to help you regain your health
McLean Is Here to Help
The Community Reintegration Unit (CRU) is designed for adults in need of crisis stabilization, providing a comprehensive range of services for those struggling with bipolar disorder, depression, and schizophrenia.
The program’s short-term treatment model helps individuals to regain their health in the least amount of time so that they may return safely to their home, community residence, or another outpatient treatment setting.
Find the care that’s right for you or your loved one. Call us today at 617.855.3141.
Program Leadership
Andrew J. Melaragno, MD, Medical Director
Dr. Melaragno’s clinical interests include the treatment of bipolar disorder, schizophrenia, and related disorders, as well as the treatment of co-occurring severe mental illness and obesity/metabolic disorders. He previously performed clinical research related to the treatment of anxiety and traumatic stress disorders and has published several articles on this topic.
Karen Slifka, RN, MS, CS, Nurse Director
Ms. Slifka began her career at McLean in the child inpatient units and later moved into the child outpatient program in therapy, medication management, and research. She has been working in the Community Reintegration Unit since 2004 and has continued her research regarding metabolic syndrome among adults with psychiatric illness.
Frequently Asked Questions
Where is the program located?
The Community Reintegration Unit is located on the Belmont campus, on the second floor of North Belknap. For more information on directions, parking, and local accommodations, please visit our Maps & Directions page.
What is the length of stay at the program? What happens at discharge?
Patients stay at the program between three and seven days.
Inpatient stays are for brief acute management of psychiatric illnesses so that patients can have continued stabilization and treatment on an outpatient basis.
Aftercare planning begins immediately upon admission.
Are visitors permitted?
Visitors are permitted, following program policies. Visiting hours are 2-8pm, seven days a week.
Please speak to the patient’s treatment team for more information. Additional details can be found on the Visitors page.
Is there access to a phone? Are cellphones and other electronics allowed?
The unit nurses station can be reached at 617.855.3280. Patient phone numbers are 617.855.3167 and 617.855.2377.
There are two patient phones on the unit that dial out to all 617 and some 781 area codes by dialing a “9“ before the area code. Within reason, staff can transfer long distance calls to these phones.
Patient phones are turned off during groups and between 10:30pm and 8am. All outgoing calls from McLean must be placed to unblocked lines. Family members should give the treatment team an unblocked contact number.
When answering the unit phones, it is important to protect the confidentiality of other patients by not offering information about another patient. Callers may not be aware that they are calling a hospital unit.
Please be mindful and talk quietly when on the telephone as a courtesy to other patients on the unit.
Cell phones are permitted on the unit. Before being permitted to keep their phone, patients are asked to sign a form agreeing not to violate peer confidentiality by, for example, taking pictures on the unit or using a recording device of any kind. If that privacy contract is broken, phones are either sent home with family or stored in security for the remainder of the stay.
There are four charging stations located in the art room, living room, kitchen, and sensory room. Staff can assist with finding one that works for your particular phone.
All cell phones must be turned off during group time, whether in a group or not. Conversations should be held in a quiet and private area on the unit to not disturb other patients.
Radios/CD players are available in the sensory room and art room for general use. Personal headphones can be signed out with staff from the nurses station, starting at the beginning of the day shift and returned between the hours of 9pm and 10pm.
A sound machine can be signed out from the nurses station for white noise.
What precautions are taken regarding restricted items and sharps?
To ensure patient safety, the following items are not allowed on the unit: alcoholic beverages, prescription or over-the-counter drugs/medications, plastic bags, knives/other sharp objects, matches/lighters, glass items (e.g., vases, picture frames).
Is family involved in treatment?
Contact between family members and clinical social workers as well as family meetings are encouraged when clinically appropriate and with the permission of the patient. Family meetings generally take place on weekday afternoons.
What are the general policies of the program?
Important Information
Patient identification wristbands must be worn at all times to ensure correct identification and administration of all medications.
Checks
Every five or 15 minutes, a staff member will walk throughout the unit to ensure each patient is present and safe on the unit. Checks are done throughout the night. Please note that staff use a flashlight to ensure patient safety.
Smoking
There is no smoking permitted on the unit. Please speak with the clinical staff about the availability of nicotine gum or patches as an alternative to smoking.
Possessions
All packages or luggage brought onto the unit by patients or visitors will be examined by staff for safety measures.
Patients are strongly encouraged not to bring items of sentimental or monetary value to the hospital. Laptop computers are not permitted on the unit. We can send items to be stored in a safe in security during the stay.
Meals
Meals are served in the dining area on the unit. McLean’s Dietary Services are available for patients with medical restrictions and special diets. The patient’s psychiatrist can place an order to meet the dietitian upon patient request.
- Snack: 6-7am
- Breakfast is served: 8-9am
- Snack: 10-10:15am
- Lunch is available: 12-1pm
- Snack: 2:45-3pm
- Dinner: 5-6pm
- Snack: 8:30-8:45pm
The unit can provide envelopes and lined paper for writing letters. The hospital provides the postage free of cost to mail those letters out. Mail is collected from the mail room daily and delivered to patients.
Patients can receive letters at the following address:
McLean Hospital
115 Mill Street; NB2 – Mail Stop #208
Belmont, MA 02478
Who is on the treatment team?
The case manager works with the patient to identify treatment goals, contain symptoms, develop plans to manage acute stressors, and help develop an aftercare plan. The case manager works with family members, significant others, and community clinicians that the patient wishes to be involved in treatment planning. Patients meet with their case manager each business day (except holidays).
The psychiatrist is responsible for prescribing medications, helping with medical problems, supporting the treatment process, and collaborating with the patient’s community medication prescriber. Patients meet with their psychiatrist each weekday and with a rounding psychiatrist on the weekend and holidays.
Every patient has a primary nurse and mental health specialist team. Patients have one discussion with staff on both the day and evening shift that focuses on an assessment of how they are doing, provides psychoeducation, and supports skill development.
Other members of the team include the nurse director and administrative assistant. The nurse director is responsible for coordinating nursing services on the unit. The administrative assistant is responsible for tasks that allow the unit to function smoothly.
The group therapist runs the group programming. The unit offers a wide variety of groups designed to support understanding of symptoms, develop skills, and provide support for the completion of treatment tasks. Patients are encouraged to attend and actively participate in the full range of treatment groups.
Is group therapy a component of patient care?
Our group program includes a range of therapeutic and activity groups using open discussion, arts-based, patient educational formats. The group schedule is posted in the hallway on the bulletin board across from the nurses station.
Our hope is that patients find the group program helpful during their stay on the unit. Group therapy can provide a sense of structure and an emotionally safe place to talk about what is going on. In group therapy, members can give each other support and insight, and experience acceptance.
We understand that each individual on the unit is here for their own unique reasons. We do not require group attendance, but the group process can help to increase a sense of empowerment.
To provide a cohesive environment, group members are encouraged to stay throughout the group meeting. In the situations that lead to leaving the room, please try to exit quietly to not disturb the group in progress.
To fully benefit from the group, members are asked to please restrain from side conversations, which can be both distracting and disruptive.
We ask that food or open beverages are not brought into the group. If a beverage is needed, please have a cap or a lid to reduce the likelihood of any spills.
Group Descriptions
Art Therapy
Encourages patients to express and understand emotions through artistic expression and the creative process.
Challenges and Goals Group
Offers patients a structured setting in which to set self-direction and thereby increase their engagement in treatment.
Cognitive Skills
Patients learn how to shift distorted thinking with positive reframing.
Community Meeting
Provides an opportunity to develop and enrich patients’ sense of being part of the community versus being isolated in a nonresponsive environment. Environmental responses can assist patients in reducing a sense of helplessness and hopelessness.
Communication Skills
Patients are encouraged to share dilemmas and strategies from their own experience. This group often focuses on creating healthy boundaries and components of healthy relationships.
Coping Skills
Patients to learn to identify and express their strengths and vulnerabilities in a nonverbal manner via experiential activities. The group explores areas such as assertiveness, boundaries, and appropriate expression of emotional states.
Creative Writing
This group is designed to offer patients an alternative means of expression through structured writing themes and exercises.
Destigmatizing Stigma
Discussion is initiated regarding the stigma surrounding mental illness, including causes and effects, and the ways to cope with and decrease stigma.
Discussion Group
In this informal gathering, patients exchange ideas, information, and suggestions on needs, problems, subjects, etc., of mutual interest.
Dual Diagnosis
This group initiates discussion regarding how individuals are affected by two separate illnesses, how the illnesses may exacerbate each other, and how symptoms can overlap and even mask each other, making diagnosis and treatment more difficult.
Expressive Therapy
A variety of techniques are explored to express feelings and conflicts in a nonverbal manner and to connect with peers through group and individual projects and enable the patient to experience support in this process.
Family Issues
The purpose of the family issues group is to provide a time for patients to process issues related to their family relationships and how they impact their hospitalization. Other agendas may include ways to cope with stressful family situations or a discussion of specific family-related themes.
Games Group
The purpose of the games group is to provide a relaxed, semi-structured environment for socialization and increased cohesion between patients. This environment may help patients to develop their awareness of the benefit of playful social contact.
Fitness/Gym
This group is designed to promote a sense of physical well-being through participation in a variety of gym/fitness-based activities. Patients have an opportunity to engage in and lead games, exercises, and cardiovascular exercise.
Healthy Living
The healthy living group provides tips for good eating and ideas for self-improvement in body, mind, and spirit.
Medication Education
This is a didactic and discussion group run by the nursing staff. This group focuses on basic information about medication use.
Meditation
During meditation, patients focus attention and eliminate the stream of jumbled thoughts that may be crowding the mind and causing stress. This process may result in enhanced physical and emotional well-being.
Open Art Studio
This group offers patients opportunities to practice self-assessment by choosing whatever medium and method would be useful in the moment.
Relapse Prevention
Patients practice mindful awareness to foster increased awareness of triggers, destructive habitual patterns, and “automatic” reactions that seem to control many of our lives.
Recovery Group
The goal of the group is to allow patients to establish goals they feel they must meet before they can transition safely. Topics include the creation of a safety plan, including contact people, and symptom management.
Safety Planning
The safety planning intervention is a collaborative effort between a treatment team and a patient. The basic steps of a safety plan include recognizing the warning signs of an impending suicidal crisis, using coping strategies, and identifying contacts who may help to resolve the crisis.
Self-Esteem
This group provides opportunities to address issues of self-esteem in a group context. Patients will develop appropriate ways of altering old thought patterns into healthy positive affirmations that will enhance a sense of self. Peer support may aid in reframing negative beliefs that impact self-perception.
Stress Management
Stress is a part of everyday life for everyone. Identifying stressors and responses can help design individual strategies for coping. Although stress is not itself a symptom of a specific disorder, it has the potential to worsen symptoms and make it difficult to focus on treatment and recovery.
Symptom Management
The symptom management group is intended to help patients gain a clearer picture of their symptoms, learn to better track and manage their symptoms, and share challenges and successes they have encountered.
Therapy Group
In this group, we address wellness issues in a supportive, safe, and nonthreatening environment. We also promote cohesiveness and an atmosphere that will encourage examination of self-care and wellness issues in the patient’s life.
Walk Groups
This staff-led fresh air break is for interested patients who have Level 2 privileges.
Wrap-Up
This group helps patients have safe closure on their day. Goals include assessing community dynamics and allowing staff to address questions and/or tensions between community members before ending the day’s programming.
Yoga
This group is based on basic principles of connecting breathing with simple yoga postures. The main objective is to help participants feel comfortable in their bodies. We focus on breathing, movement, strengthening, stretching, and resting.
What activities do patients participate in?
Attend a Group
Weekly group schedules are located in a black metal bin on the patient information bulletin board in the center of the main corridor. The staff encourage groups they think will be helpful to a patient.
Join the “Milieu”
For those who are not in the right space to attend a group, they can feel free to come out and sit in the chairs along the hall to read a book or magazine, talk to staff and peers, or just take in the activity. Sometimes the simple act of not isolating can be helpful when you are not feeling at your best.
Exercise
We have a stationary bike in the living room for general use. We also have yoga mats available for stretching that can be accessed by any patient and kept for the duration of the stay.
Healthy living, yoga, and Wii dance groups are held regularly on the unit.
Once the treatment team feels a patient is safe to leave the unit with staff and orders off-unit privileges, they are able to take advantage of daily walks and fitness center groups, in addition to gym groups five days per week.
We welcome the opportunity to help support patients in jump-starting health and fitness goals during the hospital stay.
Join or Start a Games Group
An assortment of board games and card games are available inside the nurses station. Patients can request to sign one out from any staff member.
The checkers table outside the art room is always a good place to get a game started. Unit staff run board game groups and bingo groups regularly and would encourage patients to join in on the fun!
We can also supply a deck of general playing cards that patients can keep for the duration of their stay.
Journal
We have journals and writing utensils available behind the nurses station. Feel free to ask any staff for these supplies.
Additionally, it can be a good idea to write down any questions or thoughts to share with the doctor and social worker to remember to ask them at the next meeting. Some also find it advantageous to take the journals to groups so they can write down any coping skills or other information they find useful.
Listen to Music
Radios/CD players are available in the sensory room and art room for general use.
Work on Some Art
Art supplies are always available in our welcoming art room. The open art studio is a regular part of the group schedule, and more extensive art supplies are available in these groups. Art therapy groups meet three times a week and offer the opportunity to do specific projects.
Tea & Chat
While staff frequently facilitate Tea & Chat groups, light snacks and beverages are always available in our warm and friendly kitchen for patients to enjoy while initiating conversations and storytelling sessions with each other.
Takeout
Menus are available by the patient phone in the main corridor.
Movie Night
There is an assortment of DVDs available for sign-out in the nurses station and staff can assist with signing out.
Read a Book
There are a variety of books available on the living room bookshelf for those who are interested.
Talk to Your Check-In Person
Each shift, an assignment sheet is located next to the medication window and outside the entrance to the nurses station and it list each patient’s contact person for the shift. Patients should feel free to seek them out with any concerns. The medication nurse is also listed on this sheet and should be consulted with medication needs and medical concerns.
Where can more information be found?
Unit staff are available to answer additional questions. More information may also be found in McLean’s patient guides, including Guide to Arriving at McLean Hospital. Paper copies are available upon request.
Patients may also find this video about our admission process a helpful way to understand how it works. Watch now.
McLean Is Here to Help
Find the care that’s right for you or your loved one. Call us today at 617.855.3141.