Silver Hill Hospital: Dr. Sigurd H. Ackerman, President and Medical Director

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The history of mental health at Silver Hill Hospital in New Canaan, Connecticut dates back to 1931. Dr. John Millet was a psychoanalyst looking to become part of the New York psychoanalytic movement. The original farmhouse became a six-bed treatment center. Though the conditions treated seem mild compared to the cases the hospital handles today, it marked the hospital as a place where people go to recover and get a grip on their lives.

The original house remains and is now one of 12 clinical facilities on 43 acres of land. It currently operates 115 beds. Approximately 50 of those are traditional, inpatient beds. The rest are long-term, residential treatment beds where the minimum stay is four weeks or more.

“We now treat a huge range of patients,” says Dr. Sigurd H. Ackerman, President and Medical Director. “Almost all of our patients are covered by commercial insurance on the inpatient units. In order to get insurance authorization, all the patients admitted here are quite ill or they wouldn’t be covered by their insurance policy. There’s been quite a transition in the past 80 years. Between 1931 and now, in the kind of hospital we are has more or less exactly corresponded to advances in psychiatry.”

Mental Healthcare in a Residential Setting

Silver Hill is unique in its physical structure as a hospital that primarily operates out of a home atmosphere. The only structure built specifically for the treatment of mental illness is the one that was added in 1985. The rest are literally homes that have been refurbished, of late, with the positive margin the hospital has managed to gain since the big-turnaround of the organization was implemented in 2003. The hospital had struggled some in the 1990s. The adjustment to managed care had taken a toll and revenues were down.

“We’ve put a lot of resources into renovating the buildings because there was a huge amount of deferred capital maintenance and capital improvement,” says Ackerman. “We developed a master plan for the facility grounds and buildings and we’re about 80% through with the structural portion of the master plan. The hospital is very appealing to patients physically. It’s a very nice place to be.”

They also upgraded communications and added an electronic medical chart. This began four years ago and today the hospital is completely electronic using the commercial version of the same program that is being used by the Veteran’s Administration. Medsphere’s OpenVista EHR solution makes them essentially paperless. They are still in the process of adding a couple of items, such as prescriptions, but everything is linked ready to go.

Areas of Service

The hospital handles a range of specialty services. Their current five residential programs include chemical dependency rehabilitation, a dual disorder program for people with significant psychiatric disorders who also have problems with a chemical dependency, severe personality disorders that result in poor mood and  impulse control, schizophrenia and other psychotic disorders, and a special center for treating adolescent disorders. The latter “may have a whole range of different problems but are grouped together because they are adolescents,” says Ackerman.

The challenge remains having enough room for all patients and meeting the cost. “Especially for a psychiatric hospital in this environment, the inpatient programs that we were able to run regularly lose money because we want to provide really first rate care, which means first rate staffing,” says Ackerman. “The residential programs are, for the most part, not covered by insurance, so the revenues from these programs cover the losses for the inpatient program. That’s how we’ve managed for the last seven years. That’s how we’ve had a little bit more to plow back into facility improvement, program development, IT infrastructure and so forth.”

“The thing that I’m most proud of is that the overall quality of care for patients has improved and the patient experience here has improved a lot also,” says Ackerman. “The whole thing is better. We have 11 full-time psychiatrists counting me. Eight of those are double-boarded. They are very experienced. It’s an unusually proficient group of people.”

“It means we have especially good programs now and can provide excellent patient care.. I’ve been in hospitals now for 40 years … and, overall, this is as good as I’ve seen. I’m very proud of that. The facilities are very nice. I’m pleased for that. The patient experience here is great. But the most important statement I can make is that the average patient can expect to improve substantially — and that’s a big thing to say.”

-by T.M. Simmons

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