WAILUKU - A broader, team-based approach for adolescent psychiatric care at Maui Memorial Medical Center continues to expand with the hospital adding a clinical psychologist to the mix.

Susan Rubenstein, who had been in private practice, returned to Molokini Unit II three months ago on the same day the hospital's Behavioral Health Division hired a new medical director, Dr. Jason Andrus.

Rubenstein serves as the leader of Molokini Unit II's team of health professionals caring for young patients hospitalized for mental health care.

"I miss working together as a team," she said Wednesday. "It seemed to be a good time to come back and do that here."

About a year and a half ago, Maui Memorial reopened the Molokini II adolescent behavioral unit. It had been shut down in 2004 for lack of full-time staff coverage.

Today, the unit has incorporated a new medical model that involves daily meetings by a team of health professionals that includes Andrus and another psychiatrist, Dr. LiLi Kelly. Other team members are psychiatric nurse specialist Suzanna Dee, social worker Jodi Jaslow, recreational therapist Renee Friend, occupational therapist Karen Rollins, nurse manager Susan Carroll and special projects coordinator Raina Kangas.

Team members confer daily about patients and together decide the best course of action.

"You get more of a view of what the patient is really like by talking to others on the team," Rubenstein said. "We all have our blind spots and prejudices and that's why it's good to work together as a team."

Rubenstein worked for Maui Memorial from 1995 to 1997. She said that while adolescents in the hospital have always had access to a team of health professionals, there wasn't a coordinated effort as is now in place.

While Rubenstein's primary responsibilities are to care for both adult and adolescent patients in Molokini I and Molokini II, she also provides consults on the hospital's medical floors around behavioral issues.

Andrus also returned to Maui Memorial on Sept. 2 from Boston, where he spent the last four years as a consulting psychiatrist at Children's Hospital at Boston and on the faculty of Harvard Medical School. His research focus was the impact of family function on pediatric illness.

Andrus fills the position of medical director and psychiatrist for both adult and adolescent patients left vacant by Dr. Harold McGuffey, who returned to private practice.

Andrus said he encouraged the hospital to move away from delivering mental health treatment that was physician centered to a model with a team approach.

"I'm the one pushing for it," Andrus said. "It's more clinically effective."

The Molokini II unit has an average daily census of approximately two patients. The unit has a capacity of seven beds and has had as many as five patients admitted.

Aside from carrying out its team model approach to care, Andrus said his psychiatry staff also wants to also be "trauma-informed." The hospital has applied for a grant to pay for outside professionals to provide training on psychological trauma and ways to handle its aftereffects on the wards.

In another initiative, the Molokini unit staff is addressing mental health issues in the community. It includes a monthly meeting with representatives from community, state and county agencies, including the Maui Police Juvenile Division, to talk about issues relating to the care and treatment of young people and families in distress.

Andrus has also spoken about the hospital's Molokini units in a public forum earlier this fall and with the Police Department's newest recruits.

"My hope is to have more of these things," he said.

* Claudine San Nicolas can be reached at claudine@maui news.com.