Keeping Our Patients at the Heart of Behavioral Health

Kelly Troyer just wants her son, Alex, to be happy.

And it’s a privilege that she knows he is. Alex McAbee works at Panera Bread, wears bow ties and calls himself “Mr. Charleston.”

He’s thriving, Kelly says, because of HCA Healthcare’s mental and behavioral health services. Kelly, a mental health advocate since Alex’s autism spectrum disorder diagnosis 25 years ago, says her son is treated with dignity. He feels understood and respected because they involve him in making care-related decisions. That’s what differentiates his HCA Healthcare experience from other experiences, Kelly says. Her story and her role with the Charleston-area affiliate of the National Alliance on Mental Illness position her as an expert on the services available to families in South Carolina. She knows the difficulties families can face when they have loved ones with mental health challenges. That’s why she’s so excited about the recent opening of Trident Health System’s Live Oak Mental Health and Wellness — the first mental health hospital to open in South Carolina in more than 30 years.

Live Oak’s state-of-the-art 60-bed facility will serve adolescents and adults, including geriatric patients. The footprint also allows for the addition of another 24 beds without disrupting operations. Live Oak Chief Operating Officer David Was says it’s the culmination of years of planning and diligence. HCA Healthcare is the third-largest provider of inpatient behavioral health services in the United States. It’s also one of the largest educators in psychiatry, with 14 graduate medical and residency programs nationwide.

At Live Oak, David explains the top priorities are to provide care to patients in the community with safety, dignity and privacy.

“Live Oak Mental Health and Wellness is the product of many lessons learned from our behavioral health units across the company. It has the latest and greatest design with the most bells and whistles in terms of safety, therapy and quality of life,” he says.

The difference between Live Oak Mental Health and Wellness and other mental and behavioral health facilities begins right there in the name.

“Our field has evolved to focusing more on wellness,” says Melissa Camp, LPC, director of Clinical Operations at Live Oak. “Yes, there’s a diagnosis there, and yes, there are obviously medications that are a part of that for most people, but [we’re] really trying to focus on wellness. How do we get ourselves to be healthier and stronger?”

Melissa, who has worked in the field for 22 years, says that in the past, there was heavier emphasis on symptoms and diagnosis. Today, the conversations are more evolved.

“We talk more about what wellness and healthiness look like for you and how do we help you get to that place,” she says.

Live Oak patients may include someone experiencing loss or trauma, a veteran suffering from PTSD or a brain injury, or an adolescent considering suicide. Melissa says the stigma surrounding mental health is pervasive and keeps many people from seeking treatment. Live Oak has opened its doors to the entire community to try to diminish some of the stigma.

“You’d be amazed at how many people in the mental health field, in the behavioral health field, have never been inside of a hospital like this,” she says. “It was a privilege to bring those partners in so that they could see that it is a nice place and that it’s healing and positive.”

Kelly is struck by the abundance of natural light from large windows and the beautifully manicured courtyard that includes a basketball court. The facility also has a cafeteria and state-of-the-art safety features, such as doors with hinges allowing them to open into or out of rooms.

Simply allowing patients to select their own food and eat in a cafeteria can empower them. At other facilities, meals are delivered to behavioral health patients in their rooms. Melissa says anxiety can escalate when choices are removed.

“Our patients are not physically ill. They’re able to get up and walk around, so we added the cafeteria where they select what they want. And that is empowering for people in a situation that a lot of them may not have chosen to be in,” she says.

Live Oak offers a full continuum of care. Inpatient, outpatient and intensive outpatient services are offered on the same property.

“It delivers a message to our community that not everybody needs the hospital” Melissa says. “Some people are working or have families at home, and maybe going as an inpatient would not be the right fit for them. But we can do an intensive program three days a week for three-hour blocks.”

Those in need of continuing care can also find consistency at Live Oak. Once discharged, a patient may continue a therapy regimen that best suits their needs.

“Patients can step up or down, based on their needs and individual care,” says Deb Parker, assistant vice president of Behavioral Health Nursing Operations.

Adolescent services also meet an underserved need. In its 2022 report, Mental Health America found that 15% of youth (ages 12–17) suffered from at least one major depressive episode (MDE) in the past year. The number of youths experiencing MDEs increased by 306,000 from the previous year’s data. Untreated childhood depression is more likely to persist into adulthood, according to the organization.

Live Oak will offer an inpatient unit and intensive outpatient services for adolescents.

“When you think about it, you learn math, reading and even a foreign language in school. But nobody’s teaching you how to regulate your emotions,” Melissa says. “I honestly am a firm believer that emotion regulation and distress tolerance are skills that every human on the planet needs, but especially teenagers, who are going through a whole lot in life in general and just learning how to be in the world and defining themselves.”

The team couldn’t have anticipated the overwhelming community response to Live Oak’s opening, Melissa says.

As evidence the faciity was much needed, the intake team remained busy fielding incoming calls from the first hour of opening. COO David Was points out it was near full capacity within the first week.

“We opened on June 6 with 35 inpatient beds. All of them were filled within four days, with 13 admissions on the first night of opening,” he adds.

Kelly says “That really was rewarding for me to see. It was clear that the community had been waiting for this resource.”

Families across South Carolina have already contacted her about receiving care at Live Oak. Soon, the hospital will open another wing, adding 10 more beds. Then, in August, they will add 15 beds for children ages 12-17.

She says HCA Healthcare’s investment in serving the community’s mental health needs makes her proud to be a South Carolinian.

“It can give people hope and a model for recovery and more people who can become advocates in the community,” adds Kelly.

HCA Healthcare’s financial commitment — a $48 million capital investment — is significant when delivering a complete range of services. It shines a light on what HCA Healthcare does very well and is one of the reasons Christina Oh, president and CEO of Trident Health, South Atlantic Division, says she joined the company.

“I looked at what HCA Healthcare was willing to do in building full programs. HCA Healthcare doesn’t dabble and make half steps,” she says. “If they’re going to do something, they’re going to do it well and put the resources behind it. That makes you very proud — to know if something is done, you’re going to set the standard for how it’s done.”

Read about another major HCA Healthcare behavioral health expansion project here.