Rye Hospital Center is a therapeutic milieu. This means the hospital is not only where the treatment takes place but is itself an integral part of the treatment process.
   
Reflecting psychiatry’s philosophical as well as scientific progress over the years, the therapeutic-milieu concept derives from the belief that illness is a part of life, and that patients’ self-esteem is to be valued and their regression understood.

At Rye, patients are encouraged to verbalize, socialize, lead active lives and keep in touch with the outside community. Nobody wears a uniform. Everything institutional is avoided.

Today, many patients are from the inner city. Most rely on Medicare and Medicaid (some have been attracted to "managed" Medicaid programs but quickly "disenroll" when they find out that the commercial "management" of their care is devoted largely to shortening their stay regardless of their medical needs), and a few are privately paying. Patients are usually referred by Rye's large network of referring social workers, physicians, school counselors, and other hospitals; however, there are those  patients who sign themselves in and have their first evaluation here.

Clinical Director, Dr. Elliot Roy Singer screens each admission. He says: "Patients who are the most appropriate are those who can be managed in this kind of voluntary, open setting." Nonetheless, admitting diagnoses are virtually the same as for "locked-door" institutions, demonstrating that locking people up based on disability (as opposed to criminal behavior) can often be characterized as a thing of the past.

After screening, once a patient is admitted, the clinical staff takes over and an attempt to get a meticulous history is begun. Permissions are obtained from outside sources--schools, doctors, family, hospitals--so that previous illnesses and treatment can be evaluated in connection with the most recent reason for the patient coming to the hospital. Either the patient's own doctor, or one assigned from our staff, puts the material together in a comprehensive Psychiatric Evaluation to guide all service members at the Comprehensive Treatment Planning meeting. 

Treatment includes individual, group and family therapy. "Community" and specialized therapeutic group meetings are attended by all patients regardless of age, sex, or diagnosis, as well as appropriate hospital staff. These meetings attempt to include negotiations similar to those occurring in the outside world and to offer the neighborly peer support so necessary to resolving transition-age problems and recovery.