For decades, hospitals have largely treated mental health and physical health separately.
Patients experiencing a psychiatric crisis often receive care in one setting. Patients with complex medical needs receive care in another. When someone is struggling with both at the same time, moving between those systems can be complicated, frustrating, and disruptive.
For Bobbie Jo Dodson, DO, an assistant professor in the Division of Hospital Medicine at the University of Colorado Anschutz Department of Medicine, that separation never made much sense.
"Psychiatric care has almost always been siloed from medical care," says Dodson, who is also an assistant professor in the CU Anschutz Department of Psychiatry. "Which means from the beginning, we got it wrong because the brain is part of the body."
That belief helped drive the creation of Denver Health's Integrated Medical and Psychiatric (IMAP) Unit, a first-of-its-kind unit in Colorado designed to care for patients experiencing both acute medical illness and serious mental health conditions.
The unit combines the capabilities of a traditional medical-surgical floor with the therapeutic environment of an inpatient psychiatric unit, creating a space where patients can receive both types of care at the same time.
"We're still catching up at the hospital level when it comes to integrating care," Dodson says. "This is one step toward changing that."
The need for a unit like IMAP became clear through years of patient experiences.
Dodson has spent her career working at the intersection of medicine and mental health. As a physician trained in both hospital medicine and psychiatry, she frequently encountered patients whose needs did not fit neatly into one category. Since joining Denver Health in 2016, she has kept track of cases that she believed would benefit from an integrated medical-psychiatric unit.
One patient admitted for severe depression stood out. "She was very fatigued, and it turned out she had symptomatic anemia that was severe enough to require a blood transfusion," Dodson recalls.
Because the psychiatric unit could not provide the transfusion, the patient had to be discharged from psychiatry, admitted to a medical floor, receive treatment, be discharged again, and then readmitted to psychiatry. "That was a lot of resources. It was a lot of time. It was probably confusing for her," Dodson says. "It felt like all of the mental health care grinds to a halt; you go get the medical issue taken care of and then you come back."
For patients experiencing both medical and psychiatric illnesses, those interruptions can create significant barriers to recovery. IMAP was designed to eliminate those barriers.
Building something that did not exist
Creating the unit was far from simple.
Although medical-psychiatric units exist elsewhere in the country, they remain rare. Researchers estimate only about 2.7% of hospitals nationwide have a med-psych unit. That meant there was not much of an established blueprint for Colorado to follow.
"At the beginning, it felt like there were 25 gates we had to get through," Dodson says.
Hospital leaders needed to determine how to fund the project, staff the unit, and navigate regulations for a space that would function simultaneously as a medical unit and a psychiatric unit. "You have to bring something that is brand new to someone and say, 'Make this happen for me,' but you have nothing to go off of because it has never existed before," she says.
The process required collaboration across departments, bringing together physicians, nurses, behavioral health leaders, finance teams, construction experts, and hospital administrators. "It's really quite a miracle that it happened and that it happened as quickly as it did," Dodson says.
Creating a different patient experience
The IMAP unit was intentionally designed to feel different from both traditional psychiatric units and traditional hospital floors.
Patients have private rooms with their own bathrooms, access to natural light, communal gathering spaces, psychotherapy rooms, and a wide range of therapy services, including occupational, physical, and behavioral health therapies.
"We always emphasize that it's therapeutic, not just safe," Dodson says.
That distinction matters.
While psychiatric units must meet strict safety standards, Dodson worries that conversations about mental health care often focus too heavily on security and not enough on healing.
"I don't want to keep driving home the idea that these patients are dangerous," she says. "It's not just about safety. It's about creating a therapeutic environment."
The physical design is one part of the model. All nurses on the unit are trained in both medical and psychiatric care. Patients are evaluated daily by both a hospital medicine physician and a psychiatrist, who work together to coordinate treatment plans.
"We have two specialists acting as a think tank," Dodson says.
The care team also includes social workers, pharmacists, and therapists who meet regularly to discuss each patient's needs. The goal is to reduce fragmentation and ensure patients receive coordinated, whole-person care.
One of Dodson's biggest hopes for IMAP extends beyond clinical outcomes. She wants to change the way people think about mental illness.
"If you bring mental health care back into conceptualizing it as another medical diagnosis, which it is, it will destigmatize," she says.
To explain her perspective, she often compares mental illness to diabetes. "If you give someone the diagnosis of diabetes and now they need insulin, that changes their life. They have to take medication. They have to see their doctor regularly. It's a chronic illness," Dodson says. "How is that any different from schizophrenia?"
Similar to diabetes, many psychiatric conditions require ongoing treatment, follow-up care, and long-term management. Yet, mental illness is often viewed differently. Dodson believes integrating psychiatric and medical care helps reinforce that mental health conditions are part of a person's overall health, not something separate from it.
"Mental illness is common," she says. "When it's that common, it's your neighbors, your romantic partners, your friends."
For Dodson, that reality makes integrated care not only logical, but also necessary.
The patients who remind her why it matters
Since the unit opened in December 2024, some of the most meaningful feedback has come from patients and families.
Dodson recalls caring for a patient with complex medical and psychiatric needs whose husband became emotional when he learned she would be transferred to another hospital unit. "He was tearful because he didn't want her to leave," Dodson says.
The family appreciated the comprehensive approach to care and the environment the team had created. "It spoke to how appreciative he was of that whole-person, patient-centered care," she says.
Experiences like that reinforce what first drew Dodson to medicine. "They've reinforced something I've always known, which is how resilient and strong human beings are," she says.
Working closely with patients navigating multiple illnesses has given her a deep appreciation for their strength. "When you work in mental health care, you get more of someone's story," Dodson says. "You get to know more about their life, their family, their work, their experiences. You see how amazing human beings are."
Looking ahead
As IMAP continues to grow, Denver Health is tracking more than 20 performance measures, including patient satisfaction, staff satisfaction, care coordination, and health outcomes.
For Dodson, success would mean more than positive metrics. She hopes the unit demonstrates the value of integrated care and inspires other hospitals to build similar programs.
"We want more med-psych units in this country because we need them," she says.
Ultimately, her goal is for patients and families to walk through the doors with one set of expectations and leave with another.
"My hope is that they come in and leave and go, 'Wow, that was a lot less scary and dehumanizing than I thought it was going to be,'" Dodson says.