General Psychiatry ResidencyClinical training sites
Jail Psychiatric Services
Jail Psychiatric Services (JPS), also known as Adult Correctional Mental Health (ACMH), was established in 1978 and provides all mental health services to the inmates of Sacramento County. As part of the UC Davis Department of Psychiatry and Behavioral Sciences, we provide a variety of levels of care through a contractual agreement with Sacramento County.
The Sacramento County Main Jail was built in 1989 to house approximately 1,200 inmates. The growing need for housing inmates has resulted in an increase of the total capacity to approximately 2,400 inmates. The Rio Consumnes Correctional Center (RCCC or “The Branch”) is the primary custody facility for inmates sentenced to County Jail from the Sacramento County Courts and contains our Jail-Based Competency Treatment (JBCT) program. An increasing percentage of the inmates are pre-sentence detainees housed at RCCC to keep the population at the Main Jail below the limit set by Federal decree. RCCC was constructed around 1960 with the capacity to house 750, it now houses an approximately 2,000 sentenced and pre-trial inmates for a total of 3,800 to 4,000 inmates at both locations. There are approximately 150 bookings daily. Approximately 700 to 800 inmates actively receive mental health care at any one time and more than 30 percent of inmates are on some form of psychiatric medication.
Medical students and general residents work primarily on the JPS Acute Psychiatric Unit (APU) of the Main Jail in downtown Sacramento (a 17-bed LPS unit) in an exciting, education-focused environment that provides direct contact with pre-sentenced, sentenced and individuals awaiting transfer to State Hospital or other placements in the community. Additionally, opportunities are available for elective outpatient work in a jail setting as well as a resident continuity experience working on a Jail-Based Competency Treatment (JBCT) to assist in restoration of competence to stand trial.
JPS/ ACMH strives to facilitate a dynamic, educational learning environment. Quality patient care for a marginalized population with serious mental health care needs, knowledge of clinical science, practice-based learning, interpersonal communication skills and professionalism are primary areas of focus and are refined in trainees. Forensic fellows, resident physicians, medical students, nurse practitioners, physician assistants, physicians, social workers, custody and a variety of other team members work closely together in an effort to provide a positive treatment environment for Sacramento’s inmate population.
Sacramento County Mental Health Treatment Center
The Sacramento County Mental Health Treatment Center (aka “SCMHTC” or “MHTC” or “The Treatment Center”) houses two different programs: a 23-hour Crisis Stabilization Unit (CSU) and a 50-bed Psychiatric Health Facility (PHF). PHFs are a type of inpatient psychiatric unit unique to California. MHTC provides psychiatric stabilization to uninsured and Medi-Cal (Medicaid)-insured Sacramento County residents who have severe mental illness. The majority of patients at MHTC suffer from psychotic and mood disorders (including schizophrenia, schizoaffective disorder and bipolar disorder).
PGY-2 residents rotate through the CSU and PHF. In the CSU, residents gain experience conducting initial psychiatric evaluations, safety/risk assessments and management of acute agitation for patients in psychiatric crisis. In the PHF, residents are important members of the multidisciplinary treatment teams who stabilize patients via psychopharmacology and therapeutic group activities. Each treatment team consists of an attending psychiatrist, two PGY-2 residents, one-to-two third-year medical students, three psychologists/social workers, a nurse, a discharge planner, a pharmacist and a Peer Partner.
In addition to gaining experience with complex psychopharmacology and clinical reasoning, residents learn about the outpatient mental health resources available to Sacramento County clients and deepen their understanding of the legal aspects of involuntary psychiatric care.
PGY-4 categorical residents and PGY-5 combined residents may elect to return to MHTC for Acting Attending rotations, allowing them to practice management of a multidisciplinary team and supervision of junior residents and medical students, with the support and guidance of the MHTC attending psychiatrists.
Sacramento County Adult Psychiatric Services Clinic
The Sacramento County Adult Psychiatric Services Clinic (APSS) is an adult community mental health clinic that serves the economically disadvantaged patients, including those uninsured and those insured through California’s Medicaid program. The clinic provides for an ethnically diverse population including refugees from serval countries and undocumented patients. The most common disorders are PTSD, mood, anxiety, and psychotic disorders. PGY-2 psychiatry residents spend three months working full time in the clinic. The psychiatry residents provide psychopharmacologic therapy in a team approach with nurses, therapists, Peer Partners, and case managers.
UC Davis Medical Center Psychiatry Consultation Liaison Service
The UC Davis Medical Center Psychiatry Consultation Liaison (CL) service provides expert psychiatry consultation services to medical/surgical patients in a wide variety of clinical settings. Inpatient consultations are conducted at the 646-bed UC Davis Medical Center, a Level 1 Trauma Center, and the major tertiary care medical center for inland northern California. Residents rotate on the CL service during their PGY-1 year and lead the multidisciplinary team during their PGY-4 year with selective opportunities to serve as acting attendings, mentor junior residents, teach medical students, and learn bedside psychotherapy for hospitalized patients. Educational opportunities on the CL service include case conference, process/support group, and individual supervision with specialized faculty.
UC Davis Behavioral Health Center and Child Behavioral Health Center
The UC Davis Behavioral Health Center (BHC) and Child Behavioral Health Center (CBHC) are the heart of the psychiatry department’s outpatient clinical services. The BHC is an academic outpatient psychiatry clinic serving the greater Northern California region and a diverse patient population. Our clinical staff consists of psychiatrists, nurse practitioners, psychologists, and trainees including medical students, psychiatry residents and fellows, and clinical psychology interns/postdoctoral fellows. We take a team-based approach to mental health treatment and work closely with the rest of the health system including primary care physicians and medical specialists.
The BHC and CBHC outpatient clinics provide services including psychiatric evaluation and consultation as well as ongoing care for a variety of psychiatric disorders across the lifespan. We also provide the following subspecialty mental health services:
- RESTART (Resilience, Education and Supportive Tools for Adults Recovering from Trauma) program for patients with trauma
- EDAPT (Early Diagnosis and Preventive Treatment) Program for patients with early psychosis
- Women’s Mental Health Clinic
- PMP-CCC (Pediatric Med-Psych Complex Care Clinic) and MC-PCC (Medically Complex Psychiatric Consultation Clinic) programs for patients with comorbid chronic or complex medical conditions
Residents conduct psychiatric evaluations, medication management, and psychotherapy visits throughout the PGY-3 year and carry a panel of mostly adult patients. PGY-3s have a longitudinal child and adolescent psychiatry experience for one half day a week in the PEAT (Pediatric Evaluation and Teaching) Clinic which focuses on evaluation and management of youth with psychiatric disorders. Residents can also choose from various selective continuity experiences for another half day per week, including the subspecialty clinics list above as well as offsite rotations at the VA, JPS, and MIND Institute. Residents work with different supervisors for psychopharmacology and therapy supervision in both individual and group formats, and also participate in case conferences.
VA Sacramento Medical Center (Behavioral Health Inpatient Care Unit)
The Sacramento VA Behavioral Health Inpatient Care Unit (BHICU) is part of the Northern California VA Health Care System, which serves a population of about 350,000 veterans annually, scattered over 17 counties and 40,000 square miles. The unit operates a 16 bed locked, acute psychiatric facility, meeting the latest strict VA environment of care standards.
Our mission is to provide comprehensive, compassionate and effective treatment to veterans with mental health needs, with the goal of empowering them to live meaningful, self-determined lives in their communities while striving to achieve their full potential. We have a vision to enhance veteran well-being through the use of high quality, innovative interdisciplinary care.
Our treatment team, each of whom plays a vital role in working alongside the patient in assisting their recovery, consists of addiction therapists, chaplains, dietitians, health technicians, nurses, nurse practitioners, nursing assistants, occupational therapists, psychiatrists, psychologists, and social workers. This is a very patient-centered unit with the veterans expected to be active participants in managing their recovery effectively.