The California Department of State Hospitals (DSH) manages the nation’s largest inpatient forensic mental health hospital system. The mission of DSH is to provide evaluation and treatment to patients in a safe and responsible manner, while seeking innovation and excellence in hospital operations across a continuum of care and settings. DSH oversees five state hospitals (Atascadero, Coalinga, Metropolitan, Napa, and Patton) and employs nearly 13,000 staff. 

DSH Napa is a potential placement for PPF fellows. It is the site for forensic, geriatric, addiction, and inpatient rotations. It is the oldest state hospital in California, founded in 1875. It is still in operation with approximately 1,255 beds. Fellows will have the opportunity to evaluate and treat the patients under the Civil Commitment under the Lanterman-Petris-Short Act, Incompetent to Stand Trial, Offenders with mental Health Disorders, Not guilty by reason of insanity. Residents will have the opportunity to provide specialized treatment such as Dialectic Behavior Therapy (DBT), Treatment for polydipsia, Sex offender treatment, and Intensive Substance Recovery. Napa State Hospital's clinical staff includes psychologists, psychiatrists, social workers, rehabilitation therapists, psychiatric technicians, and registered nurses.

In addition to state hospital treatment, DSH provides services in contracted jail-based competency treatment (JBCT), community-based restoration (CBR) and pre-trial felony mental health diversion programs, and the conditional release program (CONREP). DSH is responsible for the daily care to over 7,000 patients, and in FY 2020-21, DSH served 7,813 across the state hospitals, 2,403 in JBCT and CBR contracted programs and 841 in CONREP programs. In addition, as of December 31, 2020, a total of 276 individuals were diverted into county programs funded by DSH.