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 with serious mental illness 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. In addition to state hospital treatment, DSH provides services in contracted jail-based competency treatment (JBCT), community-based restoration (CBR), pre-trial felony mental health diversion programs, community inpatient facilities (CIF), and the conditional release program (CONREP). DSH is responsible for the daily care of over 7,000 patients across our continuum of care.
USCF-PPF fellows can be placed at a DSH site based on their interest and location, allowing us to tailor their clinical experience to align with their future career goals and accommodate their geographic location. Two potential placement options are described below.
DSH Napa: Placement at DSH-N is an option for UCSF-PPF 4th or 5th year fellows located in Northern California. It is the oldest state hospital still in operation in California, founded in 1875. DSH-N has over 1,200 beds and is the site for forensic, geriatric, addiction, and inpatient rotations. Fellows will have the opportunity to evaluate and treat the patients under civil and forensic commitments, including conservatees under the Lanterman-Petris-Short Act, Incompetent to Stand Trial, Offenders with Mental Health Disorders, and Not Guilty by Reason of Insanity. Fellows will have the opportunity to provide specialized treatment such as Dialectic Behavior Therapy (DBT), treatment for polydipsia, sex offender treatment, and intensive substance recovery. Fellows will be in a hybrid of in-person and remote days, with direct patient care two days a week at DSH-N, working alongside multi-disciplinary teams including psychologists, psychiatrists (including recent UCSF graduates!), social workers, rehabilitation therapists, psychiatric technicians, and registered nurses, among others.
DSH PRN: Placement with the DSH Psychopharmacology Resource Network (PRN) is a unique opportunity for USCF-PPF 5th year fellows, though UCSF-PPF 4th year fellows may be considered. The DSH-PRN team is a group of experts in psychopharmacology and aims to enhance psychopharmacology practices through consultation, education, policy changes, outcomes research, and publication. They provide services across the DSH continuum of care. The fellow will primarily work within the PRN group, which will be a hybrid of in-person and remote days, and will provide direct patient care one day a week at DSH-Napa. The fellow will have the opportunity to work on consultations, in doing so will learn to formulate the critical reason(s) for the consultation request, obtain data from various sources, recognize relevant data to include in their report, appreciate the importance of diagnostic clarity, and develop the rationale for their recommendations. There will be an emphasis on developing clear and concise writing skills. The fellow will learn the various legal commitments, gain knowledge of the DSH continuum of care, and understand how care settings can impact treatment. Additionally, the fellow will participate in article discussions and will provide education for trainees and staff. This enriching experience will advance the fellow’s knowledge of psychopharmacology practices in patients with serious mental illness while developing an appreciation of the mental health continuum of care in California.
