Community Psychiatry Rotations
Clinics and Services
San Mateo South County Community Mental Health Clinic
Located in a socio-economically deprived area, the clinic serves a high proportion of ethnic minorities. 75% African-American, 10% Hispanic, 5% Pacific Islander, 5% Caucasian and 5% Asian. The patients are approximately 40% male, 60% female; most are between 18-34 years. Diagnoses include 70% chronic affective and psychotic disorders, 15% primary substance abuse, 10% personality disorders, and 5% adjustment disorders. 50% of the patients have dual diagnoses. Treatment modalities include medication clinic, brief and/or supportive psychotherapy, crisis/family interventions and referral for hospitalization.
Residents spend the majority of their time learning and doing comprehensive psychiatric intake evaluations, including detailed psychiatric and medical histories; formulating differential diagnosis and treatment plans under the supervision of staff psychiatrists. Special attention is paid to social and cultural aspects of the patient's psychiatric illness and treatment of poly-substance abuse is emphasized as well. Residents learn to access local community resources as part of developing treatment plans.
An average resident caseload is 4-5 for initial intake and medication follow-up for severely and persistently mentally ill plus "on-duty" responsibilities for crisis interventions. The resident attends weekly staff meetings (1 hour) to review clinical case material and explore treatment options. Case-by-case consultation in weekly meetings is provided with staff psychiatrists and in consultation with other mental health professionals, including specialists in case management and substance abuse. In addition, one hour per week of individual supervision with a staff psychiatrist is scheduled for consultation and supervision at the site.
East Palo Alto Mental Health Clinic
Located in a socio-economically deprived area, the clinic serves a high proportion of ethnic minorities. Diagnoses include 70% chronic affective and psychotic disorders, 15% primary substance abuse, 10% personality disorders and 5% adjustment disorders. 50% of the patients have dual diagnoses. Residents spend the majority of their time learning and doing comprehensive psychiatric intake evaluations, including detailed psychiatric and medical histories; formulating differential diagnosis and treatment plans under the supervision of staff psychiatrists. Special attention is paid to social and cultural aspects of the patients psychiatric illness and treatment of poly-substance abuse is emphasized as well.
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