All clinical services in the General Psychiatry Division are part of Vanderbilt Behavioral Health (VBH). The services are directed by Chief Medical Officer Nathaniel Clark, MD.


General Psychiatry Inpatient Service

Medical Director: Abhinav Saxena, MD MBA

Faculty and Professional Staff:
Jonathan Becker, DO
Nathaniel Clark, MD
David Conklin, MD
Emma Finan, MFFT
Stephan Heckers, MD
Christopher Maley, MD
Sachin Patel, MD PhD
William Petrie, MD
Elizabeth Shultz, MD
Maja Skikic, MD
Jeffrey Stovall, MD

Service:  Vanderbilt Psychiatric Hospital (VPH) offers inpatient psychiatric care for children, adolescent and adults.  More than half of the 106 beds are dedicated to the care of adult patients.
The integrated team of physicians, pharmacists, nurses, social workers, mental health specialists, and administrative leaders work closely together to provide excellent care for patients who are in a psychiatric crisis, seek clarification of their diagnosis or need a revision of their failed outpatient treatment plan. We offer diagnostic expertise and specialized treatment modalities, including medication management, group programming, individual therapy, art & music therapy, transcranial magnetic stimulation, electroconvulsive therapy, and more. 
On the same campus, VPH also offers services of the award winning partial hospitalization and intensive outpatient programs. 

Education:  We serve the community by providing outstanding education of future psychiatrists, nurses, pharmacists, and social workers through our rigorous internships, rotations, and residencies.  VPH serves as the major training site for the education of all medical students at Vanderbilt University and for visiting students from medical schools across the country.


General Psychiatry Consultation-Liaison Service

Medical Director: John Smith, MD

Faculty and Professional Staff:
Michael Caucci, MD
Beto Arriola, MD, MPH
Daniel Daunis, MD
Ron Cowan, MD, PhD
Jo Ellen Wilson, MD, MPH
Cory Myers, PMHNP

Service:  Consultation-Liaison Psychiatry (CLP) is a subspecialty of psychiatric practice focused on the management of behavioral conditions in patients with other medical and surgical problems. Clinicians trained in CLP have expertise in treating a wide variety of conditions that affect patients with chronic and complex illness, with specific focus on the interplay between physiologic illness and behavioral symptoms. The General Psychiatry Consultation Service at Vanderbilt University Medical Center is responsible for over 4,500 consultations within the medical center yearly, assisting other medical services in managing problems such as delirium, depression, traumatic brain injury, stroke, aggression and violence, suicidal behavior, dementia, and difficulty coping with illness. The service provides value to patients by alleviating psychological suffering, to other medical providers by addressing barriers to effective management of general medical problems, and to the hospital system by assisting with appropriate disposition and safety planning for medically and psychiatrically complex patients. 

Education:  The consultation service serves as the primary CLP training site for PGY-2 psychiatry residents, and the primary general psychiatric training site for neurology residents at Vanderbilt. Medical students during their second year clerkships also rotate on the service, and it remains a popular choice for advanced medical students seeking additional training in psychiatry. Due to it’s unique position at the cross section of psychiatric and medical practice, the General Psychiatry Consultation Service is also a sought after elective rotation for medical trainees in other specialties and disciplines with interest in expanding their ability to manage comorbid psychiatric and medical conditions.


Emergency Psychiatry Service

Director: Amanda Wilson, MD

Faculty
Alan Lewis, MD
Eric Rueth, MD

Our Emergency Psychiatry Service (EPS) is embedded in both the Emergency Department of the Vanderbilt University Adult Hospital and the Vanderbilt Psychiatric Hospital.

  • The Adult Emergency Department manages approximately 70,000 patient visits per year, with close to 4,000 patient encounters for psychiatric reasons. Our goal is to begin emergent psychiatric interventions in the emergency department with empathy, care and respect.  
  • The Psychiatric Assessment Service (PAS) in the Vanderbilt Psychiatry Hospital is staffed by master’s prepared social workers and provides mobile crisis services and interventions 24/7 year round.

Service:  Psychiatrists provide direct patient care services and staff all cases seen by Master's prepared crisis clinicians or psychiatry residents.  Typical consultations provided by the emergency psychiatrist include assessments of safety/risk, suicidal ideation, depression, first break psychosis, addiction, agitation, dementia and capacity.  We also provide expert consultation for differentiation of primary psychiatric illness from neurologic/medical etiologies and work closely with our fully accredited Vanderbilt University Police Department.  In 2019, we began providing medication assisted treatment (MAT) with buprenorphine in the Adult Emergency Department. 

For 24/7 access to our services, please click here.

Education:  We are the primary site for emergency psychiatry training in the Vanderbilt Psychiatry Residency Training Program.  All Psychiatry PGY-2 residents rotate with the EPS service. We offer elective experiences for Emergency Department residents, PGY-3/4 psychiatry residents and psychiatric nurses.


Neuromodulation Service

Director: Jonathan Becker, DO

Faculty:
Allyson Cundiff, MD
Christopher Maley, MD
William Petrie, MD
Elizabeth Shultz, DO

Neuromodulation is a treatment technique in which nerve cells are directly stimulated to create a therapeutic effect.  The treatments are generally considered for patients who have not responded to medication.  At Vanderbilt, we offer two neuromodulation treatments: transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT).

  • TMS is indicated for patients with Major Depressive Disorder who are in an acute depressive episode and who have not responded to treatment with at least one, often several, antidepressants.  This treatment uses a magnet to generate a focalized electrical field which stimulates a part of the brain that is underactive in depression. It is well tolerated with only minor and transient side effects.  
  • ECT is one of the oldest but still the most effective treatment in psychiatry.  It is indicated for a wide range of psychiatric illnesses including treatment-resistant Major Depressive Disorder, Bipolar Disorder, Schizoaffective Disorder, and Catatonia.  This treatment involves the use of general anesthesia.  While asleep, we use a small electrical current to elicit a medically managed seizure that allows the brain to “reset” and to restore brain functions that are disrupted with acute mental illness. This treatment may be associated with temporary memory loss which resolves within a few weeks.  

Literature

  • Becker JE, Maley CT, Shultz EKB, Peters TE. Neuromodulation: Past, Present, and Future. Child Adolesc Psychiatr Clin N Am. 2019 Jan;28(1):xi-xii. 
  • Maley CT, Becker JE, Shultz EKB. Electroconvulsive Therapy and Other Neuromodulation Techniques for the Treatment of Psychosis. Child Adolesc Psychiatr Clin N Am. 2019 Jan;28(1):91-100.
  • Becker JE, Shultz EKB, Maley CT. Transcranial Magnetic Stimulation in Conditions Other than Major Depressive Disorder. Child Adolesc Psychiatr Clin N Am. 2019 Jan;28(1):45-52. 

Transplant Psychiatry Service

Director: Lesley Omary, MD

Faculty and Professional Staff:
Sarah Carpenter, PMHNP 
Katie Davidson, PMHNP
Daniel Daunis, MD

The Transplant Psychiatry Service is an integral part of the multidisciplinary Vanderbilt Transplant Center, and has been involved since the Center was developed over 30 years ago. Over 500 transplants (liver, lung, kidney and heart) were performed in 2018.

Service:  Patients undergoing life saving organ transplantation experience a variety of psychological, social and interpersonal changes during the transplant process. Transplant Psychiatry’s main goal is to identify and address these concerns. We provide pre-transplant psychiatric assessments to identify mental health issues that could increase potential risks associated with organ transplantation. Also, we facilitate treatment and referrals to improve quality of life and outcomes for our patients. We follow patients both pre-and post-transplantation for medication management. In addition, we provide psychiatric assessments for potential living kidney and liver donors prior to donation to ensure minimal psychological risks to the donors. Patients are seen in both outpatient and inpatient settings. 

Members of Transplant Psychiatry work closely and collaboratively with the organ transplant teams to evaluate and address the psychosocial issues our patients face. We participate fully in all transplant program and living donor committee meetings. 

Education:  Psychiatry residents and fellows are trained in transplant psychiatry through inpatient consults, outpatient clinic, and participation in transplant committee meetings.


Vanderbilt Street Psychiatry

Director: Sheryl Fleisch, MD

The Vanderbilt Street Psychiatry (VSP) clinic, through the Department of Psychiatry and Behavioral Sciences at the Vanderbilt University School of Medicine, began in July 2014.  The clinic occurs weekly, on Wednesdays, and is a result of a partnership between the Department of Psychiatry and Behavioral Sciences and a local nonprofit organization that has extensive experience providing street outreach and housing services to persons struggling with homelessness and mental illness.  The clinic director is a consultation-liaison and addiction medicine certified adult psychiatrist who has expertise in homelessness.  PGY-III and PGY-IV psychiatry residents can request the clinic as part of a longitudinal one-year elective rotation; a half day a week for one PGY-III and a full day a week for two PGY-IV residents.  Since inception, all clinic positions have been filled.  Each week, one second year medical student on the psychiatry clerkship will participate in the clinic for an immersive experience.  For three months out of the year, two senior medical students will participate in the clinic weekly as part of a community health immersion course. 

During rounds, the “street team” engages persons experiencing homelessness at their encampments, necessitating the ability to effectively and often quickly 1) assess the situation 2) break down barriers and 3) built rapport.   The street team wears casual attire and carries backpacks with basic medical supplies, bus passes, food cards, hygiene items, and clothing that is utilized to help meet immediate needs. The VSP clinic fills an important health care gap for patients who experience homelessness with mental illness who either cannot or will not access traditional mental health care services.


Women's Mental Health Service

Director: Michael Caucci, MD

Service:  The Vanderbilt Women’s Mental Health Service is an outpatient clinical service. Dr. Caucci, an attending psychiatrist with specialty training in consultation-liaision psychiatry, offers treatment to women (ages 18 – 65) who experience psychiatric illness.  Through collaboration with the Vanderbilt LGBTQ Health Network he extends services to persons with gender identity dysphoria, who are seeking psychiatric assessment for gender affirming surgeries or who are needing medication management for underlying psychiatric illness.   
The general clinic of the Vanderbilt Women’s Mental Health Service, located at The Village at Vanderbilt, serves clients without a significant addiction history.   
The addiction clinic of the Vanderbilt Women’s Mental Health Service, embedded within the Vanderbilt Clinic of Women’s Health at 100 Oaks, is an extension of the Vanderbilt Maternal Addiction Recovery Program (VMARP). It serves clients, during their perinatal period to over 1 year postpartum, who require long-term buprenorphine maintenance for opioid use disorder.  As part of the VMARP, the women’s mental health service has access to Obstetrics and Gynecology providers, social worker, and addiction groups.

Education:  The service offers opportunities for medical students, residents and fellows in the Psychiatry and Obstetric & Gynecology residency programs, as well as psychiatric nurse practitioners, to engage in treating psychiatric conditions over the course of the female reproductive life-cycle. Interested trainees may participate in the general or addiction clinic.