Vanderbilt Psychiatric Hospital (VPH)

VPH.jpgThe Vanderbilt Psychiatric Hospital (VPH) was founded as a psychiatric hospital for children and adolescents. The hospital has expanded the services and now provides services for children, adolescents, and adults. Residents in their PGY 1 and PGY 2 year spend time on each of the following acute inpatient units: Child, Adolescent, General Adult, Psychotic Disorders, and Addiction.

Residents spend two months in child and adolescent psychiatry during their PGY 1 year. During this rotation, residents assume major responsibility for at least five inpatients on the Adolescent Unit, including participating in treatment planning meetings involving a multidisciplinary staff. In addition, residents participate in the educational seminars for the Child and Adolescent Fellowship, providing the residents with an opportunity to integrate the inpatient experience with the evidence based teaching regarding child and adolescent psychopathology, child development, and the continuum of care between inpatient and outpatient services. Supervision is provided by two Board Certified Child and Adolescent Psychiatrists.

Residents have the option of spending elective time in either PGY 1 or PGY 4 years on the Child Unit, an 8 bed unit serving children with mood disorders, psychotic disorders, PTSD, severe ADHD, and anxiety disorders. The resident is supervised by a Board Certified Child and Adolescent Psychiatrist.

The General Adult Unit and the Psychotic Disorders Unit are primary sites of resident training in the PGY 1 and PGY 2 years. The Psychotic Disorders Unit serves patients with schizophrenia, schizoaffective disorder, mood disorders with psychotic features, and other psychotic illnesses. The team specializes in pharmacologic intervention and social service support to facilitate transition into the community. Residents have the opportunity to learn a structured approach to the management and treatment of severe psychiatric illness. Residents work to educate patients and their families about the illnesses and tofacilitate compliance through understanding of illness. The resident is supervised by a Board Certified Adult Psychiatrist.

The General Adult Unit serves patients with major affective disorders, anxiety disorders with a prominence of PTSD and OCD, somatic disorders, psychiatric disorders due to medical conditions and personality disorders. Patients admitted to this unit need acute stabilization for symptoms such as suicidality, agitation, dysphoria, mania and self mutilation. The assigned PGY 1 or PGY 2 resident learns how to perform the admission evaluation interview, formulate a differential diagnosis and treatment plan, assess for safety, initiate evidence based psychopharmacology and plan for discharge. The resident participates in daily teaching rounds supervised by a Board Certified Psychiatrist that includes psychotherapy, medication adjustment, interpretation of laboratory and other studies and teaching Vanderbilt medical students. The resident also attends the biweekly treatment team with the unit nurses, mental health specialists and social workers to discuss the patients’ progress, behaviors, goals and plans. The teaching team accepts up to eight patients with an average stay of 6 days.

The Vanderbilt Addiction Center, staffed by Board Certified Addictions Psychiatrists, has its services located in the Vanderbilt Psychiatric Hospital. Inpatient and outpatient detoxification as well as pharmacologic and psychosocial treatments are all part of an integrated system of clinical care services for adults with substance-related disorders. All PGY 1 residents spend at least one month on the Addiction Unit, and PGY 2 residents have an opportunity to spend an additional month. Residents on this service learn to manage acute detoxification of substance dependent patients following evidence based protocols. The unit serves dual diagnosis patients with addictions and other primary psychiatric disorders. The team addresses both the acute detoxification of patients and the assessment and treatment of co-morbidities. Daily rounds are held with systematic contribution from nursing, social services, occupational therapy, and other involved staff. Milieu and multidisciplinary understanding and treatment of patients are stressed. Psychosocial and biologic perspectives on illness are actively utilized with experience and training in the full range of biologic treatments. Supportive short-term psychotherapy, group psychotherapy, family / couple assessments, and social assessment / intervention are equally stressed. Residents are encouraged to familiarize themselves with a wide variety of modalities and are free to pursue more systematic training in selected areas.

All residents, faculty, and students assigned to services at Vanderbilt Psychiatric Hospital have a weekly case conference for discussion of difficult cases. The presentations involve trainees and faculty from each unit on a rotating basis, resulting in a rich educational opportunity.