The Sacramento County Main Jail is located in the heart of downtown Sacramento. The Jail houses 2,400 inmates with an 18-bed inpatient psychiatric unit. Approximately 20% of the inmates in the Jail have a prior psychiatric history. The forensic psychiatry resident provides psychiatric evaluations for the jail "outpatient" clinic. During this clinical experience, the resident goes to various housing units within the jail and assesses inmates with potential mental health issues. The resident also consults with general medical physicians regarding the interface of alcohol and drug withdrawal with potential suicidality. Educational opportunities include bi-weekly case conferences and individual supervision. Assigned supervisors have added qualifications in Forensic Psychiatry and provide ongoing supervision. For more information about Forensic Psychiatry at UC Davis, call the Division of Psychiatry and the Law office at (916) 734-0870 or e-mail Charles L. Scott, M.D.

Northgate Point Regional Support Team (RST) clinic is a county-contracted community-based outpatient mental health clinic. Most PGY-2 residents spend one afternoon per week seeing patients who have severe and persistent mental illness. The RST patients are followed longitudinally individually and in group medication management sessions. The RST clinic also offers individual therapy, group therapy, dual diagnosis case-management and peer support.  The RST patient population has either MediCal (Medicaid) or no insurance. The RST clinic serves a diverse patient population and patients have access to bilingual/bicultural case managers including Russian, Hmong, Mien, Lao, Hispanic, and African American.

The psychosomatic medicine service provides expert psychosomatic medicine consultation services to medical/surgical patients in a wide variety of clinical settings. Inpatient consultations are conducted at the 528-bed UC Davis Medical Center, a Level 1 Trauma Center, and the major tertiary care medical center for inland northern California. In addition, the fellow may be assigned to the Bioethics consult service. Outpatient consultations are conductedat the Sacramento County Primary Care Clinics and the UC Davis Medical Center departments of Internal Medicine, Transplant Surgery, and Gastric Bypass Surgery. Patients are alsoevaluatedin various rural clinics via telepsychiatry.

The Sacramento County Adult Psychiatric Support Services Clinic (APSS) is located about one mile from the UC Davis Department of Psychiatry and Behavioral Sciences.  It is an adult community mental health clinic that serves the economically disadvantaged, with essentially 100% insured through California's Medicaid program.  Approximately 30% of the patients are non-English-speaking, primarily Hmong, Mien, Vietnamese or Eastern European.  The most common diagnoses are depressive and anxiety disorders.  Second year psychiatry residents spend three months working full time in the clinic.  The psychiatry residents provide psychopharmacologic therapy and group psychotherapy.

Sacramento County Mental Health Treatment Center (SCMHTC) is a 100-bed inpatient facility combined with a 23 hour psychiatric emergency department (Crisis Center). SCMHTC is run by Sacramento County, but staffed by UC Davis physicians. Most patients are publicly-funded with primary diagnoses of psychotic disorders (45%), affective disorders (40%) and others. The inpatient unit receives about 250 admissions per month with an average length of stay of 5-6 days.  There are four inpatient treatment teams, each with an attending psychiatrist, a PGY-2 resident, 1-2 medical students, along with county psychologists, social workers and others. In the Crisis Center, PGY-2 residents work one-on-one with an attending psychiatrist triaging patients for admission to or discharge from the facility.

The Mental Health Consultation-Liaison Service (MH CLS) provides psychiatric consultations to non-psychiatrist physicians, including assessment of psychopathology and behavioral problems and recommendations for treatment, in the inpatient medical-surgical wards as well as the outpatient and Urgent Care Center settings. In addition to the assessment and treatment of referred patients, MH CLS also refers appropriate patients to Mental Health for more intense psychiatric treatment, being one more important route of access to mental health care for veterans. Junior residents and medical students focus on refining their interviewing, documentation skills and case presentations while expanding their understanding of psychiatric diagnoses and treatment interventions. The role of senior residents is that of an "acting attending," organizing the clinical and educational activities of the junior residents and medical students under the supervision of the attending psychiatrist.