The Division of Medical Psychiatry in the Department of Psychiatry and Behavioral Sciences focuses on the study, diagnosis, and treatment of psychiatric disorders in medically ill patients with complex and/or chronic medical conditions (e.g., patients with medical, surgical, oncologic, obstetrical, and neurological conditions), with a primary mission to integrate medical and psychiatric care. Established in the five missions of the department, the division has two primary goals: to increase the understanding of the pathophysiology of complex behavioral and psychiatric disturbances that arise as a direct consequence of a primary medical condition or its treatment, and to enhance the care of patients with comorbid psychiatric and general medical illnesses, in the acute inpatient medical center setting or long-term medico-surgical clinics.
The domain of Medical Psychiatry includes specific areas of knowledge and skill sets, including understanding the impact that psychiatric illnesses and the medications used to treat them can have on medical illnesses. Conversely, the presence of medical disorders can change the presentation of psychiatric illnesses. Medical Psychiatry focuses on the psychiatric impact of the general medical pharmacopeia and the ways in which psychiatric illness can affect the presentation of medical illness. Most importantly, Medical Psychiatry focuses on the medical and neurologic causes of psychiatric illnesses. Many general medical conditions or their treatments produce symptoms, which, in whole or in part, mimic psychiatric illnesses and, in some cases lead to psychiatric disorders.
The Division of Medical Psychiatry at Stanford was created in 2021 to integrate the delivery of mental health care to multiple clinics and medical services throughout the Stanford Medicine system, including Stanford Health Care (SHC), Lucile Packard Children’s Hospital/Stanford Children’s Health (LPCH), and Stanford University School of Medicine (SOM). Members and affiliated professionals include a multidisciplinary team of psychiatrists, advance practice providers, nurse practitioners, clinical case managers, and social workers with expertise in general psychiatry, consultation-liaison psychiatry, psycho-oncology, addiction medicine, medical hypnosis, acupuncture, mindfulness, medical nutrition, and forensic medicine.
Members of the Division of Medical Psychiatry have been pioneers in the expert understanding the biomedical basis of disease processes and the psychiatric manifestations and treatments of numerous medical disorders, such as delirium, central anticholinergic syndrome, and alcohol withdrawal. Through their research activities and clinical expertise, our team has had a unique role in shaping and setting the standards for the field of psychiatry in medicine.
Examples of this work include:
- Development of a unique, fully integrated mental health program within our Cystic Fibrosis program
- Development of the Transplant Psychiatry Section which provides integrated care to all blood and solid organ transplant programs at Stanford Health Care
- Development of the nation’s first Critical Care Psychiatry Service, and the first Post-Critical Care COVID-19 Clinic, in conjunction with our intensivist colleagues
- Development of a CME course, the “Immersion to Medical Psychiatry Series,” to assist incoming fellows become fully acquainted with advanced medical knowledge in the first few weeks of their training program and refresh all the pertinent aspects of their medical school training which are required to practice psychiatry in the medical setting
- Development of criteria for the psychosocial assessment of organ transplant recipients and donors
- Developing the tools for the recognition of and the protocols for the management of delirium and other alterations in mental status among the medically ill, especially in the intensive care units setting