Divisions of the Department

The Division of Child and Adolescent Psychiatry and Child Development in the Department of Psychiatry and Behavioral Sciences is an integral part of one of the preeminent child and adolescent mental health treatment consortiums in the country, which includes Lucile Packard Children’s Hospital at Stanford, Stanford Children’s Health, Stanford Hospital and Clinics, and Stanford University School of Medicine.

The mission of the Division of Child and Adolescent Psychiatry and Child Development is advancing science through exploration of psychopathology in children and adolescents; psychotherapy process and outcomes; early childhood stress/trauma; and psychological adjustment. The Division’s goal is to increase understanding of the pathophysiology of youth mental health concerns including mood, eating, childhood medical, anxiety, and autism related disorders using innovative translational approaches ranging from stem cell research to imaging and clinical trials. Services are provided through several outpatient specialty clinics, inpatient, and community-based programs.

The clinical mission is founded on a commitment to family-focused evaluation and treatment using the best available evidence-based methods as well as time-limited psychotherapeutic interventions. The Division’s treatment philosophy embodies an emphasis on improving parent empowerment and providing parent training, when indicated, to make meaningful improvements in family quality of life and optimize outcome. The assessment services also use gold standard diagnostic measures to provide parents with detailed individualized recommendations for improving day-to day and long-term functioning. Child and Adolescent Psychiatry Faculty provide comprehensive clinical services using evidencebased intervention to achieve excellence in patient care, while implementing innovative approaches and time-limited strategies to optimize functioning and long-term outcome. These services are provided through several outpatient specialty clinics, inpatient programs, and community-based programs. The outpatient clinics provide psychiatric care to children and adolescents with a variety of diagnoses from 2 to 18 years of age.

Clinic staff, consisting of child psychiatrists and psychologists, child psychiatry and postdoctoral psychology fellows, and general psychiatry residents, provide initial evaluations, second opinions, and ongoing treatment, in the areas of Early Life Stress and Pediatric Anxiety, Early Psychosis, Eating Disorders, Disruptive Behavior Disorders such as Attention Deficit Hyperactivity Disorder, Mood Disorders, Psychological Assessment, Autism and Developmental Disorders, and School-Based Mental Health.

In addition to the clinical activities, faculty in the child division are involved in a wide range of research activities including stem cell investigations, cutting edge biological and neuroimaging studies, longitudinal observational programs, and innovative clinical trials. The focus of the rich intervention research is to develop evidence-based time limited psychotherapeutic treatments that aim at improving the functioning of youth with psychiatric disorders in a short period of time. These activities are generating promising findings that are helping to advance the science of youth mental health leading to improved prognosis and long-term outcome of children and adolescents suffering from neuropsychiatric disorders.

The Division of General Psychiatry and Psychology is focused on adult mental health and carries out its work across all five of the Department’s missions. The scientific interests of our faculty cover a broad range of mental health problems and include programs in basic and translational science, treatment development and evaluation, and dissemination/ implementation. Our Division is also the home of several key departmental educational programs including our Adult Psychiatry Residency, our Adult Clinical PostDoctoral Fellowships, our T32 Fellowships in Adult Mental Health Disorders, and our graduate clinical psychology program, the PGSP-Stanford PsyD Consortium (operated jointly with Palo Alto University).

The Division provides comprehensive psychiatric and psychological services across a continuum of care. Outpatient clinics include a range of specialties encompassing Mood Disorders, Bipolar Disorder, Interventional Psychiatry (including transcranial magnetic stimulation), Geropsychiatry, Women’s Wellness, Obsessive-Compulsive Disorder, Psychosis, Integrative Medicine, Psychosomatic Medicine, Addiction Medicine/ Dual Diagnosis, Sleep Health and Insomnia, and Neuropsychiatry. The Evaluation and Brief Intervention team provides a Consultation Clinic for patients who require urgent assessment, as well as an Evaluation Clinic for short-term treatment.

The Division supports an active Consultation and Liaison service for hospitalized patients in other departments and patients seen in the Cancer Center. The Integrated Behavioral Health Service is under development to support Stanford Primary Care Medicine. The Psychosocial and Subspecialty Care Clinic provides psychotherapy including Cognitive Behavioral Therapy, Dialectical Behavior Therapy (DBT), and Couples/Family Therapy for patients with a wide range of presenting problems. Subspecialties include Eating Disorders, Sports Psychology, Adult DBT, Couples and Family Therapy, Neuropsychological Assessment, Sleep Health/ Insomnia and the Wellness Program for Stanford faculty and trainees. The Individual Psychotherapy Clinic, staffed by Department of Psychiatry residents and fellows, provides the opportunity for patients to receive long-term psychodynamic psychotherapy.

As part of a world-renowned university hospital, Stanford’s psychiatry service is prepared to treat individuals with complex and challenging illnesses. The Inpatient Psychiatry Service at Stanford is recognized for its commitment to coordinating all patient care through a multidisciplinary team including psychiatrists, psychologists, nurses, occupational and physical therapists, social workers and case managers. The 29-bed Inpatient Psychiatry Service features both open and secured unit programs. Our treatment program is structured to maintain the safety, dignity, and confidentiality of every patient on the unit.

The Division of Interdisciplinary Brain Sciences brings together faculty in psychiatry, psychology, statistics, and computational neuroscience, whose collective efforts are committed to the following:

• Leveraging interdisciplinary knowledge to provide explanatory models for human behavior that captures the inherent complexity of genetic, biological, and environmental factors
• Developing innovative methods for studying the brain and behavior and applying these tools to better understand brain – behavior associations underlying cognitive, developmental and neuropsychiatric impairments
• Addressing an individual as a whole person undergoing unique trajectories of development, across all stages of the lifespan

Psychiatry is currently undergoing a dramatic transformation, as earlier models of defining psychiatric disorders are evolving to incorporate a rapidly expanding knowledge base of mechanisms underlying human cognition and behavior. Faculty within the Division of Interdisciplinary Brain Sciences believe this dynamic environment represents an incredible opportunity – an opening to rethink mental healthcare through the combination of clinical expertise with cutting-edge scientific research.

The ultimate goal of clinical activities within the Division aims to leverage advances in both these domains, with a constant focus on improving the lives of patients suffering from psychiatric illnesses. It is an unfortunate truth that many interventions in psychiatric practice continue to have relatively low rates of treatment response, meaning a disproportionate number of individuals continue to be affected by psychiatric symptoms, causing a substantial burden on their daily functioning and wellbeing.

To address these health disparities, clinical and research initiatives within the Division are focused on several key domains:

1. Comprehensive treatment and evaluation of neurogenetic disorders, such as Fragile X syndrome and sex chromosome aneuploidies, as better understanding of these conditions with well defined causal mechanisms allows broader application to disease processes in more generalized psychiatric disorders with similar symptomatology;
   
2. Development of transdiagnostic and lifespan approaches to classification of psychiatric disorders using innovative clinical and computational methods, thereby bypassing current reliance on phenomenological rather than mechanistic frameworks;
   
3. Innovation in treatment intervention leveraging neurobiological principles, such as neurofeedback and biophysical measures, which extend beyond current mainstays of medications and psychosocial treatments.

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

The Division of Public Mental Health and Population Sciences focuses on understanding and enhancing the wellbeing of populations throughout the world and of distinct and special populations by bridging the fields of psychiatry, epidemiology, psychology, ethics, and public policy.

The Division is a newly evolving academic program engaged in the Department’s five missions. It was created to respond to the need for documentation and promotion of public mental health by public health authorities and professionals, with the goal of enhancing understanding about mental wellbeing and psychiatric disorders around the world.

This Division strives to reach the following objective in parallel with the departmental missions: developing science in the field of public mental health; developing innovative screening and intervention tools to address gaps in clinical care and treatment, particularly for vulnerable populations; organizing educational opportunities for learners of all levels at the university and globally; serving the community through program development and outreach to address the unique needs of vulnerable populations; and establishing leadership in the field of public mental health.

We meet these objectives through the creation and development of several sections, including Dissemination and Implementation Science, Public Mental Health and Epidemiology, Public Mental Health and Addiction Policy, Student Wellbeing and Young Adult Public Health, Veteran and Military Populations, and Ethics and Vulnerable/At Risk Populations. The faculty in the Division of Public Mental Health and Population Sciences has an extremely broad spectrum of expertise. The Division harnesses the academic resources of Stanford University, encompassing the renowned areas of scholarship in medicine, business, law, education, biomedical data and computer science, social sciences, policy, ethics and design. Research endeavors across our division broadly focus on improving public mental health, reducing health disparities, removing barriers to care and reducing stigma, reaching vulnerable populations, and advancing precision health in psychiatry. For example, the Veteran and Military Populations section has focused on the dissemination of novel treatments for depression and posttraumatic stress disorder, efforts that mirror the major challenge of widespread affective and stress disorders in this vulnerable population.

The Division encourages the development of professionals as well as trainees, students, and psychiatry residents. The faculty engage in the development of new science in the area of population psychiatry, as well as dissemination of that knowledge and application to communities locally and globally.

The Division of Sleep Medicine engages in the full five missions of the Department of Psychiatry and Behavioral Sciences. In our clinics we evaluate and manage patients with sleep problems across the age spectrum, from infancy to the elderly. We have one of the largest sleep clinics in the world, with 18 bedrooms for in-laboratory sleep studies, 16 sleep clinicians, 5 basic sleep scientists, and over 60 clinical and research personnel. We use cutting-edge, new technology to aid in the care of our patients, using a patient-centered care and translational approach for the diagnosis and treatment of sleep disorders in our patients. Our sleep research group is not only active in basic and translational research, but also clinical research supported by NIH and industry that includes multicenter studies assessing treatments for sleep disorders, genetic studies, new diagnostic and therapeutic tools, and evaluation of sleep-related comorbidities.

This background of our Division’s faculty in basic and/or clinical sleep research allows us to employ a bench-to-the bedside approach in using the latest discoveries not only from our research laboratories, but also those of others, in designing a customized treatment plan for our patients.

Seventy million people suffer from chronic, severe sleep disorders in the United States. That means nearly one of every four Americans has a sleep problem. No other chronic disease affects more people than obstructive sleep apnea, a potentially fatal condition that causes some individuals to stop breathing several hundred times every night. As the birthplace of sleep medicine, Stanford has been instrumental in developing the field of sleep medicine.