Grady Memorial Hospital
The Department of Psychiatry at Grady Memorial Hospital provides mental health care to people living in central Fulton County as well as the surrounding region. The department is an integral part of the State of Georgia mental health system and is located in a large urban community general hospital. It serves as the center for emergency and inpatient psychiatric services for the metropolitan region and provides outpatient services and an array of comprehensive community mental health programs for adults.
The department is a key training site for the Department of Psychiatry and Behavioral Sciences of the Emory University School of Medicine and is led by Dr. Gray Norquist, Professor and Vice-Chair at Emory. In addition, it serves as a training site for the Morehouse School of Medicine Adult Psychiatry training program. There are approximately 29 Emory faculty members and 7 Morehouse School of Medicine faculty on staff to oversee the work of approximately 26 residents, 9 psychology predoctoral interns and postdoctoral fellows, medical students from Emory and Morehouse, social work students and various other trainees.
Acute Care Service
This service includes the only 24-hour Psychiatric Emergency Service (PES) in the metropolitan region. This is a full service psychiatric emergency program with dedicated space in the emergency room. It is a 12-bed unit where patients are both evaluated and medically cleared. The service also includes a Crisis Intervention Service unit (CIS), which receives patients from the PES and where patients are stabilized before further disposition. The emergency service is directed by Patrick Amar, MD, Assistant Professor and staffed by full time faculty, psychiatric residents, psychology trainees, mid-level providers, nurses, and mental health associates. The PES service has approximately 850 visits per month.
Grady also has a 24 bed inpatient adult psychiatric unit staffed by two full-time attendings, four 1st year psychiatric residents, and a 4th year chief resident in psychiatry who directs the day to day clinical activities of the unit. It is directed by Robert Cotes, MD, Assistant Professor. Each resident carries approximately six patients on the unit, with four residents being on service at any one time. Additionally there are psychology postdoctoral fellows, medical students and other trainees.
Consultation and Liaison Services
The department maintains a Consultation and Liaison Service led by Ann Schwartz, MD, Associate Professor. The Consultation/Liaison Service provides assessments and assistance with patient management and disposition of medical and surgical patients as well as specialty liaison services to many parts of the Grady Health System. The service sees a wide variety of psychiatric disorders with over 150 consults per month. The service is staffed by 1 full-time attending and 2 part-time attendings. Multiple trainees rotate on the service, including Emory PGY-2 residents, one Morehouse PGY-3 resident, and medical students. The service also has one full-time midlevel provider.
Adult Outpatient Services
The largest Grady service is the Adult Outpatient Service located at 10 Park Place, a few blocks from the general hospital. This service is run by Jennifer Wootten, MD, Assistant Professor and staffed by additional full time Emory and Morehouse faculty. The service has approximately 2800 patient visits per month. These are primarily people with chronic and severe mental illnesses. This program is the primary training site for PGY-III psychiatry residents as well as many other trainees. In addition to the medication management services, some of the other therapeutic interventions offered to patients include recovery programs, psychosocial rehabilitation, and individual therapy. In addition, there is a primary care clinic staffed by Dr. Martha Ward. Residents rotating on the service have an opportunity to participate in an elective half day. Some elective options include the Persistent Symptom Treatment, Assessment and Recovery program, Assertive Community Treatment program, and the Grady Trauma Project.
In addition, the department has extensive community outreach programs. It provides psychiatric services to homeless shelters, supportive living facilities, and other community based programs serving patients who are unable to come to Grady Memorial Hospital on a regular basis for mental health care. All PGY-III residents rotate through these services and many 4th year residents take electives in various clinical programs.
Assertive Community Treatment Program
Assertive Community Treatment is a model of healthcare delivery that provides intensive outpatient psychiatric services in a community setting for people with chronic and severe mental illnesses. The medical director for this service is Bakari Vickerson, MD Assistant Professor at Morehouse School of Medicine with additional Emory faculty working on the teams. There are currently three teams that provide services for up to 100 consumers per team. Each team is comprised of social workers, addiction counselors, nursing staff, Certified Peer Specialists, Vocational Rehabilitation Specialists, case managers, and a program manager. In addition, Morehouse School of Medicine and Emory University residents/medical students and University of Georgia psychology interns rotate through this service as part of their Community Psychiatry training experience.
Psychiatry and Law Service
The Psychiatry and Law Service, directed by Peter Ash, MD, Professor, provides services to courts, jails, the state mental health system and other community agencies. The program has two and a half full time faculty members, three forensic psychiatry fellows and two forensic psychology post-doctoral fellows per year as well as other trainees in psychology and other disciplines.
HIV Behavioral Health Service
The Department oversees a comprehensive specialty HIV behavioral health service program at the Grady Ponce de Leon Center, which houses one of the largest HIV primary care programs in the United States, and features an internationally recognized model for comprehensive multidisciplinary and multiservice ambulatory HIV care. The Ponce Center also houses research space for HIV clinical trials as well as offices for the Clinical Research Core of the Emory Center for AIDS Research. The HIV behavioral health program at the Ponce Center, directed by Eugene Farber, PhD, Professor, provides comprehensive mental health and substance use treatment services as well as behavioral health programs for approximately 1,250 patients annually. It is staffed by faculty psychiatrists and psychologists, as well as advanced practice nurses, licensed professional counselors, and substance use treatment specialists. Program services are structured to correspond to the organization of the Ponce Center’s primary care clinics, including general Adult services, Women’s specialty services, Pediatric/teen specialty services (infants, children, youth, and families), and interdisciplinary HIV palliative care services. Behavioral health faculty and staff also offer services in a specialty clinic at the Ponce Center that provides coordinated primary care, case management, and psychiatric services for patients whose HIV treatment adherence and retention in care is complicated by chronic psychosocial instability associated with severe mental illness and/or substance use disorders. The HIV behavioral health services program at the Ponce Center is an elective training rotation for PGY-IV residents, psychology interns, and M-4 medical students. It also is a rotation site for all residents in the psychosomatic medicine and addiction psychiatry training programs.
Grady Nia Project (Nia) and Grady Compassion and Meditation Project
Since its establishment in the early 1990s, Nia, deemed a healthcare innovation by the Agency for Healthcare Research and Quality (AHRQ), has helped over 2,000 low-income African-American women in the metro-Atlanta area who have experienced domestic violence and attempted suicide. It is a culturally competent intervention program offered by Grady Health System and the Emory Department of Psychiatry and Behavioral Sciences with the mission of preventing and reducing intimate partner violence, hopelessness, depression, and suicidality in African-American women. “Nia” is a principle of Kwanzaa, and means purpose. It is hoped that through involvement in Nia, women find a sense of purpose, have more meaningful lives, and commit to living. The Nia Community Advisory Board includes community representatives and program participants. Nia provides individual, group (including DBT, ACT, Seeking Safety, STAIR), and family therapy; a 24-hour on-call system; and access to Relieflink, the nationally recognized suicide prevention app developed by the team. Community partners (Atlanta Symphony Orchestra, Atlanta Botanical Gardens) provide opportunities for the women to engage in cultural enrichment activities.
The Grady Compassion and Meditation Project (CAMP) serves men and women who have attempted suicide. It uses cognitively-based compassion meditation and builds upon the Emory-Tibet Partnership. Participants in Grady CAMP also have access to all of the co-ed groups, including treatment groups, a suicide support group, and a relationship group.
Both Nia and Grady CAMP are under the leadership of Nadine J. Kaslow, PhD, ABPP, Professor and Vice Chair in Emory’s Department of Psychiatry and Behavioral Sciences, and Chief Psychologist at Grady Health System. For her leadership on Nia and Grady CAMP, she has been named one of the Fulton-DeKalb Hospital Authority 2015 Healthcare Champions. Psychology trauma track interns and the psychology general interns rotate through the programs. Psychiatry residents can do an elective with the program and based on the resident’s interests, the elective can include a combination of individual therapy, group therapy, medication management, and clinical-research.