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Clinical Experiences

The fellowship program includes a wide variety of clinical experiences with civil evaluations and with inpatient and outpatient criminal populations. The home base for the fellows is Grady Memorial Hospital, a large county hospital in downtown Atlanta and the largest teaching site of the Emory University School of Medicine. The psychiatry service at Grady is an academic component of Emory University School of Medicine Department of Psychiatry and Behavioral Sciences.

Experience with criminal defendants

Outpatient evaluations: The service has a contract to provide court-ordered evaluations for defendants in Fulton County (Atlanta). The bulk of these evaluations are conducted on inmates in the Fulton County Jail on questions of competency, criminal responsibility, sentencing, and post-sentencing treatment recommendations. Fellows provide testimony on these cases if needed at trial, which averages several times each year.

In-jail competency restoration program: The service runs a novel program based in the Fulton County Jail that restores competency to stand trial for incompetent defendants who require less intensive services than those provided in a forensic inpatient hospital unit or who can be diverted out of the criminal justice system into the mental health system.  This program has been quite successful as a research site for this new intervention, and is more fully described here.

Inpatient evaluations: Fellows spend three half days per week on a forensic inpatient unit conducting inpatient assessments of competency to stand trial, participating in the treatment of NGRI acquittees, and formulating opinions about release of NGRI acquittees. The primary inpatient site is the state hospital in Atlanta, which has two inpatient forensic units. Fellows spend about two weeks each year at Central State Hospital, which has the state's maximum security unit. Fellows are provided with temporary housing at that location. Each site attempts to have fellows take cases that are especially likely to require testimony, and fellows typically testify about 6 times/year on their inpatient cases.

Civil litigation evaluations

Residents serve as the primary evaluator in certain classes of cases, such as disability assessments, guardianship/ civil competency cases, and law school clinic referrals. Fellows also participate with more senior forensic psychiatrists in personal injury and malpractice cases.  There is a designated 4 month half-day per week at the Atlanta VA conducting disability evaluations of veterans.

Consultation/ legal regulation of psychiatry

Fellows serve as consultants on cases arising out of psychiatric hospital work, such as those involving commitment, dangerousness assessments, and competency to consent to treatment. They consult both to the inpatient psychiatry unit and to the general hospital.

Child forensic psychiatry

For fellows who have completed a child psychiatry fellowship, a wide range of experiences are available, including assessments in abuse/neglect issues, child custody, child personal injury, and a rotation at a juvenile detention center. Georgia law places large classes of violent adolescents in the adult criminal system, and so competency and criminal responsibility assessments of juveniles are more common here than in most other jurisdictions. The Service has a number of ongoing research projects on juvenile offenders.