Vancouver General Hospital & UBC Hospital
Dr. Soma Ganesan, Medical Director, Clinical Practice Unit, Department of Psychiatry
Dr. David Hutnyk, Postgrad Site Director
UBC Hospital Outpatient Programs
BC Neuropsychiatry Program
We are a tertiary adult provincial program located at distributed sites across the province of BC. Our partners include UBC Hospital’s neuropsychiatric inpatient and outpatient services in Vancouver, Hillside Centre’s neuropsychiatric inpatient unit in Kamloops, Delta Hospital Neuropsychiatric outpatient clinic in Delta, and the Alder Unit (Lower Mainland’s neuropsychiatric residential unit) in Vancouver.
Our target population are adults with brain illnesses that cause serious disturbances in behavior, mood, intellectual abilities, or thinking processes, as well as those with psychiatric disorders that present as physical disease (somatoform disorders). Patients seen include those with Parkinson’s disease, Huntington’s disease, multiple sclerosis, epilepsy, head injury, anoxic and metabolic brain injuries, Tourette’s syndrome, vasculitides such as systemic lupus erythematosus, stroke, dementias and other neurological disorders.
UBC Hospital Neuropsychiatry Inpatient Unit (Vancouver)
Patients are referred to the unit from around the province. The inpatient program provides intensive assessment and treatment of patients with complex neuropsychiatric presentations who require and would benefit from the expertise of an acute tertiary inpatient program such as ours. Beds may be booked and held open for 24-48 hours for referrals living outside the Lower Mainland. Many patients have physical disabilities and complex medical conditions. These patients often need access to specialized radiological investigations such as MRI and CT Scans, as well as neuropsychological testing, all of which are available at UBC hospital. Patients receive psychotherapy, counselling, education, medication and support from the interdisciplinary team. ECT is available for appropriate patients. The unit follows a primary care model that is client-centered, and whenever possible involves the patient and their families in the decisions around their care.
UBC Hospital Neuropsychiatry Outpatient Clinic (Vancouver)
The outpatient clinic provides assessment, treatment and ongoing monitoring to patients with neuropsychiatric conditions whose illness can be managed in the community. The clinic runs from Monday to Friday.
Hillside Centre Neuropsychiatric Unit (Kamloops)
Hillside Centre is a provincial facility and receives and treats patients from around the province. Hillside is a 25 bed secure unit providing assessment and treatment of patients with neuropsychiatric conditions who require extended inpatient stays to achieve psychobehavioural stabilization. Eligible patients have major persistent psychobehavioural problems that include disinhibition, intrusive aggression and or inappropriate behaviours. The unit follows a primary care model that is client-centered, and whenever possible involves the patient and their families in the decisions around their care.
Alder Unit (Vancouver and Fraser Health regions)
The Alder Unit at Langara Residence provides a longterm stabilization service to meet the needs of Lower Mainland patients who have already received assessment and treatment in the acute and subacute arms of the BC Neuropsychiatry Program. Eligible patients include those requiring ongoing neuropsychiatric care and are unable to transition directly to existing Health Authority community resources. The purpose of the unit is to optimize functioning and maximize quality of life with the ultimate goal of enabling the patient to transition to a less-restrictive community living environment. To this end, the Alder Unit’s aim is to provide a supportive setting with home-like attributes but within a secured environment. A supportive setting is achieved through the development of an interprofessional team providing specialized, person-centered care.
Mood Disorders Program
The Mood Disorders Outpatient Program provides a full range of consultation and assessments for adults with mood disorders within the Vancouver Coastal catchment area, but may also accept tertiary referrals from elsewhere within the province. In general, the program provides one-time-only consultation in the area of diagnosis and/or treatment recommendations. Occasionally, clients/patients are offered short-term follow-up, sometimes in the context of a research study. The Outpatient program is also very involved with teaching medical students and residents in psychiatry.
Mood Disorders Unit 1 East
The Mood Disorders adult psychiatric inpatient program consists of a multidisciplinary team, including psychiatrists, psychologist, occupational therapist, social worker, patient-care coordinator and manager and nursing staff that specializes in the assessment, treatment and research of mood disorders such as clinical depression and bipolar disorder.
The Mood Disorder Unit at UBC hospital is a fifteen bed unit operated and run by Vancouver Coastal Health, with most patients being referred from Vancouver General Hospital. Treatment may include diagnostic assessment, group and individual therapy, pharmacotherapy, family intervention, Cognitive Behavioral Therapy, psychosocial rehab, and possibly Electroconvulsive Therapy (ECT). The unit is also very involved in multidisciplinary teaching, primarily nursing and medical students and residents specializing within psychiatry. The staff, who are specialized in the treatment of complex mood disorders and the co-morbid illnesses that are often associated within this area of psychiatry, enjoy interacting and teaching students within a multi-disciplinary team.
Neuropsychiatry 1 West
Vancouver General Hospital
BC Centre for Sexual Medicine
We are a specialty clinic within the Department of Psychiatry at Vancouver General Hospital. We provide assessment and treatment of Human Sexual Disorders. The Centre serves the entire Province of British Columbia, Canada.
Our services include assessment and treatment of individuals and couples of all ages with concerns in sexual dysfunction, reproductive health, and limited assessment and treatment services. Priority is currently given to those who have pain or other sex-functioning problems with intercourse; to other difficulties around fertility (such as vaginismus, dyspareunia or ejaculatory disorders); and to problems related to medical or psychiatric illness or trauma, to post-surgical conditions, or to physical injuries.
Geriatric Psychiatry Outreach Team
Our interdisciplinary team assesses (finds out what the problem is) and treats seniors (those over 65) who are living in the community and who have psychiatric problems. The team links with the Vancouver General Hospital STAT Centre for day hospital services and inpatient care when needed. We treat people with anxiety, depression, psychosis, memory problems and/or other cognitive difficulties, and behavioural problems associated with memory deficits. We conduct assessments of a person's ability to live safely at home and their legal, financial, and personal competency.
House calls are provided as needed. We conduct a cognitive-behavioural group for seniors recovering from depression and anxiety twice a year. Our assessment services include full neuropsychological assessments. Geriatric psychiatry rounds are given by staff and rotating students three times per month. Our team consists of three part-time geriatric psychiatrists, two nurses, a social worker, a board-certified neuropsychologist, and a secretary.
Outpatient Psychiatry Program
We provide interdisciplinary and comprehensive psychiatric assessment, consultation and treatment to adults aged 18-65 who live in Vancouver dealing with depression, generalized anxiety, social anxiety, stress management, post-traumatic stress disorder, panic disorders and borderline personality disorder. Our therapeutic approaches include cognitive, psychodynamic, psychoeducational and dialectical behavioral therapies, especially in group settings. We work with clients, and sometime their families, to recognize and support their strengths and help them strive toward wellbeing. Our goal is to improve clients' quality of life, prevent relapse and build on existing skills and the goals of each client.
Cross Cultural Psychiatry Program
We provide culturally sensitive and language-specific psychiatric assessment and treatment the following languages and dialects: Cantonese, Mandarin, Vietnamese, Farsi, French, Hindi, Punjabi Hungarian, Japanese, Spanish, Russian & Urdu. Hospital Interpreter Service is used for languages not listed above. We see people with major depressive disorders, dysthymic disorders, bipolar disorders, generalized anxiety disorders, panic disorder, post-traumatic stress disorder (early stabilization), severe adjustment disorders, and psychotic disorders for a limited number of challenging patients after discharge from inpatient programs. This program provides a full psychiatric assessment including diagnosis, medication, recommendations, and links with other resources available in the community. It provides short-term, individual psychotherapy, case review and second opinion for community mental health services, as well as psycho-education for patients and families to provide further information on their disorders. The cross cultural clinic also supports mental health services provided by the Vancouver Association for Survivors of Torture (VAST) and Bridge Clinic. We presently run Changeways programs in Cantonese & Mandarin.
Psychiatric Assessment Unit
This very unique unit provides a crisis service to the VGH Emergency Department and to the City of Vancouver, second to none in Canada. Within the 20 acute beds is a combination of four high secure rooms, four step-down secure rooms and twelve general observation beds. The unit has a high nurse: patient ratio to meet the safety and acute care needs of the patients. The highly skilled interdisciplinary team includes 10 emergency psychiatrists, provides assessment, crisis intervention, intensive care, pharmacotherapy and triage of the adult mental health patient. There is no restriction for admission and the average length of stay is about 5 days.
East One – General Psychiatry and Early Psychosis
East One is a twenty-bed adult inpatient unit at VGH. Fifteen beds are for general psychiatric disorders while five beds are for patients with early psychosis. An interdisciplinary team provides culturally-sensitive, family-inclusive care using a biopsychosocial approach to the management of symptoms and functional deficits. Community resources are involved throughout the hospitalization and discharge planning. Treatment modalities include pharmacotherapy, group and individual work.
West One – General Psychiatry and Concurrent Disorders
West One is a twenty-bed adult inpatient unit at VGH. Fifteen beds are dedicated to patients with concurrent disorders and five beds are for general psychiatric disorders. The care is provided by an interdisciplinary team and includes individual and group work. Programs for patients with concurrent disorders are based upon best practices for individuals with these issues. Community resources are involved throughout the hospital stay and discharge planning.
Brief Intervention Unit
This unit responds to the needs of the adult psychiatric patient in crisis. The interdisciplinary team discusses and makes recommendations and treatment plans for every patient at rounds each morning. The emphasis is on crisis management, pharmacotherapy, brief psychotherapy re-stabilization, and seamless return to the community within about a week with sound post-discharge follow-up.
St. Paul’s Hospital
Dr. Harpreet Chauhan, Department Head
Dr. Leona Adams, Postgrad Site Director
There are four general inpatient mental health units at St. Paul’s Hospital with a total of 60 beds. Adults with mental health and addictions are assessed and treated here and then discharged back to their communities. The patient population is challenging given the presence of not only addictions but also co-morbid chronic medical conditions such as HIV and Hepatitis C. The mental health inpatient units at St. Paul’s are all locked units reflecting the high acuity of patient illness.
Mental Health & Wellness Clinic
The Mental Health & Wellness Clinic is an outpatient service delivering care to those individuals with mood and anxiety disorders. Mental health services are time-limited, and include psychiatric treatment and group therapy with an interdisciplinary team approach, for individuals living in Vancouver. Primary care physicians affiliated with St. Paul’s Hospital are also able to access services for their patients with anxiety and depression.
Our team consists of psychiatrists, social worker/transition coordinator, psychologists, and case coordinators who provide psychiatric services on a Monday to Friday, 8:00 am – 4:00 pm schedule.
- Rapid access to psychiatric treatment & management for specific internal referrals and short term assessment, treatment and planning of 1-10 sessions for Family Practice/Clinic community referrals
- Shared Care consultations (one session) involving diagnostic clarification, medication and/or treatment recommendations for Family Practice/Clinics
- Group Therapy including interpersonal process groups as well as a skills-based cognitive-behavioural therapy (CBT) group for depression.
- Inner City Youth assessments and treatment planning.
- Reproductive Psychiatry assessment and treatment planning.
- Outpatient Electro-Convulsive Therapy intake and follow up.
Provincial Adult Eating Disorders Program
The provincial adult eating disorders program provides a specialized level of care for adults who have a diagnosis of Anorexia Nervosa, Bulimia Nervosa or other eating disorders.
Our program provides robust interdisciplinary clinical services including outpatient treatment, inpatient treatment, an outpatient day treatment program (Discovery) with a residential facility component called Vista (in collaboration with Vancouver Coastal Health), the Community Outreach Partnership Program (COPP) (in collaboration with Vancouver Coastal Health).
Complex Pain Program
The Complex Pain Centre is an interdisciplinary pain management program for patients requiring treatment of severe pain that has proven unresponsive to conventional approaches.
Our services are offered to patients within the catchment area of the Vancouver Coastal Health, with exceptions only for inpatients and Neuromodulation treatment. For the purpose of continuity of care, exceptional consideration may also be given to patients living outside of Vancouver Coast Health but who maintain a significant, ongoing clinical relationship with other physicians and programs at Providence Health Care.
Emphasis is placed on self-management and rehabilitation/activation within the context of specialized medical assessment and treatment. Our program philosophy is the belief that pain relief requires an individualized treatment approach for the many types of pain including physical, psychological, social, and spiritual pain.
Throughout the program patients are encouraged to learn self-management and take personal responsibility for their health through shared care discussion, goal setting and problem solving.
All patients are provided with information and education about the complex nature of persistent (chronic) pain and about how they can learn self management skills as either an outpatient or inpatient or both depending on the individual patient’s needs. Consultations and visits can include both individual and group sessions and will be individualized to the needs of each patient. This is done in orientation sessions, group and individual education and via written materials.
- Interdisciplinary diagnostic – assessments to assist in determining the causes and contributing factors of pain may be conducted by one or more health care professionals on the interdisciplinary team.
- Interdisciplinary therapeutic – procedures performed by, or techniques led by, the interdisciplinary team members. These may include group education and discussion sessions, physical reconditioning, learning ways to perform activities of daily living or workplace skills.
- Interventional diagnostic – a procedure done by a physician pain specialist in order to identify a disease or condition (i.e. discogram – an x-ray exam of a disc after injecting dye)
- Interventional therapeutic – a procedure done by a physician pain specialist in order to relieve painful symptoms (i.e. trigger point injections or facet joint blocks)
- Neuromodulation program – Neuromodulation involves the implantation and maintenance of spinal cord stimulators and medication pumps for the management of very specific types of treatment-resistant neuropathic and cardiac pain.
Complex pain patients are assessed by an interdisciplinary team of health care professionals on a case by case basis. Those who meet stringent medical, surgical and psychological criteria will be considered for an implantable neuromodulation device.
Inner City Youth
Providence Health Care's Inner City Youth Mental Health Program (ICYMHP) is a team of seven psychiatrists, two social workers, one occupational therapist and psychiatric nurse providing assertive outreach based treatment to transition aged youth (age 16-24) with mental illness.
ICYMHP is a collaborative initiative that targets Vancouver’s estimated 700 street youth. Recognizing the inherent challenges in reaching homeless youth, ICYMHP established strategic partnerships with shelters and housing sites in the downtown core. Along with managing and supporting the Youth Mental Health Housing Consortium, ICYMHP team members deliver clinical appointments and facilitate groups at 6 downtown sites. The philosophy of the program is based on the principles of attachment. Care is patient-centred and based on the attachment capabilities, needs and communication styles of each individual young person served.
Consultation Liaison Psychiatry
High quality and timely psychiatric consultations to patients admitted to St. Paul’s Hospital at the request of their attending or other consulting physicians are provided by the Consultation Liaison Psychiatry team.
Our team also consults to patients in the Emergency Room (ER Consult-Liaison Psychiatry) at the request of ER physicians or other specialists attending the patient (i.e. Internal Medicine, Surgery, ICU, and other services).
The Consultation Liaison service is also very active in teaching psychiatry students so patients should expect that training psychiatrists to be in attendance at most consultations.
There are a number of subspecialty outpatient clinics, including cardiac psychiatry, renal psychiatry, psycho-dermatology, cystic fibrosis clinic, HIV and assessments of Living Anonymous Kidney Donors.
In addition, the role of Consultation Liaison is vital in the hospital to advocate for mental health patients outside of Psychiatry and teach health care professionals about mental illness in order to reduce stigma. Our service is 'The Face of Psychiatry' to the rest of Providence Health Care.
Since its inception Urban Psychiatry has strived to assess, treat, and follow individuals with psychiatric illness in the Vancouver downtown community (West End, Downtown South, DTES) who would not otherwise have access to mental health care.
The primary goals are to triage potential ER patients away from SPH by attending to their psychiatric problems before they become a crisis as well as follow up with recently discharged patients to help prevent readmission.
Urban Psychiatry has addressed this primarily by collaborating with community partners to provide a broad range of community treatment programs. This collaboration involves SPH providing psychiatric clinical leadership and psychiatrists who work with social workers and support staff from the other agencies.
The two main areas Urban Psychiatry has focused upon are the youth and young adults in the Downtown South area of Vancouver and adults in the DTES area.
The DTES portion of Urban Psychiatry, the Complex Disorders Team (CDT), aspires to provide comprehensive care to individuals suffering from serious mental illness and addiction (SAMI) which is complicated by physical health issues (particularly HIV, HCV) as well as social problems such as poverty and inadequate housing. Presently CDT, headed by Dr. Bill MacEwan, works through collaborations with community partners such as VCHA's Primary Outreach Service (POS), Downtown Community Court, Vancouver Intensive Support Unit (VISU), Raincity, Atira, Community Builders and PHS housing programs.
Also CDT is extensively involved in research and the primary project Hotel study is a five year follow-up of 500 individuals residing in the DTES. This study is funded by CIHR with Dr. Bill Honer is the primary investigator and Dr. Bill MacEwan the clinical lead.
Both ICYMHT and CDT utilize joint psychiatric staffing with Providence Health Care to provide continuity of care for Urban Psychiatric patients who do get admitted to SPH.
St. Paul’s Hospital Goldcorp Addiction Medicine Fellowship
The St. Paul’s Hospital Goldcorp Addiction Medicine Fellowship is a partnership between the St. Paul’s Hospital Foundation, St. Paul’s Hospital, the Urban Health Research Initiative of the BC Centre for Excellence in HIV/AIDS and the University of British Columbia Division of AIDS.
The Fellowship program is a new multidisciplinary Addiction Medicine Fellowship that strives for excellence in clinical training, scholarship, research and advocacy and involves medical education to trainees from Psychiatry, Internal Medicine, Family Medicine and Nursing. It has been designed based on the accreditation criteria of the American Board of Addiction Medicine and includes specialty training in in-patient and outpatient Addiction Medicine as well as related concurrent disorders training. The program prepares Fellows to work clinically in the field of Addiction Medicine and take leadership roles in an academic setting and will help prepare Fellows to write examinations with either the American Board of Addiction Medicine (ABAM) and/or the International Society of Addiction Medicine (ISAM), and thus be eligible to apply for certification with The Canadian Society of Addiction Medicine (CSAM).
Program details follow:
- The program runs July 1st to June 30th annually. There may be some flexibility for residents concurrently enrolled in other programs.
- There are nine core required blocks of four weeks duration each.
- There are also 3 elective blocks to be decided on with the Program Director.
- Didactic experiences include academic half days, monthly journal clubs with staff, and conference attendance.
- There is a longitudinal component with a year-long half day back experience in the community tailored to the learning needs of the Fellow.
- There is very little in-hospital overnight call required during the year, but there are several rotations where call from home may be expected – never more frequently than 1 in 4 nights.
- The training rotations are as follows.
- The St. Paul’s Hospital Addiction Medicine Consultation Service
- Inpatient and Outpatient Chemical Dependency at Vancouver Detox
- Outpatient Chemical Dependency at Three Bridges Community Health Centre
- Women’s Recovery at BC Women’s Hospital and Health Centre
- Pain Management at Orion Health
- The Psychiatric Assessment and Stabilization Unit (PASU) / Consultation Liaison Service (CLS)
- St Paul’s Hospital’s ‘Inner City Youth Mental Health Program (ICYMHP)
- Longitudinal Outpatient Continuity of Care Experience
Our range of geriatric services include inpatient psychiatry, tertiary care, residential care, outpatient clinics, consultation liaison, and outreach. We consider patients, families and caregivers to be part of our team and invite their participation in care planning.
The interdisciplinary staff who work within these areas include family doctors, specialists including geriatric psychiatrists, and geriatricians, medical students, nurses, occupational therapists, physiotherapists, rehabilitation assistants, pharmacists, dieticians, pastoral care, and neuropsychologists.
Inpatient Geriatric Psychiatry
There are two geriatric units at Mount St. Joseph Hospital. “One South” is the 16 bed Geriatric Psychiatry Unit (GPU) for older adults with psychiatric illness such as depression, schizophrenia, and bipolar disorder or dementia with psychosocial and behavioural symptoms. “Four East” is a 22 bed Geriatric Medicine Reactivation Unit that provides sub-acute medical care to older adults. Four beds are designated as shared care between Geriatric Medicine and Geriatric Psychiatry providing care to patients with psychiatric illness and medical concerns.
Expected length of stay for our patients is between two to six weeks. During their stay, patients will be assessed by psychiatrists, family doctors, geriatricians, occupational therapists, physiotherapists, dieticians, pharmacists, social workers and nurses. A treatment plan including medications and non medication treatment such as behavioural approaches will be formulated prior to discharge. The goal of treatment is to assess, treat and stabilize patients before discharging them back home.
In addition to educational opportunities in the settings described above, St. Paul’s Hospital is pleased to offer the following elective opportunities for psychiatry residents:
Senior Resident Quality Improvement and Administration:
Residents will have an opportunity to participate on two Departmental and Mental Health Program Hospital Committees, the Quality Improvement and Performance Committee (QPIC) and the Morbidity & Mortality Steering Committee, and one Regional QI committee. The resident will have the opportunity to participate in the review and selection of cases to be presented at M&M Rounds. The resident will also have an opportunity to participate in the collection and monitoring of Quality Improvement indicators and present these to the appropriate committees and meetings (QPIC, Medical Staff Meetings). The resident will have some exposure to Regional Mental Health activities through participation in Health Authority Regional Committees.
Advanced Interviewing and Psychotherapy:
The Department of Psychiatry at St. Paul’s Hospital has for many years actively participated in the training of junior psychiatry residents within the Psychiatry Postgraduate Program at the University of British Columbia. Building upon the foundation of supportive therapeutic principles that residents are taught during their second and third postgraduate years of training, senior residents are eager to receive further teaching and supervision in specific psychotherapeutic modalities.
However, senior residents have enjoyed relatively few opportunities to return to St. Paul’s to enhance their training during their PGY 4 and 5 years. As a result of a review and redesign outpatient psychiatric services at St. Paul’s Hospital, senior residents now have an opportunity to gain expertise in advanced interviewing skills complemented by exposure to various psychotherapeutic treatment modalities (cognitive therapy, dialectical behavioural skills, motivational interviewing, mindfulness-based cognitive therapy, interpersonal therapy, brief dynamic psychotherapy, psychodynamic psychotherapy) under the primary supervision of psychiatrists and psychologists, with involvement of a large interdisciplinary group of professionals.
St. Paul’s’ Hospital (SPH) is a recognized world leader in providing care for persons living with HIV/AIDS. SPH is also the home of the BC Center for Excellence in HIV/AIDS, a primary leader in HIV research and advancements in care.
There are many people with HIV and associated co-morbid conditions being treated at SPH given its geographical location within Vancouver and its patient population. SPH provides mental health care to this population through the Emergency Department, inpatient wards, outpatient clinics and via the Consultation-Liaison (C-L) Service. The resident would be part of the C-L team but would be referred only HIV positive inpatients and would be expected to follow them as required by our service.
HIV medical care on the wards and in the John Ruedy Immunodeficiency Clinic (IDC) is provided by a team of Infectious Diseases Specialists, Internists and Family Practice Clinical Associates with special interest in HIV care. Through this clinic, a multi-disciplinary team comprised of social workers, psychologists, counselors and psychiatrists.
The rotation would ideally be 3 – 6 months in length to provide the greatest potential learning trajectory. It would be possible to tailor the rotation to an individual resident’s needs and schedule.
In addition to assessing and following outpatients referred for mental health assessments under the supervision of the IDC psychiatrists, the resident will spend a half day each week at the Dr. Peter Centre with Dr. Silvia Guillemi, Assistant Medical Director of the IDC. The Dr. Peter Centre provides residential and day health programs for persons living with HIV, unstable housing, and other complex health issues which may include addiction, cognitive impairment, or mental illness.
For information about the specific electives described above, please contact Peter Keyes, Administrative Assistant, Department of Psychiatry, St. Paul’s Hospital, 604-806-8320. More information about education at St. Paul’s Hospital is available here: http://mh.providencehealthcare.org/professionals/students-trainees
Richmond Hospital Department of Psychiatry Resident Teaching Program
Dr. Ashok Krishnamoorthy, Department Head
Dr. Kenneth Heng, Postgrad Site Director
Clinical Service Overview
Services within Richmond Hospital include an 18-bed inpatient unit, a 6-bed psychiatry emergency unit, an infant mental health clinic and an active emergency and consultation-liaison service. A unique group-focused outpatient program is also located within Richmond Hospital and provides a number of specialized groups for a range of mood, anxiety and posttraumatic disorders. The outpatient program also provides specialized assessments in the areas of the anxiety and mood disorders, geriatric psychiatry, women’s mental health and cross-cultural psychiatry.
Services located within the community are extensive and are housed close to Richmond Hospital in separate facilities. Community-based programs include Adult, Older Adult, an Infant, Child and Adolescent Community Mental Health Teams and various Addiction-related services. Also within the community is the Richmond Bridge House, a 10 bed short-stay multidisciplinary residential unit assisting patients in psychiatric crisis.
Core rotations are offered in inpatient, outpatient, child, geriatrics, community care, shared care, consultation-liason and addictions.
Elective rotations are offered in the following areas:
- Inpatient Psychiatry
- Outpatient Psychiatry
- Chronic Care
- Individual and/or Group Psychotherapy
- Infant, Child and Adolescent Psychiatry
- Early Childhood Mental Health and Developmental Child Psychiatry
- Community Child Psychiatry
- Child Therapy
- Geriatric Psychiatrys
Residents participate in variety of didactic teaching programs that include a monthly Grand Rounds, monthly postgrad site director rounds, a monthly case-based resident round (called Lunch and Learn Resident Rounds), a bimonthly psychotherapy journal club, quarterly evening Faculty Development rounds, an infant mental health journal club, and a geriatric seminar series. All rounds are accredited Section 1 Royal College of Physicians and Surgeons Group Learning Activities.
Additional teaching initiatives include an Annual Academic Clinical Day and a program-wide residents’ educational evening.
Richmond Hospital Inpatient Unit: An 18-bed short-stay unit located within Richmond Hospital offers multidisciplinary assessment and treatment for a wide-range of psychiatric illnesses. There are four attending psychiatrists, involved family physicians (including a primary responsibility for medical care), primary care nursing and a variety of specialized inpatient groups. The interdisciplinary teams also include a psychologist, pharmacist, social worker and rehabilitation therapists.
Richmond Hospital Psychiatry Emergency Unit (PEU): This is a 6-bed inpatient unit that is located near the Emergency Dept and is utilized for short-stay crisis admissions. There is also a busy Emergency Service and an active Consultation-liaison service based within Richmond Hospital.
Outpatient services and clinics: Richmond Hospital’s Outpatient program includes a 12 week group therapy program primarily for individuals with mood and anxiety disorders, and a variety of specialized group programs that include a Post-Sexual Trauma Group, Depression Group, Panic Disorder Group, Intensive Psychodynamic Group, Supportive Interpersonal Group, Obsessive-Compulsive Disorder Group, Assertiveness Group, and Changeways Groups (in English, Cantonese and Mandarin). The Outpatient program also operates specialized assessments in the areas of the anxiety and mood disorders, geriatric psychiatry, women’s mental health and cross-cultural psychiatry. .
Infant, Child and Adolescent Program: Services include an Early Childhood Mental Health program, a Child and Adolescent Community Mental Health Team, and consultation- liaison services to the Richmond school program for children with severe emotional and behavioural difficulties.
Geriatric Psychiatry Program: Services include outpatient assessments, an Older Adult Community-based Mental Health program, and geriatric psychiatry consultation-liaison services to Richmond Hospital and various nursing homes within Richmond.
Addiction Services: Teaching experiences include: (1) working with the DART (Drug and Alcohol Resource Team). This team responds to consultations within Richmond Hospital and is made up of an addictions internist, nurse, social worker, and support staff; (2) providing consultations to the Anne Vogel Clinic in Richmond. The Anne Vogel Clinic is primarily a methadone maintenance addictions clinic but also provides a limited degree of primary care, and (3) assessing individuals in healthy recovery at the Turning Point Recovery House.
Community Programs: There are three community mental health teams: an Adult Team, an Older Adult Team, and an Infant, Child and Adolescent Team as well as various community-based Addiction services. All programs are actively linked with local organizations and services such as CHIMO’s Crisis Line and Crisis and Suicide Intervention program. Mobile emergency services are also provided within the community via Mental Health Emergency Services and TRACC – Team Response to Adolescents and Children in Crisis. There is also a 10-bed multidisciplinary inpatient unit located in a residential setting (Bridge House) designed to assist patients in psychiatric crisis. Shared Care is provided within a Richmond-based family physician’s office.
BC Mental Health and Addiction Services at BC Children’s and Women’s Health Centre
Dr. Jana Davidson, Department Head
Dr. Ashley Miller, Postgrad Site Director
BC Mental Health & Addiction Services, an agency of the Provincial Health Services Authority, provides a diverse range of mental health services to people across BC. At BC Children’s and Women’s Health Centre, we provide specialized tertiary mental health treatment services for women, children, and families.
The outpatient specialty clinics provide comprehensive mental health assessments and short-term treatment of children, youth, and families.
Patients may present with problems such as disorders of mood, anxiety states, serious behavioural problems at home or at school, and other more general psychiatric difficulties. Ongoing treatment may be provided for families and/or they will be assisted in accessing appropriate community resources.
The following is a brief summary of the specialized clinics:
Teaching and Consultation Clinic
The Child Psychiatry Teaching and Consultation Clinic (TCC) is a teaching clinic for mental health trainees from many disciplines, and provides individual psychiatric assessments in a teaching environment. The TCC organizes and provides core and specialized training in child psychiatry specifically for psychiatry residents, and is also involved in training pediatric residents, psychology residents, medical students and social work students.
The Attention Deficit Hyperactivity Disorder (ADHD) Program provides outpatient services including: consultation, assessment, and treatment for children and youth with all types of ADHD. The program also provides leadership in family education, academic and clinical training, and promoting the awareness of ADHD issues in the community
Infant Psychiatry Clinic
The Infant Psychiatry Clinic’s mission is to respond to, and advocate for, the mental health needs of infants, young children (through age 5) and their families. Our goal is to help our patients to achieve their potential, to work with their strengths, and to improve their quality of life.
Mental Health Metabolic Clinic
The Metabolic Clinic provides care for children and youth with mental health disorders who are at high risk for metabolic side effects associated with taking certain types of psychiatric medication, or who have pre-existing metabolic conditions and have been diagnosed with a mental health disorder. The team includes experts in child psychiatry, pediatric endocrinology, dietary science, physiotherapy, nursing, and general pediatrics.
Mood and Anxiety Disorders Clinic
The Mood and Anxiety Disorders Clinic provides outpatient consultation, diagnosis & treatment recommendations for children and adolescents, ages 6 to 18 years, who have symptoms suggestive of a mood and/or anxiety disorder, including major depressive disorder, dysthymia, bipolar disorder, panic disorder, and generalized anxiety disorder.
The Neuropsychiatry Clinic provides diagnostic assessments to recommend and facilitate treatment for children and youth (before their 19th birthday at initial contact) with neurodevelopmental conditions who are also challenged by a combination of emotional, social, cognitive, and behavioural problems. The assessment and treatment also considers the patient’s interests, talents, and the quality of their lives.
Pediatric OCD Program
The OCD program provides outpatient assessment and treatment of children and adolescents with obsessive compulsive disorder. The clinic also provides consultation and teaching to psychiatry and psychology trainees, and hospital and community professionals, on the treatment of OCD in youth. The clinic is actively involved in conducting research to better understand the biological underpinnings of OCD, the effectiveness of the treatments provided in the clinic, as well as the psychosocial sequelae of OCD.
Provincial Youth Concurrent Disorders Program
The Provincial Youth Concurrent Disorders Program provides outpatient psychiatric consultation and treatment for youth (ages 12-24) and their families struggling with concurrent mental illness and substance use disorders. This program also provides leadership in academic and clinical training, promotes awareness of concurrent disorders and offers workshops and community based training.
Reproductive Mental Health
The BC Reproductive Mental Health Program helps women and their families dealing with emotional difficulties related to pregnancy, perinatal depression, infertility, pregnancy loss, premenstrual disorder, premenstrual dysphoric disorder, menopause and perimenopause.
Telehealth Outreach Psychiatric Services (TOPS)
TOPS provides child and adolescent psychiatry consultation, treatment recommendations, and followup for patients living in rural and remote communities. TOPS uses video teleconferencing technology so that patients do not need to travel to Vancouver to see their doctor. This is a service available in Prince Rupert, Masset, Queen Charlotte City, Kitimat, Terrace, Smithers, Hazelton, Houston, and the Nisga’a Nation. TOPS serves children up to the age of 19 who are patients of the mental health teams in these communities.
Urgent Assessment Clinic
The Urgent Assessment Clinic provides prompt psychiatric assessment and short-term treatment recommendations for children and youth (18 years of age and younger) who require urgent outpatient assessment, where local resources are unavailable or inadequate. The clinic is staffed by a multidisciplinary team including three psychiatrists, a clinical social worker, a nurse clinician and psychiatric residents.
Inpatient, Residential and Combined Services
The Adolescent Psychiatry Inpatient Unit is a 10-bed provincial program that provides assessment, stabilization and treatment to teenagers ages 12 to 18 years who experience serious psychiatric symptoms such as psychosis, mood disorders, suicidal behaviour, or anxiety states. Services include pre-admission transition planning, and consultation to community services. Using an inter-professional team model of care, in-patient services include assessment, diagnostic clarification, school evaluation, and treatment interventions including individual, group milieu and family therapy/support. The length of stay is generally 2-6 weeks, with a 6-month post discharge group to bridge the youth’s transition to community.
A family orientation to the unit is available at: http://www.youtube.com/watch?v=UiEg3-mnnXU
The Child Psychiatry Unit is a 10-bed intensive provincial program that provides a blended inpatient/day treatment model of mental health services to children under 12 with particularly challenging psychiatric disorders. Services include a school component; inter-professional assessment, diagnostic clarification and treatment; pre-admission and post-admission transition planning; and consultation to community services. The unit promotes trauma-informed care, attachment based parent/child relationship building and collaborative problem solving approaches with families and children.
Child and Adolescent Psychiatric Emergency (CAPE)
The Child and Adolescent Psychiatric Emergency Unit (CAPE) is a 6-bed provincial unit, that provides short-stay inpatient crisis/re-stabilization for children and youth (up to their 17th birthday) who are experiencing acute psychiatric problems. The inter-professional team works closely with BCCH emergency department, other mental health and emergency units across the province, and community-based services, to provide timely responses to care, discharge to community and/or transfer to longer stay mental health units.
Eating Disorders Program
The Provincial Specialized Eating Disorder Program at BC Children’s Hospital is a comprehensive, multidisciplinary, specialized program to assess and treat children and adolescents with eating disorders. The program emphasizes the involvement of parents and/or primary caregivers in the delivery of care. The program includes inpatient, outpatient, and day programs.
Our program fully integrates medical, psychiatric, psychosocial, and other aspects of care through a combination of intensive inpatient, day treatment, and outpatient services. We provide a complete range of services for children and adolescents struggling with these potentially life-threatening disorders.
A family orientation to the inpatient eating disorders unit is available at: http://www.youtube.com/watch?v=SRSdJJw2wms
Heartwood Centre for Women
The Heartwood Centre for Women, located at BC Women’s, is the new women’s provincial tertiary residential treatment program. It focuses on women with substance dependence, mental health concerns and primary health care needs.
Kelty Mental Health Resource Centre
The Kelty Mental Health Resource Centre is a provincial resource centre that provides mental health and substance use information, resources, and support to BC children, youth and their families. The Centre offers information and resources on a wide range of mental health and substance use issues affecting children and youth, as well as options for support and treatment in BC, assistance navigating the mental health system, and tips for self help, healthy living, and prevention. The Centre also provides resources and support for individuals of any age with an eating disorder or disordered eating concerns.
These services are provided to families across B.C. over the phone, in person, via email, and online. Visit the Kelty Mental Health Resource Centre website for additional information, resources, and contact details: http://keltymentalhealth.ca/
Note: The descriptions above are meant for general informational purposes. For referral information, please contact BC Children’s and Women’s Health Centre directly.
Dr. Anson Koo, Regional Division Leader
Dr. Faiza Hameer, Associate Program Director
Detailed information, including informational videos, about our UBC Psychiatry Residency Program is available at our website: www.fraserpsychiatry.com
The UBC Department of Psychiatry Residency Program has embraced a "Distributed Model" of postgraduate Psychiatry training and education which reflects the broad pan-provincial scope and educational mission of our Faculty of Medicine, which has grown in size from 120 students per year to 288 in less than 10 years to meet the rapidly growing health needs of the citizens of BC. As the UBC Faculty of Medicine has nurtured Undergraduate Education sites across Greater Vancouver and around the province, it was a natural evolution to move forward with the expansion of postgraduate training and the distribution of that training in the diverse communities of Greater Vancouver and the Province of BC in sites that have a record of excellence in clinical care and education. The UBC Department of Psychiatry has formalized several psychiatry residency "Distributed Tracks" which are based in different health authorities, but administered centrally with uniform standards, and with complete academic and social integration between tracks.
The UBC Fraser Health Greater Vancouver Psychiatry Residency Program (UBC-FHGV) is located in Greater Vancouver (the City of Vancouver and its Suburbs), a city and region which The Economist recently declared the "World's Most Liveable". Our program is based out of two main Regional Teaching Hospitals (Royal Columbian and Surrey Memorial Hospitals) and a number of other hospitals located throughout Greater Vancouver. Our teaching hospitals are easily accessible from anywhere in Greater Vancouver. The Royal Columbian Hospital is in New Westminster, 15 minutes from the City of Vancouver, and is located directly on the Skytrain Rapid Transit Line. Surrey Memorial Hospital is located in Surrey, 25 minutes from the City of Vancouver, and is also accessible by Skytrain. Our residents live throughout Greater Vancouver, including Downtown Vancouver, Richmond, Coquitlam, North Vancouver, Burnaby and others.
Our program has a record of excellence in resident education, with many psychiatrists who have won awards for teaching and education. Our clinical rotations are among the most highly rated by residents on a regular basis.
We offer highly individualized learning plans with extensive direct supervision and support from psychiatrists who value their role as mentors. Our academic program (i.e. Interviewing Course, Grand Rounds, Clinical Case Conference Rounds, STACER course, etc) is very well developed and has been noted as a highlight by many residents who have trained with us. All residents attend academic days on Thursdays in Vancouver. The Fraser Health Authority serves the largest (1.6 million) and fastest-growing population of all provincial health authorities.
Fraser Health has the highest concentration of children and young families in our province. Our hospitals and Psychiatry programs are growing to meet increasing needs, and we have hired over 50 skilled psychiatrists over the past two years to help meet the mental health needs of the citizens we serve. We offer an outstanding environment for clinical education and training with diverse populations which allow broad exposure to all areas of Psychiatry, and dedicated clinical faculty who are deeply committed to education and teaching.
For 2013, UBC-FHGV is accepting 6 positions for clinical training through CaRMS. Core rotations in the junior residency (PGY1-3) are based at Royal Columbian Hospital and Surrey Memorial Hospital. Selective and elective rotations in the senior residency (PGY4 and PGY5) are offered at a number of clinical settings in the Fraser Health Region and Greater Vancouver, based on residents' career interests and goals.
Dr. Wei-Yi Song, Associate Program Director
Victoria has a population of around 380,000 and is the main medical centre for all of Vancouver Island. This offers residents the full range of training options with the benefit of a smaller, more personalized program. The psychiatry program is currently the only complete Royal College postgraduate program on Vancouver Island. Residents can be assured of the time and attention they require to maximize their learning.
The residency program is based at the Royal Jubilee Hospital where the Psychiatric Emergency Service (Archie Courtnall Centre), Psychiatric Intensive Care Unit, Victoria Mental Health Centre, and all of the adult and geriatric psychiatry inpatient units are located. Residents will have more continuity of care of their patients when they can easily follow them from emergency to inpatient and then to outpatient programs. The inpatient units are located in the recently-opened Patient Care Centre (PCC). This is a state-of-the-art world-class facility that offers an ideal learning environment. There are many interview rooms, teaching spaces, and seminar rooms - most of which are equipped with high speed videoconferencing links. Supervisors are all based on the Royal Jubilee site which increases accessibility for teaching. Because the Postgraduate Psychiatry Program is relatively new, there is a lot of enthusiasm among the supervisors. For the residents, being based at one site for most rotations and seminars saves a lot of time.
The program still maintains close linkages with the other UBC Psychiatry Residents in the Lower Mainland (Vancouver, Richmond, and Fraser Valley) through the Thursday Academic Days for PGY2-5. These sessions are by videoconference, but once a month, the Victoria residents travel to Vancouver to join the seminars in person - often by float plane or helijet. Victoria based residents also have frequent opportunities to travel to Vancouver for other special academic and social events enjoyed by the entire UBC program.
Victoria offers some cutting-edge psychiatry programs. Supervisors on the Mood Disorders and Schizophrenia Services are internationally-renowned. The Collaborative Care program has been recognized as a leading program in Canada, as is the Tertiary Program. This program also includes several ACT (Assertive Community Treatment) teams servicing the downtown core. The Geriatric Psychiatry program offers a unique multi-service experience that is integrated with inpatient, outpatient, outreach, consultation-liaison, and nursing home consultation ensuring a continuity of learning experience. Excellent psychotherapy training is focused on 2 streams with supervision available for both cognitive behaviour therapy and psychoanalytic psychotherapy modalities.
Victoria offers an exceptional lifestyle with easy access to many recreational and cultural activities. Residents have access to facilities and events at the University of Victoria, which is only a few minutes away from the Royal Jubilee Hospital. Outdoor activities include world class cycling, hiking, and kayaking. People come from around the world to hike the West Coast Trail, or explore the world heritage site at Cape Scott. Vancouver Island also offers excellent opportunities to enhance cultural awareness of First Nations issues.
Dr Rachel Boulding, Associate Program Director
Prince George is a rural city of 81,000 inhabitants with the Northern Health authority covering a wider population of circa 300,000. Following a well-established Family Practice residency program Prince George began a Psychiatry residency program in 2008, PGY1-3.
Practicing psychiatry in Prince George is an exciting experience, which offers a busy clinical environment to home your clinical skills and clinical confidence. You will be supported by a dedicated site director and a team of 10 psychiatrists and two visiting psychiatrists. The program is actively recruiting psychiatrists aided by the attraction of the new University status of the hospital (University Hospital of Northern British Columbia) and the vision of the Health Authority.
You will have the unique opportunity to help shape the program and will be involved in shaping your own training experience. Opportunities for participation in rural outreach and native mental health initiatives occur throughout the residency years accommodated in Prince George (PGY1-3). Research opportunities are also positively encouraged within the framework of the Northern Health / University of Northern British Columbia mental health strategy.
With excellent outdoor activities on your doorstep (winter and summer), good restaurants, theater, orchestra, numerous music venues and a welcoming community, Prince George is a place in which you quickly feel at home.
For more information please contact Lisa Lakusta, our Postgraduate Programs Coordinator, at Lisa.Lakusta@northernhealth.ca or 250-565-2599 who will be able to e-mail you a guide to psychiatry and placements in Prince George. Other useful sites are www.unbc.ca and www.city.pg.bc.ca.