The range of clinical activities in Consultation-Liaison Psychiatry at the University of Maryland is extensive and diverse. There are three busy inpatient consultation services at the University of Maryland Medical Center itself, in addition to the inpatient service at the Baltimore VAMC next door. These inpatient services provide consultation to a remarkable array of medical and surgical services, including the R. Adams Cowley Shock Trauma Center, large and busy programs in heart, lung, and liver transplantation, and the Greenebaum Cancer Center, as well as a full array of general medical and surgical floors and intensive care units. This range of services is only expected to grow with demand and the growing emphasis on integrated, interdisciplinary care.
Outpatient activities are correspondingly diverse. Faculty and trainees provide services within two HIV care clinics, the diabetes center, the VA dementia clinic, and the Neurology department's movement disorders clinic, as well as to multiple organ and stem cell transplantation programs, and the outpatient service of the Greenebaum Cancer Center. The Medical Crisis Counseling Center provides outpatient psychotherapeutic services to people coping with life-changing illnesses. An additional, unique program of the C-L Division provides consultation within the Maryland Workforce and Technology Center, which provides vocational and prevocational rehabilitation services to clients with a wide variety of mental and physical conditions. With new programs under development in several areas, the division's outpatient clinical diversity can only be expected to grow.
Inpatient Consultation Service
The three consultation-liaison services of the University of Maryland Medical Center serve all adult inpatient medical and surgical areas, from the Trauma Receiving Unit of the Shock Trauma Center to the Medical Infectious Disease services, the Cancer Center, and Cardiothoracic Surgery. Each team has a primary focus: trauma, internal medicine, or oncology, but all provide service throughout the medical center. Our consultants encounter a remarkable range of patients and clinical conditions: not only does the medical center receive referrals from the other ten hospitals of the University of Maryland Medical System and serve as a tertiary care center for much of Maryland, but Shock Trauma is a Level I trauma center receiving cases from a multi-state area. Of course, such a variety of state-of-the-art medical and surgical services, provides a commensurate range of opportunities for collaboration with other providers. Through such collaborations, the Consultation-Liaison Division continues to develop new service areas and liaison relationships.
Psychiatry Consultation Services: Shock Trauma Center
The Consultation-Liaison Psychiatry Department has been in a close and long-standing collaboration with the R Adams Cowley Shock Trauma Center, an internationally renowned free-standing trauma hospital at the University of Maryland Medical Center.
In a fast-paced trauma-care setting, we provide psychiatric consultations and treatment recommendations to the Shock Trauma surgical teams. Together with medical students, residents, fellows, and attending physicians we learn and we teach while addressing the unique challenges facing Trauma care patients who have psychiatric disorders. The opportunities for cutting-edge research at this interface between psychiatry and trauma surgery are rich and exciting.
The Psychiatry consultation relationship with the Shock Trauma Center is one of tremendous growth opportunities for patient care expertise, research, and teaching.
The Consultation-Liaision Division provides consultative services for the Greenebaum Cancer Center to assist patients both on the inpatient oncology services as well as for outpatient consultations. We provide psychiatric evaluations which address the psychiatric, social, and behavioral aspects of cancer. We work with providers and patients to address many of the challenges associated with adjusting to illness, facing cancer and treatment, along with recovery after active treatment ends.
Visit the Greenebaum Cancer Center services page to learn more.
Blood and Marrow Transplant Service
We provide specific transplantation evaluations for the Blood and Bone Marrow Transplant Service. We work as an integral part of the Blood and Marrow Transplant (BMT) unit and provide consultative services for both autologous and allogeneic stem cell transplant patients. We work in close coordination with the transplant service to optimize psychiatric and behavioral factors affecting successful transplantation.
Visit the BMT service page to learn more.
The Department of Consultation-Liaison Psychiatry works closely with the Division of Transplant Surgery to help patients in the Liver, Kidney, Heart, and Lung transplant programs. We provide prompt, effective, and compassionate psychiatric evaluation for transplantation candidates. The Transplantation Team incorporates our report into an evaluation of the patient's risk of transplant-associated morbidity. We strive to improve patient's opportunities for successful transplantation and for attainment of the best quality of life post-transplantation.
We also work with the Transplant team to provide in-hospital consultations to transplant patients who are experiencing confusion, depression, and other transplant-associated psychiatric disorders. The need for psychiatric input into all phases of transplantation evaluation and treatment will grow in response to the increasing technical advancements and increasing demands for services in Transplant medicine.
Visit the Division of Transplant Surgery to learn more.
HIV Mental Health and Substance Abuse Service
The Workforce & Technology Center, a training campus of the State of Maryland Division of Rehabilitation Services, provides a unique setting for the practice of consultation-liaison psychiatry. The facility, which provides both prevocational (career assessment, work readiness and academic training, services to the visually impaired, etc.) and vocational skills training, originally developed to serve the needs of people with physical disabilities, but in recent years has shifted toward an emphasis on serving those with psychiatric and behavioral disabilities. Consultation-Liaison psychiatrists there assess clients' appropriateness for services and service needs, coordinate with case managers, instructors, physiatrists, field counselors, and community clinicians. Our goals are to maximize clients' chances of success and to minimize the chance that the rehabilitative process will disrupt their psychiatric stability. This practice focus requires our providers to develop expertise in a wide range of conditions, particularly developmental disorders, and aspects of coping with illness that are unusual in hospital and clinic-based settings.
Division of Transplant Surgery
For nearly 2 decades, mental health and substance abuse services have been integrated, and co-located (on-site) within the adult HIV Treatment Programs at the University of Maryland Medical Center. The mental health team uses a multi-disciplinary staff (psychiatrists and licensed therapists) to provide evidenced based, culturally sensitive, comprehensive mental health services including psychiatric assessment, psychiatric medication management, individual and group psychotherapy and crisis counseling that is coordinated with case managers. Non-intensive outpatient substance abuse services are also provided. These services use a multi-disciplinary staff (psychiatrists and licensed substance abuse counselors) to provide flexible non-intensive outpatient substance abuse services including ccomprehensive substance abuse evaluations, individual and group substance abuse counseling, suboxone maintenance and referral, case coordination, and aftercare planning.
Workforce & Technology Center
The consultation-liaison division provides consultative services that are integrated and co-located in the UMMC Movement Disorders Clinic affiliated with the University of Maryland School of Medicine's Department of Neurology. We provide culturally sensitive, evidence based mental health treatment for a wide range of patients with movement disorders including Parkinson's and Huntington's Diseases.
Women's Mental Health
We recognize that pregnancy can be an exciting but stressful time in a woman's life, and that some illnesses (like depression) may worsen around the time of pregnancy and delivery, while others may appear for the first time (bipolar disorder, postpartum psychosis). Medical disorders, like epilepsy, cancer and autoimmune disorders, can also complicate pregnancy, as can substance use disorders, intimate partner violence and other accidents and injuries. We in Consultation Liaison psychiatry work closely with our colleagues in Obstetrics and Gynecology, Medicine and Emergency Medicine to optimize mental health for pregnant women, as well as women suffering from infertility and pregnancy loss. We provide perinatal psychiatry education to medical students, residents, fellows, and academic and community clinicians from multiple disciplines. Members of the Division of Consultation Liaison Psychiatry also work with state and national initiatives to increase awareness of maternal mental health issues and intimate partner violence.
Baltimore Veterans Affairs Medical Center (VAMC) Mental Health Consult Service
The Baltimore Veterans Affairs Medical Center (VAMC) Mental Health Consultation Service provides inpatient mental health consultation to the Baltimore VA Medical Center Medical, Surgical services and 120 bed Extended Care Unit. Consultation is provided in the care of a wide range of mental health conditions ranging from depression, chronic severe mental illness, dementia, delirium, Post-Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), as well as substance abuse. In addition to clinical care for the nation's Veterans, the service is also a major teaching site for University of Maryland Medical School medical students, residents, and fellows.
In addition to the inpatient consult services, the mental health consultation service participates the running of one of Maryland's most comprehensive Alzheimer's Disease, Dementia and Memory Disorders Consultation Clinic along with the Geriatric Research and Education center (GRECC), Geriatric Pharmacy, and Neuropsychology Services. The clinic provides both comprehensive assessment for our nation's veterans with memory problems but is also a teaching site for the University of Maryland Schools of medicine, Pharmacy, Social Work and Nursing.