Inpatient Units and Cultural Competence and Diversity Program

The Department of Psychiatry has a total 75 acute psychiatric beds within four inpatient units. Specialized inpatient programs at San Francisco General Hospital provide the highest quality of care to individuals with severe mental illnesses. Our nationally recognized Ethnic/Minority Psychiatric Inpatient Programs were recognized by the San Francisco Department of Public Health. Each unit has developed a focus reflecting the cultural diversity of both San Francisco and the patients served by SFGH, including Asian, Latino, African American, and Lesbian/Gay/Bisexual/Transgender individuals. In addition to the Inpatient Units/ Cultural Competence and Diversity Program, the Forensic Focus Program provides a full range of inpatient psychiatric services to individuals in custody of the San Francisco Sheriff’s Department. Our services are provided in concert with the Jail Psychiatric Services and community-based case management programs.

Black Focus
Established in 1985, the Black Focus Team at SFGH is an inpatient psychiatric unit that emphasizes the factors affecting the African American mental health consumer. The goal of Black Focus is to deliver quality mental health services to people of African descent. The mission of the Black Focus Program is to gather knowledge about the unique origins, experiences and issues of African-Americans and to apply this knowledge to the area of mental health in order to develop and practice clinical skills that more accurately address African-American differences and needs.

Latino Focus
Established in 1983, the Latino Focus Team provides bilingual/bicultural care to the large Latino population of San Francisco. With a focus on Mexican and Central American dialects, 50% of the staff on the unit speaks Spanish. Latino issues covered include health care differences, HIV issues, process and effects of immigration, acculturation, psychiatric assessment, psychopharmacology, use of interpreters, post-traumatic stress disorders in political refugees, and substance abuse.

Asian Focus
Established in 1980, the Asian Focus Team offers specialized treatment to Asian/Pacific Island patients. The unit’s staff shares common linguistic and cultural backgrounds with the patients, speaking 14 Asian languages and dialects of Chinese including Cantonese, Mandarin, Toishanese, Tagalog, and Vietnamese, in addition to English. 

Earlier immigrants to San Francisco were primarily Chinese, Japanese and Filipino. Recently, the dramatic increase in population has been brought about by large increases in Korean, Indochinese and East Indian migration. Although Asians share important cultural similarities, the program takes into account the differences as well.  For example, Chinese, Japanese, Koreans, and Vietnamese may share the influences of ancient Chinese traditions, whereas Laotians and Cambodians are deeply influenced by the Indian Civilization and Theravada Buddhism. Filipino and Samoans are influenced by Polynesian/Melanesian cultures. Linguistically each group has at least one official language with several dialects. Asians, like other racial or ethnic groups, manifest behaviors that may be labeled as non-compliant or pathological. Consideration of history of immigration, level of education and socioeconomic status are included during treatment.

Women’s Focus
Women's Issues Consultation Team was established in 1983 to work with women needing psychiatric assessment and treatment during pregnancy, post-partum and menopause, as well as address parenting issues, past and present trauma such as physical and sexual abuse, rape and domestic violence. This team has developed innovative treatment approaches for women with major psychiatric disorders. It implemented the first inpatient psychiatric unit in the country treating psychotic pregnant women, and later developed specialized treatment approaches with women who self-mutilate, those doing sex trade work, and women with severe drug and alcohol dependence.  The unit also advocates for gynecological care for female patients by housing a gynecological clinic on the psychiatric unit.

Lesbian/Gay/Bisexual/Transgender and HIV/AIDS Focus
Lesbian/Gay/Bisexual/Transgender (L/G/B/T) and HIV/AIDS Focus Team was established in 1992 to provide care for this large population in San Francisco with a focus on stigma, domestic violence, and spirituality. The treatment team endeavors to provide a safe and welcoming environment with sensitive and appropriate treatment for lesbians and gay men with acute psychiatric needs. The team strives to be one that is sensitive to issues of gender and sexual orientation, and recognizes the ethnic and cultural diversity within the LGBT community. The HIV/AIDS Focus Team provides multidisciplinary care to HIV/AIDS patients with a particular focus on consultation/liaison with the world-renowned SFGH AIDS medical services and the Sojourn multi-faith chaplaincy at SFGH.

Forensic Unit
Established in1985, the Forensic Focus Team provides a full range of inpatient psychiatric services to individuals in custody of the San Francisco Sheriff’s Department. Services are in concert with the Jail Psychiatric Services and community based case management programs. 

The Forensic Unit staff is committed to providing humane and high-quality medical, psychiatric, educational, and social services to our patients who are in legal custody. Acute psychiatric emergency evaluation and short term treatment is provided as part of the San Francisco City and County jail system. All incarcerated individuals in the San Francisco County Jail system, who have been evaluated by the Jail Psychiatric Service and meet criteria for a psychiatric hold, are referred here. These patients are generally acute and require further evaluation and stabilization. Our fundamental goal is to provide the same level of psychiatric care to patients involved in the criminal justice system as that available to patients in the community. The Forensics Unit Program uses short-term, crisis-oriented approach involving families and other support systems. The Unit's treatment team consists of a full compliment of disciplines, including a social worker, psychiatric nursing staff, attending psychiatrist, resident psychiatrist, occupational therapist and a clinical nurse specialist (CNS).  The CNS also functions as the unit's nurse practitioner and assists with physical exams and medical consultation. Patient participation in the therapeutic milieu is encouraged in a variety of focused group activities together with intensive one-to-one client contact with staff.  Patient education, including teaching related to psychiatric, legal and health issues, is emphasized.  

Traditionally, these patients have been underserved and suffer a double stigmatization, mental illness and crimination of the mentally ill.  As a staff, we strive to provide care in a compassionate and non-judgmental fashion. In addition, we attempt to be advocates for our patients to the general public, the San Francisco Courts and other health care providers. This advocacy includes finding appropriate alternatives to incarceration as well as building and maintaining linkages with mental health, substance abuse, and medical care delivery systems in the community.

 

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