Division of Acute and Emergency Services

Zuckerberg San Francisco General Hospital & Trauma Center
Division of Acute Emergency Services
1001 Potrero Avenue, Suite 7M8
Box 0852
San Francisco, CA 94110
Phone: (628) 206-8426
Fax: (628) 206-8942

Division Director: Mark Leary, MD
Division Administrator: Jon Dean Green, MBA, MPH
Inpatient Psychiatry Medical Director: Emily Lee, MD, MS
Psychiatric Emergency Services Medical Director: Emily Lee, MD, MS
Jail Mental Health Chief: Loren Roth, MD

The Division of Acute and Emergency Services at Zuckerberg San Francisco General Hospital and Trauma Center includes the following programs:

Psychiatric Emergency Services (PES)

Psychiatric Emergency Services at Zuckerberg San Francisco General is the primary provider of adult emergency mental health care in the City and County of San Francisco.  The service sees approximately 8,000 patients per year, of whom approximately 20% are voluntary walk-in patients. PES provides crisis stabilization, complete medical and psychiatric assessment and evaluation services, and initial treatment, if appropriate. The staff, which includes physicians, nurses, and social workers, works closely with a number of community agencies to develop short and long-term treatment plans.

Inpatient units

The Department of Psychiatry has a total of 44 acute psychiatric beds in two inpatient units. Specialized inpatient programs at Zuckerberg San Francisco General provide the highest quality of care to individuals with severe mental illnesses.

In addition to the inpatient units, 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.

Consultation/Liaison Nursing Service

Program Coordinator: Antionette Griffin, RN, MS
Director, Psychiatric Nursing: Kathy Ballou, RN, MS
Consultation/liaison services: 8 a.m.-5 p.m., Monday-Friday; Pager: (628) 206-8402.

The ZSFG Psychiatric Nursing Consultation Service focuses on the patients’ emotional, developmental, spiritual, cognitive, and behavioral response to illness, injuries, and hospitalization in non-psychiatric clinics units throughout Zuckerberg San Francisco General, including the intensive care unit and skilled nursing facilities on the ZSFG campus.

The service provides consultation, collaboration, and education to non-behavioral health nurses and health care providers to help them deliver optimum biopsychosocial patient care. The service will also provide clinical supervision for clinical trainees as requested.

Consultation/Liaison Service

Co-Directors: David Elkin, MD, and Lee Rawitscher, MD

The Consultation/Liaison Service provides timely, competent, and culturally sensitive mental health consultation to the medical staff of Zuckerberg San Francisco General to enhance the care of patients seen in the general health setting and foster the clinical skills of the staff. Psychiatrists deliver services designed to meet the needs of patients and their health care providers in a manner that is culturally, linguistically, and economically sensitive to the patient.

The scope of care provided by the Consultation/Liaison Service includes:

  • Consultant-consultee review
  • Direct patient assessment
  • Evaluation of care provider behavior
  • Analysis of patient-significant other interaction
  • Intervention with multidisciplinary care providers and patients

The Consultation/Liaison Service also provides:

  • Diagnostic evaluation
  • Treatment planning
  • Provision of psychiatric interventions including psychiatric counseling and drug treatment
  • Consultation on legal aspects of care
  • Review and recommendations related to the patient-provider relationship
  • Intervention with significant others
  • Recommendation and referral for mental health aftercare

Electroconvulsive Therapy (ECT) Service

The Electroconvulsive Therapy (ECT) Service provides timely, competent, and appropriate administration of electroconvulsive therapy to adult patients seen at Zuckerberg San Francisco General Hospital and within the San Francisco Health Network. The ECT Service also provides consultation to mental health and primary care providers regarding the clinical utility and medical safety of ECT administration for the treatment of a range of mental health issues such as refractory depression, bipolar disorder, and psychosis. Referrals are accepted from physicians. Patients may also self-refer, but they need to be connected to an outpatient psychiatrist for treatment to be initiated. Providers or patients requesting consultation can contact the ECT voicemail at (628) 206-2930.

Forensic Focus Program

Established in 1985, the Forensic Focus Program 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 Focus Program 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 Forensic Focus 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 criminalization 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.

For more information

To find out more, contact the Department of Psychiatry at Zuckerberg San Francisco General at (628) 206-8426.