Consult-Liaison Psychiatry

Focus

The Consult-Liaison Psychiatry Service is a collaborative and multidisciplinary team that includes attending psychiatrists, attending psychologists, psychiatry second- and fourth-year residents, third-year medical students, and psychology doctoral interns. We also incorporate a triage nurse certified in addictions and mental health, a licensed clinical social worker, and a nurse practitioner.

We offer psychiatric and psychological consultation to the medically ill patients at Parkland Memorial Hospital and UT Southwestern University Hospitals, as well as providing education, emotional support, and assistance with treatment and discharge planning to the primary care medical teams caring for these patients. The Consult-Liaison Psychiatry team works to ensure positive outcomes for both patients and medical teams.  

Leadership

Celia Jenkins, M.D., is Medical Director of the Consult-Liaison Psychiatry Service and the Psychosomatic Medicine Fellowship Training Program. Dr. Jenkins is board certified in psychosomatic medicine and has served for several years on USMLE question-writing committees. She played an integral role in forming the Colleges learning communities at UT Southwestern Medical School and currently serves as a faculty mentor in Seldin College.

Dr. Jenkins instigated the implementation of the Clinical Institute Withdrawal Assessment (CIWA) at Parkland, and wrote a modified version of the protocol specifically tailored to the unique demands of the Parkland environment. The CIWA protocol has become the gold standard in determining appropriate medication dosing, shortening length of patient admission and maximizing positive health outcomes for patients experiencing alcohol withdrawal symptoms.

Dr. Jenkins has also served as a consultant on the development and piloting of a delirium protocol utilizing the CAM-ICU (Confusion Assessment Method) at Parkland, which will allow primary teams to more accurately assess and treat delirium in surgical patients.

Involvement in Education and Training

The Consult-Liaison Psychiatry Service offers an ACGME-accredited Psychosomatic Fellowship, which combines educational and teaching opportunities with inpatient consultation and ambulatory patient care activities. Fellows are active in:

  • Teaching and supervising residents and medical students
  • Conducting didactics and teaching rounds
  • Attending departmental and university lectures and conferences
  • Providing training and support to inpatient primary care and ancillary care teams
  • Addressing complex inpatient consultation and treatment needs.

The Fellowship Program has been accredited since 2007.

The Consult-Liaison Service features a weekly conference with a guest speaker every Monday. Although the conference is primarily targeted to those currently rotating on the Consult-Liaison Service, meetings are open to other interested faculty, staff, and students. Residents also have the opportunity to present case conferences with the consulting faculty of their choice, allowing for group discussion of treatment protocols and ethical implications in complex cases.

We offer a weekly Journal Club to assist residents in selecting, interpreting, and evaluating current research articles, as well as daily educational and staffing rounds with the attending faculty. Medical students attend regular teaching rounds and are evaluated on their presentation skills. Psychology interns attend weekly didactics and receive regular supervision and consultation from attending faculty.

The Consult-Liaison Service has also created the Psychiatry Student Interest Group, overseen by faculty leader Adam Brenner, M.D. Since 1981, PSIG has organized events and volunteer opportunities for students at UT Southwestern interested in psychiatry as a topic and career. It aims to increase awareness of the subject, introduce students to faculty, and provide an environment for exploration and discussion of the psychiatry field beyond the classroom. Under the direction of president Dinara Yangirova with co-vice presidents Michael Lee and Michael Zhao, the PSIG has presented medical students, interns, residents, faculty, and staff with informative and innovative lectures on a variety of topics.

Involvement in Research

Several members of the Consult-Liaison Psychiatry team have been or are currently involved in on-going research, both within and outside of the Department of Psychiatry.

Kimberly Roaten, Ph.D., will be working with the Burn Units at Parkland to study long-term psychosocial outcomes for burn patients, particularly examining psychiatric and psychological co-morbidities in burn patients, reintegration into family, social and work life post-burn injury, and psychological impact of burn injury on body image.

Eliot deGravelles, M.D., serves as primary investigator on a CTN study examining the relationship of smoking cessation to outpatient treatment success for cocaine and methamphetamine use.

Involvement in Patient Care

Students and residents rotating on the Consult-Liaison Service gain exposure to a diverse patient population, reflecting a variety of ethnic, socioeconomic, and cultural backgrounds. This is especially true at Parkland, where its status as a county hospital results in a complex and multifaceted patient population. Parkland’s position as an internationally renowned center for trauma and burn services also provides students and residents with varied and challenging treatment and consultation opportunities.

Providers on the Consult-Liaison team receive multiple opportunities to enhance their clinical, social, and teambuilding skills as they serve a patient population that ranges from indigent to affluent, speaks a variety of languages, may present with extremely complicated medical and social histories, and may present myriad challenges that affect the ability to comply with treatment or make effective medical decisions.

Providers may address issues of altered mental status, including delirium or psychosis, suicidal ideation, co-morbid substance abuse, or ante and postpartum depression, among others. They may also be called upon to offer invaluable assistance to treatment teams and families facing questions about patient capacity to understand, consent to, or decline recommended treatment strategies.