Facilities and Rotations

Western State Hospital, one of four state-operated or state-supported acute psychiatric facilities in Kentucky, is a 165-bed free-standing hospital with a median length of stay of six days for new admissions. Approximately 690 employees treat approximately 2,100 adults during the course of a year. While the pandemic initially affected the hospital, we have been able to maintain a COVID-free status among our patients, and a staff positivity rate of <.05% since late May/early June of 2020. Testing is readily available in Kentucky, and specifically in Hopkinsville. The hospital has adequate PPE, provides Fit-Testing to all employees in patient care, provides eye protection, and provides ample soap, hand-washing areas, and hand sanitizer (thank you to the amazing distilleries in the state!). We have a unit designated to treat COVID-positive psychiatric patients when the need arises, and an active in-house testing and contact-tracing protocol. At this time, interns are not providing face-to-face in-person care, but are assessing and treating patients through telehealth platforms.

 

While at Western State Hospital, doctoral interns gain firsthand experience in working with patients who struggle with severe and persistent mental illness, and in understanding the operations, purposes, and ever-changing role of a state psychiatric facility. Interns participate in initial evaluations, psychological assessments, individual and group therapy sessions, development of positive behavioral supports, recovery team meetings, program development and evaluation, staff and community education, and consultation with other mental health professionals. Specialty training opportunities include geriatrics, multiple medical needs, substance abuse interventions, neuropsychological screening and assessment, and civil and criminal forensic assessment.

 

Beginning in 2021, when the internship moved full-time to WSH, the internship developed a rotational model. Interns begin on the Admissions Unit for the first month, while being oriented to the facility and trained in policies, procedures, and use of the health record. Interns then maintain a percentage of service to Admissions for the entire internship.

 

After the first month of internship, interns rotate to treatment units in the hospital for 3-4 months, including the Comprehensive Support Program (which includes Multiple Needs), Acute, and Admissions. During the COVID-19 state of emergency, many training activities continue to be fully or intermittently via telehealth or virtual platforms. Additionally, the “state of the virus” in the community or hospital may require us to be flexible and adjust scheduling when needed.

 

WSH’s Admissions Unit is the entry point to the hospital, and initial evaluations and crisis assessment and intervention are a primary focus. On this unit, and during this rotation, interns will assist the treatment team in evaluating the needs and initial progress of newly admitted patients, deciding which patients need to stay beyond the initial 72-hour court-ordered hold, and determining which outpatients services or WSH treatment unit will best assist the patients they evaluate. Differential diagnosis, crisis counseling, and risk assessment are primary  foci, as well as working with an interdisciplinary team in a higher-pressure decision-making situation. Sample Schedule:

Admissions Rotation

 

 

WSH’s Acute Services program serves patients who will return to their own homes following hospitalization. Assessments for misdemeanor competence, ongoing assessment of patient goals and progress to goals, counseling/psychotherapy, family education, and general psychological testing are primary foci, as well as working with an interdisciplinary team in a short-term treatment setting. Sample schedule:

Acute Services Rotation

 

 

WSH’s Comprehensive Support Program serves patients who require placement following hospitalization. Behavioral supports, assessments for misdemeanor competence, civil competence assessments, general testing/service qualification evaluations, and support of the service team are foci, in addition to working with an interdisciplinary team in a setting with intermediate lengths of stay. When possible, group therapy is the most common treatment modality. At times, neuropsychological assessment is needed on this unit, or on the MultiNeeds service, with functional capacity and evaluation for major neurocognitive disorder being the most common needs. Depending on pandemic demands/situation, interns on this rotation may occasionally assist with services at Western State Nursing Facility or Glasgow State Nursing Facility; however, this cannot currently be guaranteed. Interns may gain significant experience in cross-systems crisis planning while on the CSP/MultiNeeds rotation. Sample schedule:

CSP Multineeds Intern Rotation

 

 

Order of rotation will be determined during orientation and the first month of internship, based on individual intern training needs. Each rotation has a clinician to provide direct support and in-the-moment supervision needs. Primary on-site supervisor: Susan Redmond-Vaught, Ph.D.