Analysis and Proposed Plan for Forensic Mental Health Teaching Services at Western State Hospital 10/23/2017 Table of Contents EXECUTIVE SUMMARY ……………. .........................................................................................................6 CHAPTER 1: Assessment of Needs and Goals of the Behavioral Health Agency Related to Forensic Psychiatry and Psychology Training, Education, and Workforce Development ...................................... 15 I. Introduction ................................................................................................................................ 15 II. Background Information ............................................................................................................. 15 III. Methodology: Identification and Review of the Needs and Goals of the BHA ........................... 17 IV. Needs Assessment: Core Themes ............................................................................................... 18 CHAPTER 2: Review of Available Data Sources Relevant to a Proposal for High-Quality Forensic Psychiatry and Psychology Training Programs .......................................................................................... 22 Chapter Summary ............................................................................................................................... 22 I. Introduction ................................................................................................................................ 24 II. Forensic Training in General Psychiatry Residency Programs .................................................... 24 A. Literature review ......................................................................................................................... 25 B. Query of general residency program directors ........................................................................... 30 C. Review of the University of Washington General Psychiatry Residency Program’s existing training structure and previous WSH educational opportunities ................................................... 32 Section Summary ............................................................................................................................. 33 III. Forensic Psychiatry Fellowship Training ..................................................................................... 34 A. Literature review ......................................................................................................................... 35 B. Semi-structured interview of representatives from forensic psychiatry fellowship programs .. 38 C. Secondary survey of forensic psychiatry fellowship program directors ..................................... 40 Section Summary ............................................................................................................................. 42 IV. Forensic Psychology Fellowship Training .................................................................................... 43 A. Literature review ......................................................................................................................... 44 B. Semi-structured interviews of representatives from forensic psychology postdoctoral fellowship programs ........................................................................................................................ 49 C. Focus group ................................................................................................................................. 50 D. Survey of program directors ....................................................................................................... 52 Section Summary. ............................................................................................................................ 53 V. Site Visits ..................................................................................................................................... 53 A. University of California Davis School of Medicine (Forensic Psychiatry Fellowship Program Director: Charles L. Scott, M.D.) ...................................................................................................... 54 B. Oregon Health and Science University (Forensic Psychiatry Fellowship Director: Landy Sparr, M.D.) ................................................................................................................................................ 56 2 C. The University of Massachusetts School of Medicine (Forensic Psychiatry Fellowship Director: Paul Noroian, M.D.; Forensic Psychology Postdoctoral Program Director: Ira Packer, Ph.D.) ........ 58 D. California Department of State Hospitals–Patton State Hospital (Forensic Psychology Postdoctoral Program Director: David Glassmire, Ph.D.; Forensic Psychiatry Interim Fellowship Director: Michael Cummings, M.D.) ................................................................................................ 60 Section Summary. ............................................................................................................................ 62 VI. Existing Forensic Training Programs at Western State Hospital and Child Study and Treatment Center .................................................................................................................................................. 63 A. WSH Psychology Doctoral Internship ......................................................................................... 63 B. CSTC Postdoctoral Fellowship ..................................................................................................... 64 C. WSH Forensic Psychology Postdoctoral Fellowship .................................................................... 64 D. Staff and Patient Perspectives of Training Program Features .................................................... 65 Section Summary ............................................................................................................................ 70 VII. Programmatic Themes and Challenges ....................................................................................... 70 A. Benefits of academic-state partnership on quality of hospital services ..................................... 71 B. State-academic collaboration as means to increase hospital staff recruitment and retention . 71 C. Advancing research and scholarship at state hospitals .............................................................. 72 D. Balancing education with service demands ................................................................................ 72 E. Joint education for forensic psychology and psychiatry trainees ............................................... 74 F. Role for diversified training experience ...................................................................................... 74 G. Retention of trainees in state public sector workforce .............................................................. 74 H. Interpersonal relationships for successful collaboration ............................................................ 75 I. Consistent funding of the training program(s) ........................................................................... 75 J. Logistical challenges for trainees at state hospitals ................................................................... 76 Section Summary. ............................................................................................................................ 77 Conclusion ........................................................................................................................................... 77 CHAPTER 3: Proposed Model for UW-WSH Forensic Psychiatry and Psychology Training Programs .... 78 Chapter Summary ............................................................................................................................... 78 I. Introduction ................................................................................................................................ 81 II. Environment of Care at WSH ..................................................................................................... 81 A. Hospital accreditation/certification ............................................................................................ 82 B. Patient, employee, and trainee safety ........................................................................................ 82 C. Resources .................................................................................................................................... 83 D. Funding ....................................................................................................................................... 83 3 E. Program Leadership and Personnel ............................................................................................ 83 F. Balancing Service and Education ................................................................................................ 84 III. Educational Infrastructure .......................................................................................................... 85 A. Continuing Education .................................................................................................................. 86 B. Forensic Evaluator Certification .................................................................................................. 87 C. Quality Improvement .................................................................................................................