The same symptom can require a different assessment, workflow, team, and plan depending on acuity and setting. Explore Metropolitan General's clinical environments, then use the setting guide to see how common presentations move across the system.
Department directory
Choose a setting to explore
6 connected settings
Clinical setting
College Mental Health
Developmentally responsive psychiatric care that considers academic functioning, identity, family relationships, confidentiality, access, and the transition to independent healthcare.
Care model
Specialty outpatient
Typical pace
Scheduled visits with urgent access pathways
Population
Late adolescents and emerging adults enrolled in college or university programs
Common presentations
Depression, anxiety, and adjustment concerns
ADHD and stimulant-related questions
Sleep disruption, substance use, and emerging serious mental illness
PMHNP priorities
Clarify developmental and functional history
Balance autonomy, privacy, and appropriate supports
Coordinate campus, primary care, and community resources
Care team
PMHNPs, psychiatrists, therapists, primary care clinicians, student support services, and community partners
Presentation-to-setting guide
Clinical content does not live in only one department
These are common points of care—not rigid rules. Acuity, medical stability, safety, patient preference, access, and available supports determine the appropriate setting.
Clinical focusCommon settingsWhat changes
Psychiatric assessment, MSE, risk, and medical differential
All settings
The depth, pace, available collateral, and immediate purpose change by setting.
Depression, anxiety, obsessive-compulsive, and trauma-related care
CollegeGeneral AdultIntegrated Care
Emergency or inpatient care may be needed when acuity or safety changes.
Bipolar disorder and psychosis
General AdultEmergency/PESInpatient
Patients may move between all three during an episode and recovery.
Sleep-wake concerns
CollegeGeneral AdultIntegrated CareSpecialty
Assessment may include medical, medication, behavioral, circadian, and sleep-specialty pathways.
Substance use and addictive disorders
All settings
Screening, harm reduction, withdrawal risk, recovery supports, and medication treatment span the system.
Personality disorders, self-harm, and therapeutic boundaries
General AdultEmergency/PESInpatient
Consistent team communication and longitudinal risk formulation are especially important.
Feeding, eating, nutritional, and metabolic concerns
College Mental HealthIntegrated CareSpecialtyEmergency/PESInpatient
Level-of-care decisions depend heavily on medical status as well as psychiatric presentation.
Psychotherapy, lifestyle, and integrative approaches
CollegeGeneral AdultIntegrated CareSpecialty
These approaches complement—not replace—indicated medical, pharmacologic, and safety interventions.
Movement through care
Prevention & early identification→Outpatient treatment→Urgent assessment & stabilization→Coordinated recovery
Consultation, referral, collateral, and care coordination cross every setting. Patients may move in either direction as needs, risks, resources, and treatment response change.