Bronx Psychiatric Center [BPC], the primary forensic fellowship training site, is located approximately 1 mile from the Albert Einstein College of Medicine academic center.

Clinical
Rotations

BPC, a facility of the New York State Office of Mental Health, is a 550-bed psychiatric hospital with associated on-site outpatient clinic, day treatment, vocational rehabilitation, residential, and substance abuse/methadone maintenance programs.

In addition to its comprehensive range of inpatient and ambulatory clinical services, BPC offers the latest in psycho pharmacologic research, cutting-edge community interventions, and training programs for psychiatric residents, medical students, and other mental health disciplines (e.g. clinical psychology). The facility also serves as an integral part of the continuum of care and monitoring for forensic patients who have been transferred from secure facilities, including prisons and jails (e.g. Rikers Island Correctional Facility) and forensic psychiatric units within the system (e.g. Mid-Hudson Psychiatric Center)

Forensic residents are required to spend 2 full days a week at BPC during the training year, or a full-time equivalent of 4.5 months.

BPC is home base for both in-hospital activities and state-wide consultation. The in-hospital work includes performing consultations on general and forensic patients in the areas of dangerousness, violence, right to refuse treatment, civil commitment and retention, guardianship sexual offender assessment, and medico-legal review of insanity acquitees.

Residents also participate in the weekly Hospital Forensic committee at which forensic patients are reviewed for privileging and discharge. Consultations at BPC provide many opportunities for court testimony.

Treatment opportunities include participation in a program for sexual offenders. State-wide work is focused on forensic evaluations of insanity acquitees (both immediately past -acquittal and at critical treatment junctures), risk assessments at state hospitals and correctional settings, and program evaluation research generated through an affiliation with the New York State Office of Mental Health Bureau of Forensic Services.

Residents also participate in the evaluation of non-state cases referred to the program by other agencies, e.g. the John Jay Legal Services of Pace University School of Law. These referrals involve issues including health care law, domestic violence, asylum, and child custody.

Residents are generally actively involved in 2-3 consultations at any given time.

Forensic faculty includes the Program Director, a part-time attending with Added Qualifications in Forensic Psychiatry whose schedule mirrors that of the forensic residents, and who has overall responsibility for resident education and training on-site and throughout the program. Faculty also includes a second full-time attending physician with Forensic fellowship training.

Residents receive supervision weekly by both the program director (3-4) hours) and the consulting attendings (1-2 hours). The faculty also supervises the state-wide and non-state cases that are referred to the program for evaluation and consultation.

Additional Rotation Sites

Westchester Jewish Community Services

Westchester Jewish Community Services(WJCS) is a non-sectarian, not-for-profit agency, serving children, adolescents and adults of all ages.

The Court Assessment Program is a division of WJCS that provides evaluative services for Family, Domestic Violence and Supreme Courts in Westchester and surrounding areas. The program provides mental health evaluations for parties (adults and children) involved in ongoing custody-visitation proceedings or children and adolescents involved in delinquency proceedings.

Acting in the best interest of the child(ren), evaluations objectively inform the court with regard to the parental capacity of adult parties involved in said proceedings, and the emotional, educational and social adjustment of children who are either subject children in custody proceedings or respondents in delinquency cases. Information provided is intended to assist judges in making dispositions in these cases and expert testimony is provided if deemed necessary by the court.

Forensic residents who participate in this rotation will be trained in conducting forensic mental health evaluations within the context of custody-visitation and delinquency/PINS cases. The required availability for residents is one day a week for a six month period.

Initially, residents observe evaluations and then conduct evaluations and complete a report with the direction of the program director and site supervisor. Training with regard to the provision of expert testimony is also provided. Reports will be presented to the court and residents will have opportunities for expert testimony. Residents attend a series of lectures regarding issues relevant to the forensic assessments they are performing.

Faculty consists of a forensic psychologist with extensive experience in both performing family court cases and training fellows to do same as well as a Board-certified psychiatrist with Added Qualifications in Forensic Psychiatry. The faculty provides both direct service and ongoing supervision of residents. Residents have at least one hour of individual supervision with a forensic faculty member each week.

Bronx Mental Health Court

The Bronx Mental Health CourtThe Bronx Mental Health Court is an alternative to incarceration program for evaluation, placement and monitoring of defendants who are referred for possible diversion from jail and prison into residential and outpatient mental health settings. The Bronx TASC office is located in the vicinity of the Bronx Criminal Court and Bronx Supreme Court buildings.

The patients evaluated for diversion comprise an ethnically, racially, socioeconomically, culturally and diagnostically diverse population of defendants. They have usually been charged with a felony and are facing prison time if not diverted into treatment under court supervision. Each defendant referred is evaluated comprehensively for history of mental illness, current clinical condition and risk assessment. The majority of cases in which pleas are taken and diversion approved are transferred to a specially-created mental health court for monitoring.

The forensic residents are required to spend one full day a week for 6 months on this service. Each week the resident evaluates at least one new referral and participates in the diversion team’s review of oncoming cases of evaluation and/or monitoring. Working with the diversion service provides the residents with active exposure to this increasingly important area of forensic psychiatry.

In addition to further experience in evaluating patient/defendants in a forensic setting, diagnosing mentally ill offenders, and conducting risk assessments, the residents are exposed to the dynamics of court-based diversion including: what kinds of defendants are referred, how the mental health system views them, as well as what challenges there are in running a diversion service. Opportunities to participate in ongoing multi-system collaboration and research are available.

Forensic faculty consists of two psychiatrists with Added Qualifications in Forensic Psychiatry and one who is forensically trained and eligible for Added Qualifications. The faculty provides both direct service and ongoing supervision of the residents. Residents have at least 1 hour of individual supervision each week with a forensic faculty member.

Bronx Forensic Court Service

The Bronx Forensic Court Service is located in the Bronx Criminal Court Building, which is about 4 miles from the primary site of fellowship training.

The Court Clinic provides forensic psychiatric consultations to the Bronx Criminal Court. The patients evaluated comprise a mixed population of criminal defendants ethnically, racially socioeconomically culturally, and diagnostically. They face criminal charges ranging from minor misdemeanors to major felonies, and are at various phases in the legal process, from pre-arraignment to post-acquittal or post-sentencing.

The Forensic residents are required to spend one full day a week for 6 months at the Court clinic. Each resident is expected to evaluate 1 or 2 new cases per week under supervision. The Clinic provides the residents with educational experiences related to the Clinic’s 4 main areas of activity; conducting court-ordered competency to stand trial evaluations; providing pre-sentence evaluations; performing treatment evaluations; and testifying in court as an expert witness.

Forensic faculty consists of one psychiatrist with added qualifications in Forensic Psychiatry and one forensic psychologist. The faculty provides both direct service and ongoing supervision of the residents. Residents have at least 1 hour of individual supervision each week with a forensic faculty member.

Sing Sing Correctional Facility/Prison-based Mental Health Service

Sing Sing Correctional Facility, located 20 miles from the primary site of training, is a Maximum Security Prison with an Outpatient Satellite Unit consisting of a 21 bed crisis Unit (with six mental observation cells) an Intermediate Care Unit (a Day Hospital model) with 62 beds and a general population census of about 300 active patients, most on psychotropic medication. Their diagnoses include Axis I and Axis II disorders, ranging from active psychosis to persistent character pathology.

Outpatient responsibilities include initial psychiatric evaluations as well as continuing medication cases. The fellow functions as part of the mental health team and attends morning rounds and participates in evaluating admissions to the residential crisis unit. Four (4) hours on site are devoted to these duties. Caseloads average 12 -15 patients.

Clinical training also occurs on the Intermediate Care Unit (ICU) . Participation in Community Meetings and DOCS programming as interest of the fellow dictates is available. Six (6) hours will be devoted to these duties.

Forensic residents are required to spend two full days a week for six months at Sing Sing Correctional facility located in Ossining, N.Y.

Opportunities to visit related facilities include CNYPC at Marcy, Downstate Correctional Facility for initial processing of inmates and Bedford Hills Correctional Facility, New York States’ only maximum facility for women. Depending on interest, up to four (4) hours a week may be allocated to Downstate or Bedford Hills.

Clinical on site supervision is provided by the Clinical Director and a Board Certified Psychiatrist with added qualifications who coordinates the program with the Program Director. Other teachers include social worker, psychology and administration staff with significant experience in correctional psychiatry.

North Central Bronx Hospital Assisted Outpatient Treatment [AOT] Program

The North Central Bronx Hospital [NCBH] Assisted Outpatient Treatment[AOT] Program is located at North Central Bronx Hospital, which is about 5 miles from the primary site of fellowship training.

The AOT program a grant-funded program created by Kendra’s Law which provides for court-ordered assisted outpatient treatment for certain people with mental illness who may need supervision to survive safely in the community. The AOT program staff includes psychiatrists, psychologists, social workers, peer specialists, and an attorney trained and well versed in civil forensic issues. They answer inquiries, accept referrals, conduct investigations, help create treatment plans, and initiate or assist in petitioning the Court for mandated mental health services for eligible individuals throughout the Bronx.

The program has an active quality assurance/performance improvement program and participates in ongoing research concerning the process and outcomes resulting from Court-mandated outpatient psychiatric treatment. The AOT staff has ongoing communications with agencies and providers throughout the Bronx to facilitate the full and appropriate implementation of Kendra’s Law.

The forensic residents are required to spend one full day a week for 4 months at the NCB AOT program site. Each resident is expected to evaluate 1 or 2 new cases per week under supervision. The program provides the residents with educational experiences related to its main areas of activity:

The training and supervision will occur on an individual basis, in formal and informal case discussions, and by attendance and participation in bi-weekly AOT staff team meetings and other AOT clinical conferences and educational and training activities.

The Director of the AOT Program is a Board-certified psychiatrist with special qualifications in forensic psychiatry, who is also an attorney at law; he provides overall supervision of the program and has overall responsibility for forensic resident education and training at the site.

Other AOT staff involved in resident training and supervision include a second Board-certified psychiatrist with extensive forensic psychiatry experience, an on-site attorney specializing in AOT matters, and psychiatric social workers, psychologists, and peer specialists. Residents have 1 hour of individual supervision each week with forensic faculty in addition to their clinical activities.

NYC DOHMH/Correctional Health Services Mental Health Services

The mission of the N.Y.C. DOHMH/Correctional Health Services (CHS), Mental Health Services is to provide quality mental health care to the inmate population of the New York City Department of Correction. Mental health services are provided for the detection, diagnosis and treatment of mental illness. Currently, mental health services are provided at 11 sites, 9 of these programs are provided on Rikers Island.

Forensic psychiatry fellows from Albert Einstein College of Medicine of Yeshiva University who participate in this program will be given an orientation to our services, policies and procedures, and general Correctional Health Services/Department of Correction rules and regulations, as well as be trained in conducting mental health assessments and continuing mental health treatment planning within the context of the correctional setting for female offenders.

During their training at the Rose M. Singer Center, the woman's building on Rikers Island, the fellows will initially observe and then conduct evaluations. In addition, they will actively participate in further medication management, risk assessment, treatment team meetings, crisis intervention, and write progress notes under the supervision of the PHS Director of Mental Health Services or designee. The fellows will receive one hour of supervision from the PHS Director of Mental Health Services or designee.