Forensic Psychiatry Fellowship

Clinical Rotations

Sample Rotation Schedule 

  Monday Tuesday Wednesday Thursday Friday
Fellow #1  Bronx Psychiatric Center Correctional Health Services Court Clinic Didactics Bronx Psychiatric Center EAC/TASC (Mental Health Court Diversion)
Fellow #2  Bronx Psychiatric Center Westchester Jewish Community Services Didactics Bronx Psychiatric Center Rikers Island Correctional Facility
Fellow #3  Bronx Psychiatric Center Sing Sing Correctional Facility Didactics Bronx Psychiatric Center Sing Sing Correctional Facility
 

Bronx Psychiatric Center (BPC)

BPC, the primary forensic fellowship training site, is located approximately one mile from the Albert Einstein College of Medicine academic center.

A facility of the New York State Office of Mental Health, the BPC is a 156-bed psychiatric hospital that offers:

  • Associated offsite outpatient clinic
  • Vocational rehabilitation
  • Substance abuse/methadone maintenance programs

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 (eg Rikers Island Correctional Facility), as well as forensic psychiatric units within the system (e.g. Mid-Hudson Psychiatric Center).

In addition to its comprehensive range of inpatient and ambulatory clinical services, BPC offers:

  • The latest in psychopharmacologic research
  • Cutting-edge community interventions
  • Training programs for psychiatric residents, medical students and other mental health disciplines (e.g. clinical psychology)

BPC is home base for both in-hospital activities and state-wide consultation. The in-hospital work includes consultations on general and forensic patients in the areas of:

  • Dangerousness
  • Violence
  • Right to refuse treatment
  • Civil commitment and retention
  • Outpatient commitment
  • Guardianship
  • Sex offender assessment
  • Medical/legal review of insanity acquitters

Our fellows also participate in the Hospital Forensic Committee, at which they will help to review patients for privileges and discharge.

Statewide work at BPC is focused on:

  • Forensic evaluations of insanity acquitters (both immediately post-acquittal and at critical treatment junctures)
  • Risk assessments at state hospitals and correctional settings
  • Forensic program and policy development for New York State Office of Mental Health.

Fellows additionally participate in the evaluation of non-state cases referred to the program by other agencies, such as Correctional Health Services Court Clinic, Brooklyn Defenders, Veteran Advocacy Project,, as well as private law firms.

These referrals include:

  • Fitness to stand trial
  • Health care law
  • Domestic violence
  • Immigration proceedings
  • Guardianship
  • Veteran status hearings
  • Child custody evaluations

Consultations at BPC provide many opportunities for court testimony.

Faculty at BPC includes the Program Director and the Associate Program Director, who share overall responsibility for education and training onsite and throughout the program and directly train fellows for a total of three to four hours a week. The faculty also supervises the statewide and non-state cases that are referred to the program for evaluation and consultation.

Fellows are generally actively involved in three to five consultations at any given time, including both Bronx PC and Statewide work. Forensic fellows are required to spend two full days a week at BPC during the training year, or a full-time equivalent of four and a half months.

 

Westchester Jewish Community Services

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

Fellows are assigned to The Court Assessment Program, a WJCS division that provides evaluations for the Westchester County Family, Domestic Violence and Supreme Courts. The program offers mental health evaluations for both adults and children who are involved in ongoing custody-visitation proceedings, as well as for children and adolescents engaged in delinquency proceedings. The Court Assessment Program’s goal is always to act in the best interests of the child or children involved. Evaluations objectively inform the court with regard to the parental capacity of adult parties involved—as well as the emotional, educational and social adjustment of children who are either subjects in custody proceedings or respondents in delinquency cases. Evaluations are intended to assist judges in making dispositions in these cases.

Fellows are trained in conducting forensic mental health evaluations within the context of custody-visitation and delinquency/PINS (Person in Need of Supervision) cases. A child under the age of 18 who does not attend school or behaves in a way that is dangerous or out of control — or often disobeys his or her parents, guardians or other authorities — may be found to be a Person in Need of Supervision or "PINS". All PINS proceedings are heard in Family Court.

After an initial period of observing evaluations, fellows will conduct evaluations and complete a report under the guidance of the site supervisor. Reports will be presented to the court and fellows will have opportunities for expert testimony, if deemed necessary by the court. Fellows 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. The faculty provides both direct service and ongoing supervision. In addition, fellows have at least one hour of individual supervision with a forensic faculty member each week. Fellows are required to spend one day a week for a four-month period dedicated to this service.

 

Bronx Mental Health Court/Bronx TASC Mental Health Program

The Bronx TASC Mental Health Court Program seeks to craft a meaningful response to the problems posed by defendants in the criminal justice system suffering from mental illness. It offers an alternative to incarceration by evaluating, placing and monitoring defendants who are referred for possible diversion from jail and prison into residential and outpatient mental health settings. Working with the diversion service provides the fellows with active exposure to this increasingly important area of forensic psychiatry.

The Bronx TASC office is located in the vicinity of the Bronx Criminal Court and Bronx Supreme Court buildings.

This group of patients comprise an ethnically, racially, socioeconomically, culturally and diagnostically diverse population. 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 and current clinical condition, and risk assessment is conducted. The majority of cases in which pleas are taken and diversion approved are transferred to a specially created mental health court for monitoring.

Each week the fellow evaluates at least one new referral and participates in the diversion team’s review of oncoming cases requiring evaluation and/or monitoring.

In addition to further experience in evaluating patient/defendants in a forensic setting, diagnosing mentally ill offenders, and conducting risk assessments, fellows are exposed to the dynamics of court-based diversion. These include:

  • Knowledge of what kinds of defendants are referred, how the mental health system views them
  • Understanding the particular challenges of running a diversion service
  • Opportunities to participate in ongoing multisystem collaboration and research in diversion

Forensic faculty at Bronx TASC consists of the Fellowship Program Director, Associate Program Director and a forensic psychologist, who provide direct and ongoing supervision. Fellows receive at least one hour of individual supervision each week with a forensic faculty member. The forensic fellows are required to spend one full day a week for four months on this service.

 

Sing Sing Correctional Facility/Prison-based Mental Health Service

Sing Sing Correctional Facility is located in Ossining, NY, some 20 miles from Montefiore. Sing Sing is a Maximum Security Prison with:

  • A general population census of about 300 active patients, most on psychotropic medication. Their diagnoses range from active psychosis to persistent character pathology
  • An Outpatient Satellite Unit with a 21-bed crisis Unit (with six mental observation cells)
  • An Intermediate Care Unit (a Day Hospital) model with 74 beds

The Clinical Director of the mental health unit and Unit Chief coordinate the program and provide clinical onsite guidance and supervision. Other teachers include social workers, psychologists, and administration staff with significant experience in correctional psychiatry.

The fellow functions as part of the mental health team and attends morning rounds and participates in evaluating admissions to the residential unit. Caseloads average 12- 15 patients. Outpatient responsibilities include initial psychiatric evaluations, as well as continuing medication cases. Four hours on site are devoted to these duties, and caseloads average six to seven patients. Clinical training also occurs on the Intermediate Care Unit (ICU), CORP reentry unit, Residential Crisis Treatment Program (RCTP) and Special Housing Unit (SHU). Participation in Community Meetings and DOCS programming is also available, should the fellow be interested. Six hours will be devoted to these duties.

Our fellows spend two full days a week for four months at Sing Sing.

Depending on individual interest, fellows also have opportunities to visit and spend time at related facilities, including:

  • The Central New York Psychiatric Center (CNYPC) in Marcy, NY
  • Bedford Hills Correctional Facility, New York States’ only maximum facility for women.
 

NYC DOHMH/Correctional Health Service Mental Health Services

The mission of the Correctional Health Services division of the NYC Health and Hospitals Corporation is to provide quality mental health care to individuals in the custody of the New York City Department of Correction. Mental health services provided include the identification, diagnosis and treatment of mental illness. NYC Department of Corrections houses both sentenced and detainee adult/adolescent males and females at eight sites, seven of which are on Rikers Island.

In addition to mental health staff (e.g. psychiatrists and other mental health professionals, nurse practitioners, and physician assistants, discharge planners, and activity therapists), the facility is run by a full complement of medical staff including but not limited to physicians, physician assistants, nurses, substance abuse counselors and dentists. At any given time mental health services are provided to approximately one quarter (25%) of all inmates on Rikers Island.

Our forensic psychiatry fellows are given:

  • Training in conducting mental health assessments and continuing mental health treatment within the context of the correctional setting
  • An orientation to all services, policies and procedures
  • An orientation to Department of Corrections rules and regulations
  • Exposure to clinical administrative and treatment decision making within a correctional setting

Our fellows spend one full day a week for four months at Rikers Island.

Correctional Health Services Forensic Psychiatric Evaluation Court Clinics (FPECC)

The four Court Clinics in the respective county/borough courthouses (Bronx, Brooklyn/Staten Island, Manhattan, and Queens,) - a forensic-evaluative rather than treatment division within the larger Correctional Health Services - are responsible for conducting competency to proceed evaluations under Criminal Procedure Law Article 730 (CPL 730) and pre-sentencing evaluations under Criminal Procedure Law Article 390 (CPL 390) for defendants with cases in the Criminal and Supreme Courts in New York City, the majority of whom are detained in the NYC jails. CPL 730 requires that two qualified examiners (board-eligible psychiatrists and/or licensed psychologists) conduct each evaluation and prepare written reports for the Court in a timely manner. Defendants, whether in custody or at liberty, are either produced in person to the relevant clinic location or, as and when deemed advisable due to COVID-19 precautions, seen remotely by videoconference. Court testimony is occasionally required at judicial hearings with respect to CPL 730 evaluations.

Fellows conduct these court-ordered psychiatric evaluations of adult criminal defendants related to competence to stand trial or pre-sentencing investigations in both Manhattan and the Bronx and prepare the required written reports. Both direct and indirect supervision is provided by the Manhattan FPECC Director as well as experienced colleagues during the court clinic rotation.

Our fellows spend one full day a week for four months on the FPECC rotation.

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