Forensic Psychiatry Fellowship

Clinical Rotations and Rotation Sites

Sample Rotation Schedule 

  Monday Tuesday Wednesday Thursday Friday
Fellow #1  Bronx Psychiatric Center EAC/TASC (Mental Health Court Diversion) Didactics Bronx Psychiatric Center Bronx Psychiatric Center
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 1 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 (e.g. 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)

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.

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 acquittees

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

Consultations at BPC provide many opportunities for court testimony.

Statewide work at BPC is focused on:

  • Forensic evaluations of insanity acquittees (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 participate in the evaluation of non-state cases referred to the program by other agencies, such as Correctional Health Services Court Clinic, Brooklyn Defenders, CUNY Law School and the John Jay Legal Services of The Elisabeth Haub School of Law at Pace University, as well as private law firms.

These referrals involve include fitness to stand trial, health care law, domestic violence, immigration proceedings, guardianship, veteran status hearings and child custody evaluations.

These referrals include:

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

Fellows are generally actively involved in 3-4 consultations at any given time, including both Bronx PC and Statewide work.

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.

 

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. Fellows are required to spend one day a week for a four month period dedicated to this service.

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. 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.

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. Expert testimony is provided if deemed necessary by the court.

 

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 residents 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, 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 fellows are required to spend one full day a week for four 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 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, here 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 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.

 

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 62 beds

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

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.

Clinical training also occurs on the Intermediate Care Unit (ICU), CORP reentry unit, Residential Crisis Unit (RCU) and Special Housing Unit (SHU). Participation in Community Meetings and DOCS programming is also available, should the fellow be interested.

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 hours on site are devoted to these duties. Caseloads average 6-7 patients.

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

Fellows also have opportunities to visit related facilities, including:

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

Depending on your individual interest, you may spend time at Downstate or Bedford Hills.

 

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 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 eleven sites, nine of which are on Rikers Island. Rikers Island houses both sentenced and detainee adult /adolescent males and females.

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

Our Forensic psychiatry fellows who participate in this program will be 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 general Correctional Health rules and regulations
  • Exposure to clinical administrative decision making within a correctional setting

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

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