Forensic Psychiatry Fellowship

The fellowship program uses clinical, didactic, and scholarly experiences to educate trainees about three major topic areas:

• The use of psychiatric expertise to aid in the resolution of legal issues;
• The treatment of patients in forensic treatment settings, including maximum-security hospitals, correctional institutions, and community programs; and
• The legal regulation of psychiatric practice.

The goal of the program is not to transform psychiatrists into legal experts, but rather to develop the knowledge and skills necessary to facilitate effective communication between psychiatric and legal audiences.

Each year, fellows and faculty members in the Yale Law & Psychiatry Division complete over 100 forensic evaluations in various areas of criminal and civil law, including:

• Criminal responsibility
• Pre-sentence reports
• Custody
• Termination of parental rights
• Civil commitment
• Independent medical evaluations of disability
• Immigration and asylum evaluations
• Fitness for duty
• Forced medication
• Medical malpractice
• Psychic harm
• Risk assessment and management

All fellows are assigned to the Law and Psychiatry rotation on a part-time basis for 12 months. Over the course of the year, each fellow typically completes 10-15 forensic evaluations, most of which require reports and/or testimony.

New Haven Office of Court Evaluations

The New Haven Office of Court Evaluations (NHOCE) has responsibility for performing all competence to stand trial evaluations in the south-central part of Connecticut, amounting to approximately 200 evaluations per year. All fellows are assigned to this rotation on a part-time basis for 12 months. Fellows perform evaluations individually and as part of a forensic team consisting of a physician, psychologist, and social worker. Testimony is routinely required; fellows can expect to testify about competency to stand trial evaluations between 10 and 20 times over the course of the year.

VA Connecticut Health Care System

The VA Connecticut Healthcare System (VACHS) in West Haven is a 200-bed tertiary care hospital affiliated with the Yale School of Medicine. VACHS offers a full range of inpatient and outpatient psychiatric services, and in recent years has developed a number of innovative treatment programs for justice-involved veterans. Two fellows each spend two days per week attached to the VA Connecticut. There they learn how to undertake:

• Evaluations for court diversion of defendants presenting to the Veterans Justice Outreach program from state and federal courts;
• Evaluations of veterans with mental health needs who are being released to the community from prison;
• Evaluations of cases referred to the forensic psychiatric consult service based at the VA hospital in West Haven, Connecticut; and
• Behavioral risk management consultation to the VA hospital.

Whiting Forensic Hospital

Whiting Forensic Hospital consists of maximum-security and enhanced-security treatment units in Middletown, Connecticut. It is the state’s only forensic psychiatric hospital. Patients are sent to Whiting from:

• Other psychiatric hospitals if they are too dangerous to be managed;
• Department of Correction facilities if their treatment needs exceed the capacity of prison mental health services;
• Criminal courts after an insanity acquittal; and
• Criminal courts for restoration to competence.

Each fellow provides year-long individual psychotherapy to two patients at Whiting and is assigned an on-site psychotherapy supervisor.

Yale Law School

Fellows spend one-half day attending classes, serving as a psychiatric consultants, and/or evaluating clients in one or more Yale or Quinnipiac Law School clinics.

• Veterans Legal Services: In this clinic, established in 2010, students represent Connecticut veterans in litigation before administrative agencies and courts regarding VA benefits, discharge upgrade, immigration, and pardon matters. Forensic fellows serve as psychiatric consultants to the law students and faculty supervisors, or they may evaluate the clients regarding psychiatric disabilities.
• Immigration and Refugee Assistance Project (IRAP): IRAP organizes law students and lawyers to develop and enforce a set of legal and human rights for refugees and displaced persons. Forensic psychiatry fellows service as consultants to the law students and faculty supervisors, sometimes evaluating clients regarding trauma and psychiatric illness.
• Criminal Justice Clinic: The Criminal Justice Clinic defends indigent clients accused of misdemeanor and felony offenses in New Haven. The clinic also handles a wide variety of sentencing cases, including federal clemency petitions. Forensic psychiatry fellows serve as consultants to the law students and faculty supervisor in the clinic.
• Arthur Liman Seminar: This class explores the theory and practical application of public interest law. Topics vary each semester and may include punishment, fees and fines, prisoners’ rights, healthcare, and others. Forensic psychiatry fellows serve as mental health consultants, facilitating discussion amongst the students and sometimes presenting on topics related to psychiatry.
• Quinnipiac Prisoners’ Rights Clinic: The Quinnipiac Law School prisoners’ rights clinic represents inmates in jail, state prisons, federal correctional facilities, and immigration detention facilities who are challenging their conditions of confinement. Fellows serve as consultants to the law students and faculty supervisor about mental healthcare in correctional settings.

Quinnipiac Law School

In addition to Yale Law School clinics, fellows attend classes and serve as psychiatric consultants in Quinnipiac Law School's Civil Justice Clinic, which focuses on sentencing policy, juvenile justice, prison conditions, prisoner reentry issues, professional ethics, and the problems of access to justice. The clinic is supervised by Prof. Sarah Russell, who also leads the Connecticut Juvenile Sentencing Project and the Prisoner Reentry Project.

Attorneys' Offices

Each fellow is assigned as a psychiatric consultant in a legal office for one-half day per week over the course of the year. Fellows help attorneys think through psychiatric aspects of their cases, review other experts’ reports, and observe trials. The placements include:

State Attorney's Office – New Haven Judicial District
Patrick Griffin, JD, State’s Attorney
The New Haven State’s Attorney’s office is located in the New Haven courthouse, approximately 1 mile from Connecticut Mental Health Center. Attorney Dearington is the primary supervisor, but fellows may also work with the other 28 attorneys who staff the office. Fellows assigned to this placement typically consult in cases involving the insanity defense, competency to stand trial, dangerousness, or pre-sentencing mitigation.

State Attorney's Office – Ansonia/Milford Judicial District
Kevin Lawlor, JD, State’s Attorney
The Milford State’s Attorney’s office is located in the Ansonia/Milford Superior Court building, approximately 10 miles from Connecticut Mental Health Center. Fellows work with a group of 8 attorneys, including the supervisor, Kevin Lawlor. Consultation cases typically involve the insanity defense, competency to stand trial, dangerousness, or pre-sentencing mitigation.

Federal Public Defender's Office – New Haven
Kelly Barrett, JD, Assistant Federal Public Defender
The Federal Public Defender's Office is located approximately 1 mile from Connecticut Mental Health Center. The experience is similar to the state’s attorney placements, but fellows at this site will also learn the unique aspects of federal courts, including their sentencing guidelines. Attorney Barrett is the primary site supervisor, though fellows also work with other attorneys in the office.

Superior Court – Juvenile Matters at New Haven
Vincent Duva, JD, Supervising Juvenile Prosecutor
The New Haven Superior Court for Juvenile Matters is located approximately 1 mile from Connecticut Mental Health Center. The child-track fellow is assigned to this placement, serving as a psychiatric consultant for three prosecuting attorneys on issues relating to families with special needs, neglect, pre-adjudication issues, competency, dangerousness, and other delinquency situations. The primary faculty member is Cathleen Edwards, Supervising Juvenile Prosecutor.

State Attorney's Office – Fairfield Judicial District
Joseph Corradino, JD, State's Attorney
The Fairfield State’s Attorney’s office is located in the Bridgeport Superior Court building, approximately 20 miles from Connecticut Mental Health Center. Fellows work with a group of attorneys, consulting on cases involving the insanity defense, competency to stand trial, dangerousness, or pre-sentencing mitigation.

The fellowship includes a robust didactic curriculum, offering approximately 8 hours per week of formal didactic education. Seminars are spaced throughout the week and are held at Connecticut Mental Health Center and Connecticut Valley Hospital. The courses include:

Law and Psychiatry Case Conference (Fridays, 8:30-10 am, all year)

• In this seminar, the entire Law and Psychiatry faculty gathers together with the fellows to discuss a forensic evaluation. Each week, a fellow or faculty presents a case that is in progress, gathering feedback from the group.

Court Clinic Case Conference (Tuesdays, 3-4 pm, all year)

• Every Tuesday, a fellow participates in team competence to stand trial evaluations together with a psychologist and social worker. In the case conference, fellows present the cases seen by the team and discuss their findings.

Landmark Cases Seminar (Mondays, 4:30-6 pm, 32 weeks from August to May)

• This course is co-taught by a judge and forensic psychiatrist. Each week, fellows read 2-4 landmark decisions related to law and psychiatry, discussing the salient aspects for forensic psychiatry practice.

Foundations of Forensic Psychiatric Practice (Fridays, 1-2:30 pm, all year)

• In this course, fellows learn about the theoretical foundations of current forensic practice and evolving areas of research and scholarship in the field. Content areas include criminal law, civil law, report writing and testimony, and many others.

Forensic Patients and Systems of Care (Thursdays, 11 am – 12:30 pm, July to March)

• This course focuses on topics related to the treatment forensic psychiatric patients, such as the organization of mental health systems, management of insanity acquittees, psychotherapy in forensic treatment settings, community forensics, correctional psychiatry, and public policy. Guest lecturers are invited to teach about areas in which they are expert.

Fostering Justice (alternate Wednesdays, 4-5:30 pm, September to May)

• This course explores the intersection of social justice and forensic psychiatry. Fellows and faculty discuss the role of race, gender, class, sexual orientation, ability, and other important topics in the criminal justice system and forensic psychiatric practice. Other topics include bias in forensic evaluations, advocacy as a forensic psychiatrist, and creating diversity, equity, and inclusion in the field of forensic psychiatry.

PGY-2 Course: Legal Regulation of Psychiatric Practice and Forensic Psychiatry (Tuesdays, 10 am to 12 pm, March to June)

• This course focuses on teaching PGY-2 psychiatry residents the basics of law and psychiatry, including the legal regulation of psychiatric practice and beginner-level forensic psychiatry. Fellows attend the class and help residents read and comprehend legal cases.

Journal Club (every other Wednesday, 4-5:30 pm, October to May)

• In this class, fellows read recent legal decisions related to psychiatric practice and forensic psychiatry. Discussions are led by an attorney and forensic psychiatrist.

The Mock Trial (two Fridays in December)

• Each fellow testifies in a mock trial that is conducted by a real judge and experienced attorneys. The exercise is observed by Law & Psychiatry faculty members, who provide immediate feedback. In addition, the testimony is video-recorded, and fellows are given a DVD of their testimony to review in supervision.

Trainees are encouraged to engage in scholarly activities during the fellowship. Faculty members are always willing to meet with fellows to discuss ideas about research projects, articles, or book chapters. In addition, the program offers the following structured scholarly activities:

• AAPL Annual Meeting and Review Course: All fellows attend the annual meeting of the American Academy of Psychiatry and the Law (AAPL) and the Forensic Psychiatry Review Course in October. The AAPL meeting is a highlight of the fellowship year, providing an overview of the field and an opportunity to meet scholars and trainees from around the country.
• Legal Digest Exercise: Each fellow works with a faculty co-author to review and summarize a recent legal decision for the “Legal Digest” section of the "Journal of the American Academy of Psychiatry and the Law." Fellows complete the draft article in the fall, and the completed pieces are published in March of the fellowship year.

Fellows are assigned several individual supervisors to help work through forensic cases over the course of the year. At any given time, each fellow has the following supervisors:

• Two caseload supervisors, responsible for meeting weekly to discuss ongoing forensic evaluations
• One psychotherapy supervisor, responsible for meeting weekly to discuss the fellow’s two therapy cases
• A “testimony resource” faculty member who can accompany the fellow to court and provide feedback about performance during testimony

Each fellow will also meet individually with Dr. Zonana for supervision for three months out of the year. Additional supervisors are always available and can be assigned as necessary.

Faculty members routinely accompany fellows on evaluations, particularly at the beginning of the year. As the trainees become more experienced, they work more independently, although the faculty supervisors continue to monitor their work. All fellows’ reports are reviewed and revised by faculty supervisors before completion.

In the last half of the training year, forensic trainees who have demonstrated mastery in the evaluation and formulations of cases are provided the opportunity to supervise some work of beginning trainees (who participate in competency to stand trial or other cases) and to make contributions to the training seminars. In the latter context, the fellows are asked to review and present discussions of didactic material to the group.

We have completed fellowship recruitment for the 2024-2025 academic year. We will begin reviewing applications for the 2025-2026 academic year on May 1, 2024.

To apply, please submit the Forensic Psychiatry Common Application and supporting documents via email or mail to the following address:

Email:
aida.segui@yale.edu

Mailing address:
Law & Psychiatry Division
Connecticut Mental Health Center
34 Park Street
Room 152
New Haven, CT 06519