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Yale Hispanic Psychiatry Fellowship

Overview

The Yale Hispanic Psychiatry Fellowship provides advanced training in culturally sensitive and recovery-oriented behavioral health services for Latinx/Hispanic populations. Culture, race, ethnicity, and language influence communication between patients and providers, health access, and treatment outcomes. There is strong evidence that cultural differences contribute to health disparities and unequal access to care and that cultural knowledge and identity are significant determinants of treatment outcomes. Trainees will gain knowledge and skills focused on recovery-oriented and culturally appropriate mental health services for the Latinx community with a focus on promoting systems change.

Background

Since the early 1970s, the Yale Department of Psychiatry, in collaboration with the Connecticut Department of Mental Health and Addiction Services (DMHAS), has been developing culturally and linguistically appropriate programs to serve the Latinx community. This collaboration has produced the Hispanic Clinic of the Connecticut Mental Health Center (CMHC), the CT Latino Behavioral Health System (LBHS), and the DMHAS Health Disparities Initiative, a public-private partnership between DMHAS and the Yale Program for Recovery and Community Health (PRCH).

A shared mission among these programs is to improve access to care for monolingual Spanish speakers by incorporating the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (The National CLAS Standards). The services continue to expand and respond to the growing needs of the community. These programs are the basis for the Yale Hispanic Psychiatry fellowship.

Fellowship Structure

Learning Objectives and Didactic Experience

Fellows will:

  • Identify and analyze the socio-cultural, linguistic, economic, and systemic factors that limit Latinx patients’ access to mental health services.
  • Develop strategies to reduce barriers, improve outreach, and enhance engagement for bilingual and monolingual Latinx patients.
  • Recognize and respect Hispanic patients’ diverse cultural backgrounds, values, and beliefs in mental health assessment and treatment planning.
  • Utilize evidence-based interventions that are culturally sensitive and promote recovery-oriented care for Hispanic populations.
  • Analyze the impact of health disparities, stigma, and structural influences on mental health outcomes for Hispanic patients. And incorporate this understanding into treatment planning, including the identification of appropriate resources and advocacy for equitable care.
  • Integrate cultural considerations and knowledge of structural influences into the assessment, diagnosis, and treatment of mental health disorders in Hispanic patients. And tailor treatment approaches to address cultural values, preferences, and potential barriers to care.
  • Develop effective strategies to educate and advocate for culturally sensitive mental health care within healthcare systems.
  • Provide training and guidance to healthcare professionals to address unconscious bias, micro-aggressions, and promote culturally competent interventions.
  • Develop skills in providing effective clinical supervision and mentorship to medical students, psychiatric residents, and multidisciplinary staff.

Foster an inclusive and culturally sensitive learning environment to promote the professional growth of trainees.Develop and implement a research project that addresses the unique mental health needs of Hispanic populations and advances recovery-oriented care.

Fellows spend 50% effort (20 hours per week) participating in didactics and experiential learning to increase the scientific foundation to address mental health care for Latinx communities.

Main Seminars and Supervision

Hispanic Psychiatry Advanced Seminar: A Continuum of Learning

Seminar on Recovery-Oriented Services

Seminar on Forensic Psychiatry

Supervision with experts in Cultural Psychiatry

Supervision with experts on administration and policy in mental health

Mentorship to develop a research or quality improvement project

According to the fellows’ interest, a concentration on Substance Use, Specialized treatment of early Psychosis, Street Psychiatry, Psychotherapy for Latinx communities, or other related experience(s) could be arranged.

Clinical Experience

Fellows spend 50% effort providing direct clinical services and/or consultation within public psychiatry mental health settings that need bilingual/bicultural psychiatrists. The sites may include the Hispanic Clinic of CMHC, Community Forensic Services, other CMHC clinical sites, Greater Bridgeport Community Mental Health Center, Connecticut Valley Hospital and/or other community settings serving Latinx/Hispanics.

Clinical Rotations

Hispanic Clinic, CMHC

Hispanic Clinic at Greater Bridgeport Community Mental Health Center

Other DMHAS mental health sites in need of psychiatric care for Latinx patients

Research and Scholarship

Fellows are expected to develop and complete a health-disparities, recovery-oriented project aiming to improve clinical care and safety of ethnic minority populations. They will choose a mentor who will oversee the development, implementation, and dissemination of the findings. The aim will be to present the project at a national meeting and to write a manuscript suitable for publication.

Eligibility and Application Process

Requirements

  • Graduation from an accredited Psychiatry residency program
  • Eligibility for Board Certification in Psychiatry
  • Eligibility for employment and MD licensure in the state of CT
  • Bilingual Spanish/English, preferably bicultural

Fellows who meet eligibility criteria are appointed to the faculty of the Department of Psychiatry in the Yale School of Medicine at the rank of Instructor. A yearly salary is paid at the level commensurate with this rank as determined by the Department. Fellows who need to maintain status as a trainee may participate as a PGY5 advanced-resident. Medical benefits, malpractice coverage, and reimbursement for licensure are included in the compensation package. The program will also pay travel expenses for a professional conference. The Yale School of Medicine issues a Certificate of Completion of advanced training to individuals who successfully complete the one-year program.

Application Process

To apply, please send:

  • An updated CV
  • A letter of interest describing your background, career goals, and how the fellowship will facilitate the achievement of your goals
  • Three professional references sent directly to Dr. Díaz

Contact Information:

Esperanza Díaz, MD
Professor of Psychiatry
Medical Director Hispanic Clinic and CT LBHS
Associate Residency Program Director
Director, Yale Hispanic Psychiatry Fellowship
34 Park St, W127
New Haven CT. 06519
esperanza.diaz@yale.edu
203-974-5825

References

Diaz, E., Armah, T., Linse, C., Fiskin, A., Jordan, A., Hafler, J. Novel Brief Cultural Psychiatry Training for Residents. Academic Psychiatry, 2016, 40: 366-368 doi:10.1007/s40596-015-0279-z PMID: 25636254

Paris, M., Silva, M. A., Diaz, E., Bedregal, L. E., Cole, R. A., & Añez-Nava, L. The Connecticut Latino Behavioral Health System: A Culturally Informed Community-Academic Collaboration. Psychological Services. 2016. May: 13(2):140-7. doi: 10.1037/ser0000065. PMID: 27148948. 2017, Division 18 Psychologists in Public Service Best Paper Award in Psychological Services, deemed to be the most outstanding contribution to the literature.

Aggarwal N, Lam, P., Castillo, E., Weiss, M.D., Diaz E, et al How Do Clinicians Prefer Cultural Competence Training? Findings from the DSM-5 Cultural Formulation Interview Field Trial. Academic Psychiatry. 2016 Aug; 40(4): 584-591. doi: 10.1007/s40596-015-0429-3. PMID: 26449983

Diaz, E., Añez, L.M., Silva, M., Paris, M., Davidson, L. Using the Cultural Formulation Interview to Build Culturally Sensitive Services, 2017. Psychiatric Services. 2017, 68:112-114. doi: 10.1176/appi.ps.201600440. http://alert.psychnews.org/2016/11/cultural-formulation-interview-can-help.html

Lewis-Fernandez, R., Aggarwal, N., Lam, P., Galfalvy, H., Weiss, M., Kirmayer, L., Paralikar, V., Deshpande, S., Diaz, E., Nicasio, A., Boiler, M., Alarcon, R., Rohlof, H., Groen, S., VanDijk, R., Jadhav, S., et al. Feasibility, Acceptability, and Clinical Utility of the Cultural Formulation Interview: Mixed-Methods Results from the DSM-5 International Field Trial. British Journal of Psychiatry. 2017 Jan 19. pii: bjp.bp.116.193862. doi:10.1192/bjp.bp.116.193862. PMID: 28104738

Mendiola-Iparraguirre, A., Restrepo-Toro, M.E., Gomez, N., Costa, M., and Diaz, E. Learning and Teaching Latino Mental Health, Social Justice and Recovery to Visiting Students: A Pilot Study. Revista Iberoamericana de Psicologia 2021.

Diaz, E., Anez Nava, L., Parke, S., Silva, M., Lu, F., Davidson, L., Restrepo-Toro M., Jordan, A., Garcia Vassallo, G., Mendiola, A., Steiner, J., Dike, C. “Addressing Health Equity and Racism Through a Hispanic Psychiatry Fellowship” Psychiatric Services 2022 https://doi.org/10.1176/appi.ps.202100220

Fellowship Directors and Core Faculty

Meet the directors and core faculty of the fellowship.

Fellowship Directors and Core Faculty