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PPF Clinical Sites

Goals and Objectives
CMHC ACT Walter S. Mathis, MD The Assertive Community Treatment team consists of a small group of highly committed clinicians with diverse experiences and specialties who use a team-based approach and assertive client engagement, often in the community or in their homes. These are clients with highly complex illnesses and extra-clinical confounds whose care requires a wholistic approach to their goals and needs. Diagnostically, schizophrenia, schizoaffective disorder, and substance abuse disorders are well-represented. Each client is covered in rounds by the entire team every day, seen by a clinician every week, and seen by a physician 1-2 times a month. The physician’s role is broad, including managing pharmacology and medical care, oversight of treatment planning, collaborating with emergency and inpatient psychiatric services, and coordinating housing, employment, addiction, and forensic services. The ACT team has daily rounds (8:45a-9:30a) and a weekly team meeting Mondays at 3p – all via zoom. The supervising Attending is on site Mondays, Tuesdays, and Thursdays. Successful fellowship experiences have included attending rounds at least once a week and the Monday meeting when possible. This rotation requires a minimum of 0.2 effort (8 hours/week) and a year-long commitment. Gain a robust understanding of the diverse social resources available to help clients and how to wield them creatively and with the most impact; Develop a skillset for engaging clients in unconventional settings – both therapeutically and assessment and mitigation of risk;Become comfortable and adept in a leadership role on a clinical team; Reflect on the personal challenge of sitting with clinical risk and recognizing the limits for what we can do for our clients.
CMHC CFS Susan Parke, MD Community Forensic Services is a multidisciplinary team providing clinical services to legally involved individuals who are deemed at increased risk of re-offending, harm to self/others, or whose treatment in other settings has been challenging. We work in collaboration w/state & community agencies that run various jail diversion and community re-entry programs in New Haven for legally involved clients with SMI &/or co-occurring disorders. Fellows will have the opportunity to perform diagnostic evaluations on new clients, provide medication and other tx management, and follow these clients throughout their stay (most stay for ~90 days). Depending on interest, the fellow could manage some of our longer-term patients, often w/more complex issues. Best days are Tuesday & Wednesdays. Learn about the issues that come up when caring for legally involved individuals; Gain expertise in risk assessment; Have the opportunity to perform diagnostic evaluations/optimize medications; Work w/community agencies & a multidisciplinary team to optimize care
CMHC Hispanic Clinic Esperanza Diaz, MD, and Andrea Mendiola, MD The Hispanic Clinic is located at 34 Park Street (CMHC) and provides outpatient mental health care to Spanish-speaking-only Hispanic patients. Services provided at the Clinic include individual and group therapy, medication management, case management, and collaboration with community organizations. Fellows joining the Hispanic Clinic will carry a caseload of patients that they will follow up with the assigned clinicians; they will have the opportunity to perform first psychiatric evaluations, medication management follow-ups, treatment management, and team coordination. If interested, fellows can also participate in weekly clinical rounds and staff meetings. Fellows may have the opportunity to join didactics for junior trainees. Flexible. Tuesdays if interested in participating in rounds. Gain knowledge about sustainable recovery-oriented and culturally appropriate mental health services for Hispanics; Understand the barriers of monolingual Hispanics to access behavioral health services and ways to address them; Apply medical knowledge appropriate for recovery from mental health problems considering Hispanic culture, values, barriers, and structural influences; Coordinate recovery-oriented care with the treatment team
CMHC 4th Floor Inpatient Robert Beech, MD, PhD; and Dale Sebastian, MD The CMHC 4th floor Inpatient program provides a wide array of recovery-oriented, holistic and rehabilitative services for those struggling with serious mental illnesses and co-morbidities requiring inpatient level of care. The Fellow is part of multi-disciplinary teams providing clinical expertise as the team-leader while liaising with community providers, other medical specialties and family to optimize care. The ability to manage patients through the acute illness phase of illness and later support their transition into the community provides the unique opportunity of applying novel strategies including use of strength based assessments, CBT for psychosis and formulation of person-centered care-plans. The fellow is actively involved in administrative, QI initiatives, teaching and supervising residents, psychology fellows and medical students. Flexible Develop clinical expertise in the management of patients with complex medical, psychosocial and cultural needs; Acquire training in recovery oriented practices and other evidence-based psychotherapies; Demonstrate leadership skills through participation in clinical, administrative and quality improvement initiatives; Learn to identify health care inequities, mental health resources and navigate organizational/ system complexities; Develop and further academic interests through teaching and supervision of trainees.
CMHC MCI John Cahill, MD, PhD MCI runs mobile crisis, walk in critical intervention, admission and evaluation, transition of care and crisis line services for the Greater New Haven Area. The role is that of MCI Medic on Duty – working with MCI director (Geanine Peck) and multi-disciplinary team of clinicians. There is also clinical supervision of PG3 residents and opportunities for QI projects in related areas. Flexible Develop clinical skills by serving in MCI ‘Medic on Duty’ role, as part of the MCI multi-disciplinary team; Gain working knowledge of systems of care in the Greater New Haven area, including mobile crisis and working with local law enforcement (CIT); Gain experience in providing direct clinical supervision of PG3 resident rotation in MCI; Develop decision making skills around triaging and management of clinical risk
CMHC SATU Srinivas Muvvala, MD SATU is part of the outpatient addiction services of CMHC and provides state-of-the-art services for the evaluation and treatment of alcohol, drug use and comorbid psychiatric disorders. It offers individual, group, and family therapy, specialized pharmacotherapies for those eligible, and referral to other treatment programs based on client need. Additionally, SATU conducts nationally and internationally renowned clinical research with major studies and pilot projects covering a broad scope of topics and research methodologies. Any morning works best but we can accommodate afternoons To understand the diagnostic criteria of substance use disorders (SUDs); To be able to conduct an empathic, focused, diagnostic interview of patients presenting with SUDs; To understand evidence-based pharmacologic and psychotherapeutic treatments for SUDs; To develop an understanding of how vulnerabilities or strengths within the social determinates of health can impact the course of patients with SUDs; To be able to present a concise patient formulation and develop a culturally informed treatment plan for patients with SUDs; To learn how to effectively access current literature on patients with SUDs.
CMHC STEP Vinod Srihari, MD STEP is an Early Intervention Service (EIS) serving individuals within the first 5 years of first episode psychosis onset, aged 16-35, within a geographic catchment area. We deliver a population and outcomes-oriented model of care. STEP is part a national network of clinics called EPINET. There are clinical research, Workforce development and policy opportunities focused on recent onset schizophrenia spectrum disorders. 0.2 effort (8 hours/week) and year-long minimum. Must include Mondays 4-5 PM for rounds To independently assess and formulate new onset illness; To oversee treatment plans in a multi-disciplinary team; To appreciate role of integration of research mission with clinical care delivery; To understand role of Public-academic collaboration in system reform.
CMHC Street Psychiatry Emma Lo, MD, and Fabiola Arbelo Cruz, MD Street psychiatry is the delivery of mental health and addictions care in street-based community settings in order to improve access to care for people experiencing homelessness. Fellows will conduct outreach with the team to a variety of sites such as encampments, the New Haven Green, and soup kitchens. Their role will involve engagement work, addressing basic needs, medical triage, referrals to social services, triage evaluations, intakes for med management e.g. buprenorphine induction, and care coordination. M 9-1 or 1-5; T 1-5; W 9-12 or 4-7. Open for 1-2 fellows, one half day per week for the full year; Biweekly 1 hour seminar/supervision required – time TBD with fellows’ schedule Develop clinical skills in street-based community settings; Practice outreach and engagement with a complex, diverse patient population; Navigate health and social service systems; Describe social determinants of health affecting people experiencing homelessness; Advocate for social justice and health equity for rough-sleeping populations
CMHC YAS Timothy VanDeusen, MD Young Adult Service (YAS) at West Haven: The Young Adult Service carries about 85 patients aged 18-25 early in the course of severe mental illness, e.g. 1st episode psychosis or have persistent mental illness from childhood, e.g. ADHD. Patients are referred from DCS (Department of Child Services), YPH, Community, or the State Commissioners Office. Many patients enter our program on multiple medications, so fellows are given the opportunity to taper off medications (de-prescribe) and re-evaluate the patient’s clinical status. Fellows also have the opportunity of teaching residents and medical students that rotate at the clinic. Tuesdays 9-1 preferred when students and residents are onsite. Other days and times can be arranged as well. Learn and implement a developmental treatment approach when applying clinical skills within this population; Develop a broad range of treatment styles when working with young adults; Prioritizing treatment when facing multiple psychiatric and medical co-morbidities; Achieve skill when working within a multidisciplinary team
CMHC Wellness Center Ani Annamalai, MD Wellness Center is a primary care clinic at CMHC. The purpose of this elective is to provide public psychiatry fellows interested in medical co-morbidities an opportunity to work with patients with serious mental illness (SMI) in an integrated primary care setting. Patients in this clinic are representative of CMHC clientele and include those with low income and from diverse ethnic backgrounds. The fellow will work directly with Dr. Annamalai who is board certified in both internal medicine and psychiatry; she is also an outpatient psychiatrist at CMHC. Fellows will be able to do physical health evaluations under her supervision and manage chronic disease (e.g. hypertension, diabetes). Monday afternoons To experience working in a primary care clinic that exclusively serves patients with serious mental illness (SMI); To learn principles of chronic disease management for common conditions seen in patients with SMI (e.g., diabetes, hypertension); To develop effective communication strategies between mental health and primary care providers; To understand the systemic barriers in delivering optimal primary care for patients with SMI; To learn how social determinants of health impact patients with SMI from diverse backgrounds
CVH/WFH CVH Vinneth Carvalho, MD Connecticut Valley Hospital (CVH) is a large state public hospital located in Middletown, CT. It has total of 17 inpatient units with a total bed capacity of 361. Patients are admitted to either the Addictions Services Division (ASD) or the General Psychiatry Division (GPD). Specialized services offered at CVH include a Young Adult Service (YAS) unit, Traumatic Brain Injury unit and several units that serve the geriatric population. Fellows will be given the opportunity to work with the CVH leadership team including the Chief Medical Officer and the Medical Directors of both Divisions (ASD & GPD) on projects related to clinical administration. Such projects may include trends in the use of Restraint and Seclusion, PRN medications, polypharmacy, pain management modalities and treatment related to opioid and alcohol use disorder. Projects may also include the development and initiation of consultation services. Any day or days of the week Fellows will gain insight into what it takes to deliver high quality health care in a large psychiatric facility and will be able to experience working with multidisciplinary teams to enhance and optimize patient care. Fellows will be exposed to and will have the opportunity to participate in a variety of programs at their choosing including: Addictions Service consultation; Consultation on complex patient cases in GPD; Consultation on pain and palliative care patients; Attendance and participation in risk management meetings; Attendance and participation in administrative meetings; Attendance and participation in case conferences and Critical Incident Review (CIR) meetings; Participation in quality improvement projects.
CVH/WFH WFH Tobias Wasser, MD Whiting Forensic Hospital (WFH) is CT’s only forensic psychiatric hospital. WFH is a 229-bed inpatient forensic setting made up of 11 inpatient units divided between maximum and enhanced security services. Each service has 18-24 bed inpatient units focused on either competency restoration services for individuals found not competent to stand trial or long-term treatment for individuals found not guilty by reason of insanity. Flexible Expose fellows to inpatient forensic psychiatry environment; Gain insight into the intersection of the criminal justice and public mental health systems; Learn about management of public hospital system
CHC CHC Tichianna Armah, MD Community Health Center, Inc. is a Patient centered Medical Home, and a Federally Qualified Health center caring for 150,000 CT residents, located only in underserved areas. We are among the National Health Service Corps sites providing care throughout the lifespan. Fellows would work as a part of a fully integrated, inter-professional and multidisciplinary collaborative team-based care model. Fellows would primarily evaluate and treat alongside a therapist who shares in the patient's care. In addition to carrying your panel of patients, there are options for teaching students, Nurse Practitioners, and psychiatrists through formal and informal avenues as we run NP and post-doctoral residency programs. Opportunities include but are not limited to engaging in Quality Initiatives and other leadership opportunities. Teams include Family Medicine Physicians, Psychiatrists, Psychiatric APRNs, PsyDs, LCSWs, LMFTs, RNs, LPNs, Family Nurse Practitioners, Nutritionists, chiropractors, and may include dentists, pediatricians, OBGyns, podiatrist, and pharmacists. Psychiatry at CHC is a combination of individual clients, consulting with Medicine colleagues through the shared EHR, in meetings or 1:1 and leadership where desired, and the option of treating pts MAT and group therapy. Current care is primarily remote through Telehealth with option to be in person providing primarily telehealth to clients, we are transitioning back to a hybrid of in person visits. All days of the week possible however Thursdays are an important day if interested in teaching didactics to NP residents across the country or desire to interact with one of our staff of 30 other psychiatry providers in our monthly meetings Experience a fully integrated, inter-professional and multidisciplinary team-base care setting and how to function effectively as a Psychiatrist to optimize patient care; Gain expertise in stabilizing patients and consulting with PCPs; Have the opportunity to preform diagnostic evaluations/optimize medications; Engage in a Quality improvement endeavor; Teach one or more didactics to Psychiatric Mental Health Nurse Practitioners on a topic of interest
VA Integrated Care Clinic Kirsten Wilkins, MD In Primary Care-Mental Health Integration (PCMHI) at the West Haven VA, fellows have the opportunity to work in an interdisciplinary mental health team embedded in the VA primary care clinic. Fellows will work closely with attending psychiatrists, as well as PCMHI psychologists, a nurse care manager, and a peer specialist. Fellows will perform initial evaluation and triage of patients referred directly from primary care, many of whom have never been in mental health care. They will provide brief treatment (3-6 visits) of patients in the primary care setting, often in collaboration with other PCMHI team members and the primary care provider. Monday and Thursday afternoons Provide evidence based, wholistic, and collaborative patient care to individuals referred to mental health services by primary care provider; Learn about pharmacological treatments and brief psychotherapeutic interventions for mild mood, anxiety, cognitive, sleep, adjustment, and substance use disorders; and the interplay between mental health and medical problems; Demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and other health professionals
VA ORC Ellen Edens, MD The Opioid Reassessment Clinic is a primary-care based clinic designed to assess the safety and efficacy of long-term opioid therapy in the management of chronic pain. The ORC is an interprofessional clinic composed of primary care, psychiatry, health psychology, pharmacy, and nursing. Tuesday mornings Practice performing pain assessments appropriate for a mental health professional; Develop sills in motivational interviewing; Develop treatment plans for patients with chronic pain