||CMHC First Floor
||John Cahill, MD, Medical Director; Geanine Peck, RN, Team Director
||Acute Services represents the figurative (as well as literal) ‘front door’ at CMHC. Our highly-integrated multidisciplinary team operates walk-in services, triages, mobile crisis visits, emergency coverage to other CMHC teams, in addition to receiving and following scheduled intakes. Acute Services handles the majority of admissions to CMHC; performing the initial formulation, stabilization and management before clients are either supported in transition to another system of care or referred internally to a continuity care team. Public Psychiatry Fellows take clinical lead on service, in collaboration with our experienced Team Director. They particularly enjoy the diversity of clinical experiences – with elements of urgent as well as longitudinal care and contact with clients from all walks of life (including those not otherwise eligible for continuing care at CMHC). The fellow will have ample opportunity to initiate treatment (often in individuals for whom this represents their first contact with care) – and crucially, follow them long enough to see a response. There is also ample opportunity to supervise trainees and participate in new (and ongoing) academic projects. Acute Services, due to our extensive interfacing with the community, also provides an essential orientation to the wider environment and system of care in the Greater New Haven area.
|Assertive Community Treatment (ACT) Team
||CMHC First Floor and Community Locations
||Monica Kalacznik, MD, Medical Director; Stan Mathis, MD, Attending; Gail Sicilia, APRN, Team Director
||The Assertive Community Treatment Program at CMHC provides comprehensive clinical, rehabilitation and case management services to a cohort of individuals with severe and persistent psychiatric illness, often complicated by substance use, medical illness and complex social concerns. Service is provided by a multidisciplinary team at CMHC, in patient’s homes and in a variety of community settings. Every effort is made to individualize services and to provide intensive, trauma-informed out-patient care. Public Psychiatry Fellows function as an integral part of the Team. The fellow provides medical back-up services to a small caseload and participates in administrative and teaching duties on the team. There is extensive opportunity for home and community visits and for collaboration with in-patient units, legal services, and agencies providing medical, nursing, housing and other supports.
|Community Forensic Science
||Susan Parke, MD, Medical Director; Nancy Anderson, APRN, Team Director
||CMHC’s Community Forensic Services is a multidisciplinary team that provides clinical services to individuals who are criminally involved, who because of their histories are deemed at increased risk of re-offending, self-harm or harm to others, or whose treatment in other settings has been challenging. We work in collaboration with state and community agencies that run various jail diversion and community re-entry programs in New Haven for legally involved clients with serious mental illness and/or co-occurring disorders. Fellows joining the team would have the opportunity to perform initial diagnostic evaluations on new clients, provide medication and other treatment management, and follow these clients throughout their stay on the team (most stay for approximately 90 days). In addition, depending on interest, the fellow could manage some of our longer-term patients, often with more complex issues.
||Esperanza Diaz, MD, Medical Director; Luis Anez-Nava, PhD, Program Director
||Public Psychiatry fellows interested in serving Hispanic bilingual, bicultural populations in the US Mainland will be welcome at the Hispanic Clinic. The Clinica Hispana of CMHC is a collaborative endeavor between DMHAS and the Yale University School of Medicine. The Clinic provides recovery-oriented and culturally sensitive mental health services to the Latino communities of New Haven. The target population is composed of monolingual Latino/a men and women, 18 years of age and older, suffering from a range of psychiatric and substance use disorders. We are able to serve people regardless of their ability to pay and never asked for their legal status. The clinic provides a wide range of outpatient clinical services within six distinct arenas: Mental Health, Substance use, Co-occurring disorders, an Intensive Group Program (Ambulatory Specific Adjunctive Group Therapy Program, ASAP), Peer/Consumer Support, and Consultation and Education. Fellows will learn Hispanic specific barriers to care, limitations for an effective exchange of information with patients and families, health disparities and stigma affecting health outcomes, structural influences to care, how to conduct cultural informed evaluations and innovative approaches serving the Hispanic Population.
|Integrated Care at St. Raphael's Campus (HSR)
||Primary Care Clinic at Yale-New Haven Hospital - St. Raphael Campus
||Alice Papsun, MD; Ani Annamalai, MD
||This new initiative for collaborative care will be located in the Primary Care Clinic at the St. Raphael campus of YNHH. The fellow will have the opportunity to provide consultation to primary care residents about psychiatric diagnoses, treatment, and community resources. The fellow will work under the supervision of a faculty psychiatrist and help to develop aspects of this educational and clinical program. (More details to follow)
||Yale Refugee Clinic at Primary Clinic at YNHH, Wednesdays from 5:30 to 8:30 pm
||Ani Annamalai, MD, Medical Director, Yale Refugee Clinic
||The Yale Refugee Clinic at Yale New Haven Hospital (YNHH) provides comprehensive health screening for all newly arrived refugees in the Greater New haven area. The clinic is based at the Yale Primary Care Center (YPCC) and staffed by internal medicine attendings, residents and medical and nursing students. The clinic director is both an internist and a psychiatrist. The purpose of the health examination is to screen refugee patients for undiagnosed physical and mental health problems, provide preventive health counseling and establish them for care within the U.S health system. Primary psychiatric diagnoses are post-traumatic stress disorder, depressive disorders and unspecified somatic symptoms related to adjustment difficulties. Public psychiatry fellows will have the opportunity to perform mental health screenings and provide ongoing care to a small number of patients for time limited psychotherapeutic or pharmacologic treatment. For patients with language needs, on-site interpreter will be provided. There are also opportunities to work with the resettlement agency, mental health facilities in the area and the department of public health to expand the referral base for mental health treatment for this vulnerable population with cultural challenges. There is also ample opportunity to engage in research projects ranging from clinical improvement to program development.
|Specialized Treatment for Early Psychosis (STEP)
||CMHC, Second Floor
||Vinod Srihari, MD, Director; John Cahill, MD, Medical Director; Jessica Pollard, PhD, Clinical Director
||The STEP Program (www.step.yale.edu) includes a population-based early intervention service for psychotic disorders. The service targets a 10-town catchment region with an NIH-funded early detection campaign (www.mindmapct.org) that is integrated with a first-episode service (‘STEP clinic’), based at CMHC. The program supports a range of translational research projects and also seeks to influence national policies that supports dissemination of best practice and translational research, via learning healthcare networks.
|Substance Abuse Treatment Unit (SATU)
||1 Long Wharf, New Haven
||Srinivas Muvvala, MD, Medical Director; Donna LaPaglia, PhD, Program Director
||SATU provides state-of-the-art services for the evaluation and treatment of alcohol and drug use disorders and comorbid psychiatric and medical conditions. It offers individual, group, and family therapy, specialized pharmacotherapy for addiction including medication assisted treatment, comprehensive psychiatric care and also referral to other treatment programs based on client need. Additionally, SATU conducts nationally and internationally renowned clinical research with major studies and pilot projects. The aims of the research program are the development of effective service delivery programs and innovative treatments for substance use disorders.
||CMHC and Community Locations
||Jeanne Steiner, DO, Attending Psychiatrist
||CMHC is developing a new Street Psychiatry program in partnership with an existing multi-agency Outreach & Engagement team. In conjunction with Acute Services, psychiatry trainees will join outreach staff from either CS-HHC or Columbus House for their rounds in sites frequented by individuals who are homeless, participate in weekly multi-agency O&E rounds, perform basic medical and psychiatric screening to individuals encountered by the O&E team, and facilitate referral or reconnection with existing MH/SA services.
|Transitional Living Program (TLP)
||CMHC, Fifth Floor
||Robert Beech, MD, Medical Director; Avon Johnson, LCSW, Director of Impatient Services
||The Transitional Living Program (TLP) at CMHC is an open (unlocked) 10-bed unit offering 24 hour nursing care and supportive services for clients with severe mental illness who have been recently hospitalized and require additional support to return to the community or who are at risk for hospitalization due to exacerbation of their symptoms, but do not currently meet criteria for inpatient hospitalization. Clients on the TLP are expected to return to the unit by 9PM but may attend off- site programs or engage in other activities during the day. The fellow rotating at this site will serve as the Attending Psychiatrist for the unit, with on-site supervision provided by Dr. Beech.
|Whiting Forensic Hospital
||Tobias Wasser, MD, Medical Director
||The Whiting Forensic Hospital is a 229-bed forensic psychiatric hospital dedicated to the treatment of individuals with mental illness and/or substance use disorders and significant legal involvement. Patients treated at Whiting typically fall into one of three categories: 1) Patients found not guilty by reason of insanity; 2) Patients found not competent to stand trial; or 3) Civil patients whose aggression cannot be managed in a less secure setting. The hospital is made of two services – the Whiting maximum-security service and the Dutcher enhanced-security service. Fellows rotating at this site will have the opportunity to be exposed to this unique forensic treatment setting from both a clinical and administrative perspective, with significant flexibility in the allocation of time and responsibilities based on the individual fellow’s interest.
|Young Adult Service (YAS)
||CMHC, West Haven Mental Health Clinic
||Tim VanDeusen, MD, Medical Director; Tom McMahon, PhD, Program Director
||The Young Adult Service (YAS) offers support to 18-25 year olds who have recently been diagnosed with a major psychiatric diagnosis or those who’s mental illness has persisted since childhood. The majority of our patients have been exposed to violence, experienced neglect, or suffered emotional, physical, or sexual trauma. Many have lived within Department of Child Services foster care and residential settings as children and adolescents. This is a great opportunity for trainees to expand their understanding of childhood and late adolescence/early adulthood development and learn how patient’s developmental trajectory informs the biopsychosocial formulation. Trainees will also learn how the gap between child and adolescent services and adult services within the public mental health system contributes to negative outcomes for youth with serious mental illness and how programs like YAS address this gap. Teaching opportunities are available with Yale medical students and psychiatry residents who present and discuss their cases during our weekly one hour case conference.