Curriculum - Academic Modules Overview
Structure of the Public Mental Health System- This module starts in the summer and continues throughout the year, describing the history of the regulatory and fiscal structures that support the BH care system. It specifically focuses on income support, medical insurance and social services supported with public funding.
Recovery-Oriented Services and Evidence-Based Practices for the SMI- the conceptual lens through which we teach all the other modules in the fellowship curriculum.
The Role of the Psychiatrist in Public Outpatient Mental Health Care- Psychiatrists are doctors first and having specialty training in psychiatry makes us uniquely suited for leadership and management roles as well as providing direct care. This module focuses on the various roles that psychiatrists can have and highlights the skills and knowledge necessary for these roles.
Primary clinician- direct care
Secondary consultant- to a PCP, other clinicians, or other systems of care/services
Tertiary consultant- to a care coordinator first who then collaborates with a PCP or other clinician
Medical director- of an organization
Program director- of a program embedded in a larger organization
Housing for people with mental Illness- an overarching view of the housing system (primarily in New York), from homelessness and shelters to supportive housing, with emphasis in the legislative, policy and fiscal aspects, as well as the provision of psychiatric and medical treatment in each setting.
Management in Public Mental Health- Psychiatrists are asked to take the lead in clinical decision making, risk management and as the member of the team with medical legal liability. It is also often the role of the psychiatrist to be the Medical Director of a program or organization. This is a yearlong module consisting of didactics on management principles, self-assessment of management styles, organizational structure and on how to manage organizational change; as well as a cohort of guest speakers in leadership roles throughout the nation, who will present various management problems from a “real world” perspective.
Substance use disorders and dual diagnosis - 50% of people with SMI have co-occurring substance use and many others with common mental illness have substance use disorders. This module focuses on the interface between mental illness and substance abuse, on the EBP treatments available for integrated treatment, and on the engagement tools and practices used to motivate people to engage in integrated care
Assessment, engagement and treatment, including MAT and MI
Technology and Informatics- More and more our medical care is becoming more dependent on technology to improve treatment and access to care. In psychiatry, technology is particularly useful in providing direct patient care and team management. This module focuses on the use of technology to expand access to behavioral health care, as a tool for BH assessment, and as a means of remote management.
Shared medical records/RIOS/ Predictive analysis
Health Care Equity- Social determinants of health play a major role in the prevalence and outcomes of mental illness and overall health. This module focuses on disparities, with emphasis on cultural and socio-economic markers, and looks at strategies for addressing those disparities.
Literature review and data
Bias and micro aggressions
Trauma Informed Care- Trauma informed care is now an ACGME milestone and is essential for providing person centered, efficacious care. This module focuses on recovery oriented trauma assessments, understanding and recognizing the impact that trauma and complex trauma has on people’s ability to function, and becoming familiar with interventions geared towards prevention and treatment.
Domestic violence/ ACEs/ Emergency care/ Family and environmental trauma
Advocacy- As community/public psychiatrist we have an opportunity and expectation to act as advocates for the people who we provide care for, our team mates, our programs and organizations and we can do this at the local, state and national level. This module focuses on the principles of advocacy and the different tools used to advocate.
Personal advocacy as psychiatrists
Population based advocacy
Cause based advocacy
Child Psychiatry and Services-Just about every year we have child trained Fellows and children’s health, custody, developmental disabilities and childhood trauma are common topics that need to be address in adult psychiatry as well. In this module we begin to explore children’s behavioral health services, child specific treatments and preventive care.
Implementation of Change- this is a conceptual module that focuses on equipping fellows with the tools they need to improve programs and healthcare systems. It includes an introduction to implementation science, CQI principles, strategy workshops, and culminates in Fellows implementing change in their job sites.
Integrated/Collaborative Care- Only 30% of people receive behavioral health care from psychiatrists. From the Public Health perspective, many people are not getting the level or quality of care needed to adequately meet treatment need. To address access to treatment, behavioral health workforce shortage, and stigma that often keeps people from seeking care, several new models of integrated care have been developed. This module focuses on the general principles of integrated/co-located care, the IMPACT model and on similar models being developed for people with SMI.
Collaborative/Integrated care; Co-located care; IMPACT model; Certified Community Behavioral Health Clinics (CCBHC); Personalized Recovery Oriented Services (PROS), Federally Qualified Health Centers (FQHC)
Mental health and the Legal System- The legal system and the behavioral health system are both responsible for the safety and wellbeing of the public. The civil mental health and criminal justice legal systems all impact the lives of people with serious mental illness, co-occurring disorders and complex needs. This module focuses on the history of over incarceration of people with mental illness and minorities, how we understand criminogenic risk and needs, and how the legal system is used to mandate people to treatment. We explore the role of community psychiatrists at the intercept points in the legal system.
Civil Rights and civil liberties- social justice
Civil system- mandated treatment, immigration, family court, domestic violence, housing-tenants’ rights
Criminal system- misdemeanors, felonies, bail, overcrowding, specialty courts, mental health of incarcerated, re-entry, Forensic
Leverage/Coercion- used to engage people in treatment
Predictors of violence /safety
Global Health- An overview of core principles of global mental health, including guest speakers with extensive experience in the field.