Services, Policy, and Law
Lisa Dixon, MD
Services, Policy, and Law focuses on research and training activities that broadly target dimensions of behavioral health care practice at the community, clinical, system and policy levels. Area faculty members recognize that efforts to promote health must consider issues well beyond the consultation room, using an array of tools including traditional research designs, electronically-supported technical assistance activities, and evaluation and quality improvement protocols, as well as training programs. Activities tend to be multidisciplinary with input from multiple stakeholders. The area includes 45 faculty members who work within four centers, two advanced training fellowships, and three focused programmatic units. Activities are funded by federal and state governments, foundations, philanthropy, and industry.
The Public Psychiatry Fellowship is the nation’s oldest and largest public/community psychiatry fellowship program. It facilitates recruitment and retention of high caliber psychiatrists into leadership roles as public psychiatrists. Fellows spend two days a week in seminars, supervision, and consultation with the fellowship faculty.
The Health and Aging Policy Fellows Program provides professionals in health and aging with the experience and skills necessary to translate cutting-edge science and practical clinical experience into sound health policies that will positively impact healthcare for older Americans. The program has an interdisciplinary focus accepting physicians, nurses, social workers, psychologists, dieticians, healthcare administrators, epidemiologists, economists, and lawyers from academic and practice settings, spanning career stages from newly-minted PhDs to senior professors and community leaders into the fellowship. The program also offers a Behavioral Health track which allows fellows to influence policy at the intersection of aging and mental health and substance use disorders, including late-life depression and suicide, interventions for behavioral manifestations of dementia, opioid use among the elderly, accelerated aging in people with serious mental illness, and other potential topics of interest to applicants.
- To conduct research focused on improving the outcomes of individuals with serious mental illness and cognitive challenges with an emphasis on the delivery of evidence-based practices and developing knowledge on psychiatric diagnosis and assessment
- To test new behavioral health quality and performance measures and promote the widespread use of evidence-based practices by providing technical assistance and implementation supports in NYS programs
- To deliver education and conduct research on the impact of law and ethics on psychiatry and on medical treatment and research more broadly, and on the role of psychiatry in the legal and correctional systems
- To promote mental health and reduce the burden of mental illness in under-resourced communities around the globe
- To provide professionals in health and aging with the experience and skills necessary to translate cutting-edge science and practical clinical experience into sound health policy.
- To provide training and leadership experience within public psychiatry for fellows, thereby facilitating leadership roles as public psychiatrists
- Multiple studies focusing on improving the care of schizophrenia and other psychotic disorders in real life treatment settings across the life cycle
- Multiple policy-related studies focusing on integration of behavioral health and general medical care integration, quality measuremen,t and innovative accountability and payment models
- Research in the Center for Law, Ethics and Psychiatry includes several NHGRI-funded studies of the legal, ethical ,and social impact of genetic and genomic research and clinical testing. Center faculty also participate in NIH-funded studies of goals and practices for next generation prenatal testing, genetic bases for kidney diseases, the All of Us Research Program, and the neurobiology of violence in a psychosis-risk cohort.
Programs and Centers
CPI promotes the widespread use of evidence-based practices (EBP’s) throughout New York State. CPI uses innovative approaches to build stakeholder collaborations, develop and maintain practitioners’ expertise, and build agency infrastructures that support implementing and sustaining EBP’s. CPI offers online training tools and resources as well as supports to help programs build capacity to implement these practices.
The Global Mental Health Program promotes mental health and reduces the burden of mental illness in under-resourced communities globally by delivering postgraduate educational programs that prepare clinicians and researchers to advance the field of global mental health, developing training programs that build capacity for research and clinical care in low- and middle-income countries, conducting basic and applied research that has global relevance, advancing community awareness and understanding of mental illness, and advocating for human rights of people with mental health illness.
The Center for Law, Ethics, and Psychiatry undertakes education and research on issues related to the impact of law and ethics on psychiatry and on medicine more broadly, and on the role of psychiatry in the legal and correctional systems. Center faculty train medical students, residents in psychiatry and other specialties, fellows in forensic psychiatry, clinical and research fellows in other areas of psychiatry, law students, graduate students, research staff, faculty members, and the general public. The center is home to the NIH-funded Program Center for Research on Ethical, Legal and Social Implications of Psychiatric, Neurologic and Behavioral Genetics (see http://braingenethics.cumc.columbia.edu/ ).
The Diagnostic and Assessment Lab is devoted to the development of structured interviews and other assessment tools including training materials for making diagnoses in accord with the Diagnostic and Statistical Manual (DSM) and International Classification of Diseases (ICD). The Structured Clinical Interview for DSM Diagnoses, first developed for DSM-III diagnostic assessment in the early 1980s by the Biometrics Research, Psychiatry Department, New York State Psychiatric Institute at Columbia University has been significantly revised over the past 30 years. The current version is the Structured Clinical Interview for DSM-5 (SCID-5). Visit to learn more about the SCID-5 instruments and training materials.
The Integrated Performance Measurement Center analyzes and reports on the impact of Medicaid reforms on service use and outcomes within the NYS public mental health system, and will also identify and test new behavioral health quality and performance measures to support the NYS Department of Health’s Value-Based Payment Program.
The Cognitive Health Program addresses the need for a focus on cognition when providing mental health services. It has garnered an international presence through educational campaigns, an annual conference on Cognitive Remediation in Psychiatry, research on methods to best address cognitive health, training programs for practitioners to deliver cognitive health services, and through consulting to systems of care interested in addressing cognitive health. Cognitive Health Program staff developed Teach Recovery, which provides mental health professionals with ongoing access to information so they can gain knowledge about addressing cognitive health as it relates to psychiatric recovery. Web-based education is an essential tool for clinicians with limited access to in-person training. Through education, Teach Recovery empowers the mental health professional to change lives.
OPAL is supported by the National Institute of Mental Health as one of its new Advanced Laboratories for ACcelerating the Reach and Impact of Treatments for Youth and adults with mental illness (ALACRITY) Research Centers. The goal of these centers is “to foster innovative research aimed at increasing the effectiveness of existing interventions, improving delivery and quality of evidence-based services, and accelerating the diffusion, implementation, and continuous improvement of new practices in diverse settings.” See: https://www.columbiapsychiatry.org/opal
The Columbia–WHO Center for Global Mental Health promotes mental health and reduces the burden of mental illness globally. The Center supports the World Health Organization (WHO) by developing global research collaborations and data infrastructure, and by disseminating research related to prevention, identification, classification, and treatment of mental disorders worldwide. The Center also works to enhance clinical research capacities related to delivery of services, develop training resources to improve treatment and care across a range of contexts, and support on activities that advance the implementation of WHO’s Mental Health Action Plan 2013-2030 specifically in under-resourced communities. At Columbia, the Center serves as a hub for faculty, scholars, and students who are working in the field of global mental health with training and education programs, including the Global Mental Health Scholars Program, Council Grants Program, University Seminars, and Summer Internship and Practicum Programs.
The Center for Mental Health and Justice strives to promote mental health and reduce the burden of mental illnesses across the criminal justice spectrum through collaborative research projects and educational/training programing. This work spans the criminal justice system from “Intercept 0” diversion and community-based crisis response, to “Intercept 1” EMS/police encounters, to “Intercept 4 and 5” jail/prison re-entry and community corrections. Additionally, the Center strives to promote mental health and reduce the risk of mental illnesses and substance use disorders by advancing social justice. This pertains to the Center's focus on the broader social determinants of mental health (e.g., adverse childhood experiences, housing instability, food insecurity, pollution exposure, to name just a few) through research, programs, and policy.