Interns provide treatment and testing services throughout the year in the Ambulatory Behavioral Health Services clinic. In addition, throughout the year, interns select and rotate through four 3-month major rotations, described below.
Ambulatory Behavioral Health Services
The Ambulatory Behavioral Health Services (ABHS) provides an array of outpatient psychiatric services and is comprised of several specialized clinics for the treatment of children, adolescents and adults experiencing a wide range of mental health problems. Psychology interns work in ABHS on a part time basis for the entire training year. Their primary responsibilities include providing individual, group, and family therapy. They also conduct psychological testing cases in the outpatient clinic.
Staffing: ABHS is staffed by multi-disciplinary teams of mental health professionals including psychiatrists, psychologists, social workers, community liaison workers, caseworkers, activity therapists and nurses.
Adult Inpatient or Dual Diagnosis
Women’s Forensic Inpatient
Consultation Liaison Service
Psychiatric Emergency Room
Child/Adolescent Partial Hospitalization Program/ Pediatric Consultation Liaison
Outpatient Integrated Care
DESCRIPTION OF ROTATIONS
Elmhurst Hospital Center is a training hospital affiliated with the Mount Sinai School of Medicine; as such some of the units serve as a training rotation for psychiatric residents, child psychiatry fellows, clinical psychology interns, clinical psychology externs, and medical students. Interns are provided with a rich learning experience in which teaching and training are an integral part of most units.
Inpatient Units (Adult Inpatient, Dual Diagnosis, Adolescent Inpatient, Child Inpatient, Women’s Forensic Inpatient):
Inpatient units serve a diverse patient population with respect to race, culture, ethnicity, age, gender and psychiatric diagnosis. Inpatient services provide assessment and treatment to patients on the inpatient psychiatric units with a broad range of psychiatric diagnoses.
The Adolescent Inpatient Unit serves a varied patient population, including patients presenting with suicidality and self-injurious behaviors, mood disorders, conduct disorders, personality disorders, psychotic disorders, and developmental disorders. This unit places an emphasis on the evaluation and psychotherapeutic treatment of trauma and attachment disorders.
The Child Inpatient Unit serves children ages 5-13, with a similar range of disorders as the adolescent unit. This rotation also places an emphasis on the treatment of trauma, as well as utilizing behavioral interventions as part of the milieu treatment.
The Adult Inpatient Unit is the designated training unit, a 20-bed service serving a broad age range and variety of diagnoses. Interns collaborate closely with the interdisciplinary team and individual and group psychotherapy are emphasized on this rotation. There is also the opportunity to facilitate family meetings and sometimes conduct short-term family and couples’ therapy.
The Dual Diagnosis Unit provides individual and group treatment specific to substance use disorder including addiction recovery groups, peer support groups, and individualized addiction treatment for inpatients suffering from severe mental illness and substance use problems.
The Women’s Forensic Unit is similar in its mission as the other inpatient units, but is specialized in regards to the patient population who are women and come to EHC either pre-arraignment (in NYPD custody) or from the Rikers Island jail facility. The interaction between mental health issues and the legal system is a constant consideration. Collaboration with attorneys, diversion programs, and Rikers Island staff occur regularly. Malingering assessment tools are utilized to diagnose malingering and factitious disorders. Competency evaluations are also conducted. Monthly multidisciplinary team meetings are held at Rikers Island.
Staffing: All inpatient units have a multi-disciplinary staff and clinical team, including nurses, community liaison workers, psychiatrists, psychologists, social workers, and activity therapists. Staffing also often includes psychiatric residents, clinical psychology interns and externs, and medical students.
The Consultation Liaison service provides psychiatric consultation, assessment and treatment to patients on inpatient medical units. Evaluations conducted include capacity to make medical decisions. Interns evaluate patients with primary Axis I and II psychiatric disorders, as well as psychological problems secondary to a medical illness or situational stressor.
Staffing: Two psychiatrists run the service along with psychiatric residents and psychology interns. The interns on this service are supervised by the psychiatrist on the service as well as a psychologist on the faculty.
Comprehensive Psychiatric Emergency Program (CPEP)
The Psychiatric Emergency Room serves a diverse patient population with respect to race, culture, ethnicity, age, gender and psychiatric diagnosis. The Psychiatric Emergency Room provides consultation to patients in need of acute psychiatric evaluation. After initial triage by nursing staff the patient is evaluated by the psychologist or social worker, as well as by the staff psychiatrist. After a diagnosis is arrived at, a treatment plan and disposition are determined. The patient may be discharged, hospitalized or continue to be observed in the emergency room for a maximum of 72 hours.
Staffing: The Psychiatric Emergency Room is staffed by psychiatrists (adult and child), a psychologist, social workers, nursing staff, as well as assistant coordinating managers. Staffing also includes at times psychiatry residents, clinical psychology interns and externs, and medical students.
Child/Adolescent Partial Hospitalization Program (with minor rotation in Pediatric Consultation Liaison)
The Child/Adolescent Partial Hospitalization Program (PHP) is a 45 day outpatient program provided through Elmhurst’s Child/Adolescent Psychiatry Department. Interns will participate in the delivery of intensive mental health services which include individual, family, and group therapy. Interns will also take part in patient interviews conducted by the PHP team. While on this rotation interns will be expected to assess pediatric patients in medicine who require psychiatry consults. Assessments will seek to determine if the patient requires a psychiatric inpatient hospitalization.
Staffing: This service is run primarily by the attending psychiatrist and coordinator. The team also consists of an RN, social workers, child/adolescent fellows, and medical students. The interns on this service are supervised by the psychiatrist on the service as well as the child inpatient psychologist on the faculty.
Outpatient Integrated Care
Psychiatrists and social workers are located within the primary care setting to improve medical outcomes, reduce admissions to the hospital, and to identify patients in need of therapeutic intervention. Psychology interns will see patients within primary care settings including internal medicine and the HIV Clinic for screening, assessment and short term psychotherapy.
Staffing: This rotation is run by an attending psychiatrist. A psychologist in ABHS will provide additional supervision. Primary care physicians, nurses, and social workers will also be providing patient care and collaborative training for interns.