BronxCare Health System’s Department of Psychiatry, under the leadership of Dr. Ketki Shah, Chairman, Psychiatry, offers comprehensive care for mental health and chemical dependence affecting adults, adolescents, and children. It accounts for more than 200,000 outpatient visits annually, and is widely recognized as a leader in the provision of community mental health services. Our dedicated and talented staff provide excellent patient care.
Our robust Inpatient Psychiatric service includes three Adult Inpatient Psychiatric Units and one Child and Adolescent Inpatient Psychiatric Unit. On the medical units, our Consultation Liaison service works hand-in-hand with our medical colleagues to manage acute psychiatric and behavioral issues for patients with co-occurring medical illness. While working with our patients, we employ a variety of therapeutic modalities with an emphasis on the biopsychosocial model using evidence based treatment strategies and working with multidisciplinary teams. Our Inpatient teams work closely with our Outpatient services to ensure safe transitions and continuity of care. The recent expansion of our Mobile Crisis Team has afforded us the opportunity to visit our patients in their homes and collaborate with community partners to provide emergency intervention to those in crisis. Our two Adult Outpatient Psychiatric Clinics and one Child and Adolescent Outpatient clinic provides individual and group medication management and psychotherapy for the community at large. Innovative implementation of Peer Specialists, Care Coordination Services and Community Health Workers to our multidisciplinary team has also enhanced the patient experience and improved mental health service delivery in our department, reducing length of stay and preventing hospital readmissions. Peer Specialists in particular promote and exemplify the model of recovery; enhance hope and social networking through role modeling and activation. Their presence supplements existing treatment with education, empowerment, and aid in system navigation.
There are two Adult Outpatient Psychiatry clinics and a Child and Adolescent clinic (Child Study Center), all of which provide comprehensive mental health services to the Bronx community. The services provided include psychiatric evaluations, psychopharmacological interventions, as well as individual, group and family therapy. Outpatient services see about 5,000 individual patients with approximately 233,000 visits a year. Clinic hours are available on Saturdays and late evenings, providing more flexibility to our patients. Our staff of Psychiatrists, Nurse Practitioners, LPNs, Social Workers, and Licensed Creative Arts Therapists work together to provide high quality care. We also partner with our Behavioral Health Care Coordination Program to assist High Risk patients with managing both medical and psychiatric care. Care Coordinators are a direct community link and reach patients in their homes, accompany them to appointments, and work with the clinic team to ensure that patients receive all their services. Referrals come from all five boroughs and primarily our patients reside in the Bronx. We also boast short wait times to engage in care and can generally provide an appointment with a mental health clinician within 2 weeks.
Our Comprehensive Psychiatric Emergency Program (CPEP) provides services to more than 7,000 psychiatric emergencies annually. The recent expansion of the CPEP Mobile Crisis Team has enabled us to respond to more than 1,200 emergencies in the community annually. Mobile Crisis also provides interim visits for those who have recently been discharged from our Inpatient service with a goal of improving medication compliance and engagement with outpatient psychiatric service. This treatment strategy is one of many novel approaches to reduce psychiatric readmission rates.
The Department of Psychiatry has implemented Collaborative Care, an evidence-based model of integrated behavioral health care with vast expansion into family medicine, internal medicine and other medicine subspecialties at BronxCare Health Center. Collaborative Care enhances the scope of primary care to provide effective, team-based treatment for common behavioral health conditions like depression and anxiety without referral to specialty mental health care. It has become the gold standard for depression care, and is linked with better medical outcomes for patients with diabetes, cardiovascular disease, cancer, and chronic arthritis pain. Collaborative Care provides patient-centered team care, is population based, and has a high degree of accountability as reimbursement is based on outcomes. Incorporating a combination of integrated care and co-location throughout our hospital has afforded our medicine colleagues a direct consultation to our specialty. Additionally, we have enhanced the patient experience for the population we serve and improved access to mental health care.
Life Recovery Center’s inpatient program consists of a 20-bed detoxification and 25-bed rehabilitation unit. The wide range of outpatient services provided include medication assisted treatment (MAT), Opioid Treatment Program (OTP), Impaired Driver Program (IDP), intensive outpatient services, individual and group counselling with day and evening hours. Employing recovery based models, we work with our patient to identify substance abuse triggers and help them develop the skills needed to return to a productive lifestyle. There is also a Community Residence within the Life Recovery Center that offers individuals a stable living environment during their period of recovery. It includes individual bedrooms with private bathrooms. Many of the Life Recovery Center patients have medical problems that must also be addressed and so a dedicated team of physicians, nurses, and support staff provide these services at the inpatient and outpatient levels.
Academically, the Department of Psychiatry is thriving. Our Department has a number of nationally and internationally recognized leaders and teachers in the field of psychiatry and psychology. Educational experiences include a dynamic Adult Psychiatry Residency Program as well as three highly sought after fellowships: Consultation Liaison, Child and Adolescent and Addiction Psychiatry. Our residents and fellows have been published in peer review journals, presented at regional, national and international conferences and have been recipients of a number of national awards. In addition, our department provides opportunities for medical students in their third and fourth year clerkship years.
BronxCare Health System was recently selected to be the New York City Zero Suicide grant site. It is a 5 year, first-ever Zero Suicide grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). The Zero Suicide model is both an aspirational and pragmatic approach for systematically integrating suicide prevention in healthcare settings. The Department of Psychiatry is implementing this model in inpatient, outpatient, CPEP, and addiction services.
In an effort to bring innovative treatment modalities to BronxCare, our department is moving in the direction of incorporating telepsychiatry and Transcranial Magnetic Stimulation (TMS) services into our current practices. These cutting edge, evidence based methods will broaden mental health delivery and provide alternative forms of treatment and broadening our opportunities to reach patients with mental health needs in the Bronx community.
“Mind and body both are crucial aspects of health; a clinician needs to always address both to get optimal outcomes of treatment”
—Dr. Ketki Shah, Chairman, Psychiatry