Clinical Rotations and Rotation Sites

Bronx Psychiatric Center (BPC)

BPC, the primary forensic fellowship training site, is located approximately 1 mile from the Albert Einstein College of Medicine academic center.

A facility of the New York State Office of Mental Health, the BPC is a 156-bed psychiatric hospital that offers:

  • Day treatment
  • Associated off-site outpatient clinic 
  • Vocational rehabilitation
  • substance abuse/methadone maintenance programs

The facility also serves as an integral part of the continuum of care and monitoring for forensic patients who have been transferred from secure facilities, including prisons and jails (e.g. Rikers Island Correctional Facility), as well as forensic psychiatric units within the system (e.g. Mid-Hudson Psychiatric Center).

In addition to its comprehensive range of inpatient and ambulatory clinical services, BPC offers:

  • The latest in psychopharmacologic research
  • Cutting-edge community interventions
  • Training programs for psychiatric residents, medical students and other mental health disciplines (e.g. clinical psychology)

Forensic fellows are required to spend two full days a week at BPC during the training year, or a full-time equivalent of four and a half months.

BPC is home base for both in-hospital activities and state-wide consultation. The in-hospital work includes consultations on general and forensic patients in the areas of:

  • Dangerousness
  • Violence
  • Right to refuse treatment
  • Civil commitment and retention 
  • Outpatient commitment
  • Guardianship
  • Sex offender assessment
  • Medical/legal review of insanity aquitees

Our fellows participate in the Hospital Forensic committee, at which they will help to review patients for privileges and discharge.

Consultations at BPC provide many opportunities for court testimony.

Statewide work at BPC is focused on: 

  • Forensic evaluations of insanity acquitees (both immediately past -acquittal and at critical treatment junctures)
  • Risk assessments at state hospitals and correctional settings
  • Forensic program and policy development for New York State Office of Mental Health. 

Fellows participate in the evaluation of non-state cases referred to the program by other agencies, such as Bellevue Hospital Center, CUNY Law School and the John Jay Legal Services of The Elisabeth Haub School of Law at Pace University, as well as private law firms.

These referrals involve include fitness to stand trial, health care law, domestic violence, immigration proceedings, veteran status hearings and child custody evaluations.

Fellows are generally actively involved in 3-4 consultations at any given time, including both Bronx PC and State-wide work.

Faculty at BPC includes the Program Director and one of the Associate Program Directors, who share overall responsibility for education and training on-site and throughout the program and directly train fellows for a total of three to four hours a week. The second Associate Program Director (an MD/JD) provides additional case supervision on a weekly basis.

The faculty also supervises the state-wide and non-state cases that are referred to the program for evaluation and consultation.

Westchester Jewish Community Services

Westchester Jewish Community Services (WJCS) is a non-sectarian, not-for-profit agency that serves children, adolescents and adults of all ages.

Fellows are assigned to The Court Assessment Program, a WJCS division that provides evaluations for the Westchester Country Family, Domestic Violence and Supreme Courts. The program offers mental health evaluations for both adults and children who are involved in ongoing custody-visitation proceedings, as well as for children and adolescents engaged in delinquency proceedings. Fellows are required to spend one day a week for a six month period dedicated to this service.

Fellows are trained in conducting forensic mental health evaluations within the context of custody-visitation and delinquency/PINS (Person In Need of Supervision) cases. A child under the age of 18 who does not attend school, or behaves in a way that is dangerous or out of control--or often disobeys his or her parents, guardians or other authorities--may be found to be a Person In Need of Supervision or "PINS". All PINS proceedings are heard in Family Court.

After an initial period of observing evaluations, fellows will conduct evaluations and complete a report under the guidance of the site supervisor. Reports will be presented to the court and fellows will have opportunities for expert testimony. Fellows attend a series of lectures regarding issues relevant to the forensic assessments they are performing.

Faculty consists of a forensic psychologist with extensive experience in both performing family court cases and training fellows to do same. The faculty provides both direct service and ongoing supervision. In addition, fellows have at least one hour of individual supervision with a forensic faculty member each week.

Bronx Mental Health Court/Bronx TASC Mental Health Program

The Bronx TASC Mental Health Court Program seeks to craft a meaningful response to the problems posed by defendants in the criminal justice system suffering from mental illness. It offers an alternative to incarceration by evaluating, placing and monitoring defendants who are referred for possible diversion from jail and prison into residential and outpatient mental health settings. Working with the diversion service provides the residents with active exposure to this increasingly important area of forensic psychiatry.

The Bronx TASC office is located in the vicinity of the Bronx Criminal Court and Bronx Supreme Court buildings.

This group of patients comprise an ethnically, racially, socioeconomically, culturally and diagnostically diverse population. They have usually been charged with a felony and are facing prison time, if not diverted into treatment under court supervision. Each defendant referred is evaluated comprehensively for history of mental illness, current clinical condition and risk assessment. The majority of cases in which pleas are taken and diversion approved are transferred to a specially-created mental health court for monitoring.

The forensic fellows are required to spend one full day a week for six months on this service. Each week the resident evaluates at least one new referral and participates in the diversion team’s review of oncoming cases requiring evaluation and/or monitoring.

In addition to further experience in evaluating patient/defendants in a forensic setting, diagnosing mentally ill offenders, and conducting risk assessments, here fellows are exposed to the dynamics of court-based diversion. These include:

  • Knowledge of what what kinds of defendants are referred, how the mental health system views them
  • Understanding the particular challenges of running a diversion service.
  • Opportunities to participate in ongoing multi-system collaboration and research in diversion.  

Forensic faculty at Bronx TASC consists of a forensic psychiatrist who is also an Associate Fellowship Program Director and a forensic psychologist, who provide direct and ongoing supervision. . Fellows receive at least one hour of individual supervision each week with a forensic faculty member.

Sing Sing Correctional Facility/Prison-based Mental Health Service

Sing Sing Correctional Facility is located in Ossining, NY, some 20 miles from Montefiore. Sing Sing is a Maximum Security Prison with:

  • A general population census of about 300 active patients, most on psychotropic medication. Their diagnoses include Axis I and Axis II disorders, ranging from active psychosis to persistent character pathology
  • An Outpatient Satellite Unit with a 21-bed crisis Unit (with six mental observation cells)
  • An Intermediate Care Unit (a Day Hospital) model with 62 beds 

The fellow functions as part of the mental health team and attends morning rounds and participates in evaluating admissions to the residential unit. Caseloads average 12 -15 patients. Our fellows spend two full days a week for six months at Sing Sing.

The Clinical Director of the mental health unit and Unit Chief coordinate the program and provide clinical on-site guidance and supervision. Other teachers include social workers and psychology and administration staff with significant experience in correctional psychiatry.

Clinical training also occurs on the Intermediate Care Unit (ICU), CORP re-entry unit, Residential Crisis Unit (RCU) and Special Housing Unit. Participation in Community Meetings and DOCS programming is also available, should the fellow be interested.

Outpatient responsibilities include initial psychiatric evaluations, as well as continuing medication cases. The fellow functions as part of the mental health team and attends morning rounds and participates in evaluating admissions to the residential crisis unit. Four hours on site are devoted to these duties. Caseloads average 6-7 patients.

Clinical training also occurs on the Intermediate Care Unit (ICU). Participation in Community Meetings and DOCS programming is also available. Six hours will be devoted to these duties.

Fellows also have opportunities to visit related facilities, including:

  • The Central New York Psychiatric Center (CNYPC) in Marcy, NY
  • Downstate Correctional Facility
  • Bedford Hills Correctional Facility, New York States’ only maximum facility for women. 

Depending on your individual interest, you may spend up to four hours a week at Downstate or Bedford Hills.

NYC DOHMH/Correctional Health Service Mental Health Services

The mission of the Correctional Health Services division of the NYC Health and Hospitals Corporation is to provide quality mental health care to the inmate population of the New York City Department of Correction. Mental health services are provided for the detection, diagnosis and treatment of mental illness. Currently, mental health services are provided at eleven sites, nine of which are on Rikers Island. Rikers Island houses both sentenced and detainee adult /adolescent males and females.

In addition to mental health staff (e.g. psychiatrists and other mental health professionals, nurse practitioners, social workers and activity therapists), the facility is run by a full complement of medical staff including but not limited to doctors, nurses, HIV counselors and dentists. At any given time mental health services are provided to one quarter (25%) of all inmates on Rikers Island.

Our Forensic psychiatry fellows who participate in this program will be given:

  • Training in conducting mental health assessments and continuing mental health treatment within the context of the correctional setting
  • An orientation to all services, policies and procedures 
  • An orientation to general Correctional Health rules and regulations
  • Exposure to clinical administrative decision making within a correctional setting 

Research Opportunities

Our fellows enjoy many research opportunities. We expect them to participate either in ongoing division work or to develop an independent project of their own with the anticipated goal of giving a year-end presentations of their individual work.

In addition, we encourage fellows to submit abstracts for annual meeting presentations. These have covered a wide range of topics, including:

  • Legal research into liability issues
  • Risk assessment in mentally ill offenders
  • Emergency Department care
  • Comparison studies of sexual offenders
  • The ethics involved when psychiatric patients must decide on elective surgery

The Court Assessment Program’s goal is always to act in the best interests of the child or children involved. Evaluations objectively inform the court with regard to the parental capacity of adult parties involved—as well as the emotional, educational and social adjustment of children who are either subjects in custody proceedings or respondents in delinquency cases. Evaluations are intended to assist judges in making dispositions in these cases. Expert testimony is provided if deemed necessary by the court.