The Department of Psychiatry at Mount Sinai Morningside and Mount Sinai West is a major provider of psychiatric care for the diverse communities of the New York Metropolitan area. Our clinical divisions provide over 2000 inpatient admissions, 20,000 outpatient visits, and 70,000 substance abuse treatment visits. The faculty consists of over 35 full-time or half-time psychiatrists, 25 psychologists, and many esteemed voluntary faculty, all with academic appointments at the Icahn School of Medicine at Mount Sinai. The faculty in all five divisions of the department actively participate in the supervision and teaching of residents.
Adult Inpatient, Emergency Room, and Geriatric Psychiatric Services
The Mount Sinai Morningside and West Inpatient Service provides acute psychiatric treatment on two units to over 2000 adult patients each year. These units offer comprehensive assessment, treatment, and discharge planning services and utilize a multidisciplinary staff for the treatment of a broad range of psychiatric disorders. Psychiatry residents rotate on inpatient units at both sites, working alongside psychology interns, medical students, and senior residents to learn the assessment and management of acute psychiatric conditions. The inpatient addictions rotation is on a unit that serves as an acute detox as well as 28 day rehab. Residents learn the assessment and treatment of substance dependence and hone their motivational interviewing skills. Residents train in geriatric psychiatry and have the opportunity to learn about the care of veterans during an inpatient month at the Mount Sinai-affiliated Bronx VA.
Psychiatric Emergency Services are provided at both hospitals within the Comprehensive Psychiatric Emergency Program (CPEP). These units collectively serve over 6000 patients a year. The CPEP model of care allows residents a comprehensive approach to managing psychiatric emergencies with well-coordinated components including 72-hour extended observation beds, a mobile crisis team, and crisis residence beds. Residents spend three months in the CPEP during their first two years, learning emergency evaluation and treatment under close attending supervision.
The Adult Consultation/Liaison Service interacts with the rest of the hospital by responding to the diverse and complex psychosocial needs of medical and surgical inpatients. PGY2 residents work closely with attendings to learn the basics of C/L, provide assessments, crisis management and treatment recommendations. As experienced PGY4s, they return to further hone their C/L skills and learn more sophisticated and subtle aspects of C/L care.
Addiction Institute at Mount Sinai
The Addiction Institute at Mount Sinai Morningside and West is a nationally respected comprehensive alcohol and drug dependency treatment service. The breadth of services includes an evaluation service, inpatient and outpatient detoxification, residential rehabilitation, and extensive clinical services. This division is also active in nationally recognized research into treatment of alcohol and substance abuse. Residents rotate on the inpatient addiction unit at West during the PGY2 year. Residents often return to this division for a range of outpatient addiction electives during their PGY4 year.
Adult Outpatient Services
The Adult Outpatient Psychiatry Clinic (OPC) provides short and long term treatment for the full range of adult psychiatric disorders. This clinic has over 20,000 visits a year with a multidisciplinary team delivering both traditional and specialized treatments. Residents spend a significant portion of PGY3 and 4 years in this clinic, learning outpatient diagnostic assessments, psychopharmacology, individual, group and family therapies, and specialized treatment. For example, the Clinic experience requires residents to become competent in the major types of therapies, including long-term psychodynamically-oriented therapy, both individual and group cognitive behavioral therapy, supportive psychotherapy, and pharmacological treatments. Residents receive 5 hours of supervision per week on these varied therapies by skilled specialists in addition to their didactics.
The Psychiatric Recovery Center (PRC) is designed to provide care to seriously mentally ill adults by providing psychiatric treatment using a recovery model. Components include dual diagnosis (substance abuse and mental illness) treatment, integrated primary care services onsite, and health home care coordination. A dedicated program within the clinic (PEER) customizes treatment for those below the age of 25 with a first episode of psychosis, focusing on early intervention to maximize functioning.
Residents begin to see outpatients in PRC during their PGY2 year and then continue with their PRC patients longitudinally through graduation, learning sophisticated psychopharmacology and comprehensive care of individuals with serious mental illness. Residents may also spend extra time in PRC during their PGY4 elective block.
Center for the Intensive Treatment of Personality Disorders
This unique program is one of very few such specialized programs dedicated to the treatment of severe personality disorders. A program of daily treatment allows for intensive care in an outpatient setting while allowing many patients to continue work or school simultaneously. While the program predominantly uses DBT as a theoretical framework, it is informed by a number of other treatment modalities including psychodynamic therapy and pharmacotherapy to reduce the high risk of impulsivity and self-harm in these complex patients. PGY 2 residents rotate at the CITPD for 10-12 weeks where they carry a small caseload, and learn the intricacies of managing these challenging patients within a team framework and with ample supervision. Working in this outpatient setting as early as the second year prepares our residents for the PGY 3 outpatient year and engenders confidence in working with challenging patients.
Child and Family Institute, Child and Adolescent Inpatient Unit
The Child and Family Institute provides a broad range of general and specialized outpatient and inpatient services for children and adolescents. Residents rotate at Mount Sinai Morningside's Child and Adolescent inpatient unit during their PGY2 year, where they learn about the indications for and modalities of acute care in this population. Outpatient services include evaluation, clinic care, a crisis service, a therapeutic day hospital for emotionally disturbed and truant adolescents, an adolescent and pre-adolescent after-school program, a language and learning disabilities unit, and the Early Childhood Center. Residents rotate within this division one half day a week for their entire PGY3 year, evaluating and treating children and their families. Residents receive individual supervision from Child and Adolescent attendings who also serve as mentors for those interested in pursuing further training in child psychiatry. This division provides a major site for training the Mount Sinai child and adolescent fellows each year.