BronxCare’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.
Collaborative Care, an evidence-based model of integrated behavioral health care, is now in place at six BronxCare primary and family medicine practices. It expands the scope of primary care to provide effective, team-based treatment for common conditions, such as depression and anxiety, without referral to specialty mental health care. It has become the gold standard for depression care and is linked to 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.
Currently, the Department has three Adult Inpatient Psychiatric Units and one Child and Adolescent Inpatient Psychiatric Unit. On the medical units, the Psychosomatic Medicine service works closely to manage acute psychiatric issues. A variety of therapeutic modalities are practiced. The emphasis is on collaborating with multidisciplinary teams, with a focus on the bio-psycho-social-cultural and spiritual model. Inpatients are discharged to outpatient services at BronxCare practices, as well as its community partners. Peer Specialists and Community Health Workers have also recently joined the staff. As a result of their efforts, recovery is promoted, and social networking, through role modeling and activation, as well as continuing education is enhanced.
There are two Adult Outpatient Psychiatry practices and a Child and Adolescent practice (Child Study Center), all of which provide comprehensive mental health services to the community. Services include psychiatric evaluation and psychopharmacological interventions, as well as individual, group, and family therapy. Outpatient services see about 5,000 individual patients, with 233,000 visits a year. Practice hours are available on Saturdays and late evenings, providing more flexibility to patients. Psychiatrists, Nurse Practitioners, Licensed Practical Nurses, Social Workers, and License Creative Arts Therapists provide high quality care. “We also partner with our Behavioral Health Care Coordination Program to assist high risk patients in managing medical and psychiatric care,” stated Dr. Shah. Care Coordinators often reach out to their patients’ homes, accompany them on important appointments, and work with the team to ensure patients receive all their care.
The Comprehensive Psychiatric Emergency Program (CPEP) provides services for more than 7,000 psychiatric emergencies annually. Its Mobile Crisis Team has recently expanded and is responding to an additional 1,200 emergent problems annually across the Bronx. The team also tries to visit patients discharged from the inpatient service within seven days, which is beneficial in terms of reducing readmission rates.
BronxCare’s Life Recovery Center is one of the few facilities in New York State to combine inpatient, outpatient, and resident treatment programs for individuals with chemical dependency problems. The Life Recovery Center includes an inpatient program consisting of 20 detoxification and 25 rehabilitation beds. Medication-assisted treatment, an opioid treatment program, and an impaired driver program, as well as individual and group counseling (with day and evening hours), are also part of the wide-ranging services provided. Evidence-based treatments designed to help individuals identify substance abuse triggers and also develop the skills needed to return to a productive lifestyle are utilized. There is also a Community Residence within the Life Recovery Center that offers individuals a stable living environment during recovery. It includes individual bedrooms, with private bathrooms. Many of the Life Recovery Center patients have medical problems that must also be addressed. Physicians, nurses, and support staff provide these services at the inpatient and outpatient levels.
BronxCare’s Department of Psychiatry was recently selected as a New York City Zero Suicide grant site. This grant is a five year, first-ever initiative 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 health care settings.
“Mind and body both are crucial aspects of health; a clinician needs to always address both to get optimal outcomes of treatment.”