Educational Objectives :
The Community Psychiatry rotation at the Brockton Multi-Service Center (BMSC) is intended to provide residents with experience in making a comprehensive biopsychosocial assessment of patients in the community psychiatry setting, formulating individualized treatment plans for outpatients, working effectively with a multidisciplinary outpatient itreatment team, and treating and monitoring patients using various forms of somatic therapy and psychotherapy. In addition, a formal didactic component broadens residents’ understanding of mental health care delivery in community-based clinics. The Community Mental Health rotation at the Dr. John C. Corrigan Mental Health Center is intended to provide residents with experience in making a comprehensive biopsychosocial assessment of patients in the community psychiatry setting. Residents develop skills in acute care and integrated inpatient-outpatient treatment in a community-based setting.
Description of Rotation :
PGY-III residents spend a required 1-year rotation (1/2 day/5 hours/week) either at Brockton Multi-Service Center or the Corrigan Mental Health Center. The Brockton Multi-Service Center is a facility of the Massachusetts Department of Mental Health (DMH) Southeastern Area network. This DMH-funded facility serves as a catchment area that includes Brockton and surrounding towns. The center is a fully-accredited Joint Commission facility.
Residents evaluate, diagnose, and treat clients in the Intake Department, the Outpatient Clinic, and in Emergency Services. Residents spend a half-day a week in the outpatient clinic, seeing their patients every 2-4 weeks for pharmacotherapy and/or weekly for individual therapy. At the Center’s Intake Department, residents are the first to provide comprehensive assessments of clients who have just been made eligible for DMH services; residents will follow some of these clients throughout the year with regular participation in the client’s treatment team. During the rotation, residents also spend a half-day or more a month working in Emergency Services, where they evaluate, diagnose, and treat patients in crisis and make decisions about disposition under supervision. Residents also have the opportunity to visit the various community programs at the center and in the community, including Program for Assertive Community Treatment (PACT teams), residential programs, and the peer-run Club House. Supervision is provided for intake, psychopharmacology, psychotherapy and crisis work. A seminar series on topical issues in community psychiatry is also held on a monthly basis.
PGY-III residents spend a required, one-year rotation (1/2 day per week) at the Corrigan Mental Health Center. The Dr. John C. Corrigan Mental Health Center in Fall River, MA is a DMH-funded facility serving a catchment area that includes Fall River, New Bedford, and surrounding towns. The Center is a fully accredited, JCAHO facility that provides a variety of training experiences. The Center has, among its multiple facilities, a busy Crisis or emergency services unit which operates on a 24-hour basis; a locked Inpatient Unit with 16 beds; and a Day Treatment rehabilitation unit (Partial Hospital Program) which has a capacity of 20 beds. Residents rotate in the Crisis Intervention Service/Urgent Care and the Day Treatment Rehabilitation Unit (Partial Hospital Program).
The Crisis Intervention Service/Urgent Care is staffed by two full-time psychiatrists who have extensive experience in the area of crisis intervention and assessment. Urgent Care is a crisis unit-related outpatient clinic where clinical evaluations, initial treatment and referrals are completed. Residents’ clinical supervision is supplemented by case-based teaching thru “mini-lectures” addressing relevant topics. The Resident learns skills necessary for rapid assessment, differential diagnosis, formulation, clinical planning and intervention. Residents work in this service seeing new patients under the supervision of an attending psychiatrist.
A parallel component of this rotation is the Partial Hospital Program. The Partial Hospital program is designed as a step-down to hospitalization both for patients coming from the Crisis Unit and for patients who might enter the hospital or come out of the hospital. The program is organized around medical and recovery-oriented interventions involving individual assessment and management. The resident performs assessments on admissions to the Partial Hospital program. S/he participates in varied activities which include assisting or leading group sessions and providing brief individual therapy to patients who need additional support beyond that provided by group meetings. The resident also attends family meetings and interdisciplinary treatment meetings that may occur in the course of care for an individual in the program. This part of the rotation provides an opportunity to follow a patient for longer periods.
The rotation provides an opportunity for supervision of individual cases with one of the Attending supervisors. Supervision involves review of relevant clinical issues and fosters understanding of the nature of community patient problems.