Episode Description:

Dr. Margie Balfour and Dr. Rob Gadomski discuss key takeaways from the Crisis and Emergency Services chapter of the Textbook of Community Psychiatry including the 988 Suicide and Crisis Lifeline, differences in crisis response by state, the role of law enforcement in managing mental health crises, and more!

Timestamps:

00:10 Introductions

01:49 988 Suicide and Crisis Lifeline

08:30 Components of the Ideal Mental Health Crisis System

14:31 Differences of Mental Health Crisis System by State

17:19 Law Enforcement Involvement in Mental Health Crisis

23:54 Measuring Success in Crisis Systems

33:29 Final Thoughts

Roadmap to the Ideal Crisis System

Purchase the Textbook of Community Psychiatry

Created by the American Association for Community Psychiatry (AACP).

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Guest:

Margie Balfour, MD, PhD is a psychiatrist and national leader in crisis care, quality improvement, and law enforcement responses to behavioral health emergencies. She is Chief of Quality and Clinical Innovation at Connections Health Solutions and an Associate Professor of Psychiatry at the University of Arizona. Dr. Balfour was named Doctor of the Year by the National Council for Mental Wellbeing for her leadership at the Crisis Response Center in Tucson, Arizona, and received the Sam Cochran Criminal Justice award from the National Alliance on Mental Illness for her work to help law enforcement better serve people with behavioral health needs. She co-authored Roadmap to the Ideal Crisis System: Essential Elements, Measurable Standards, and Best Practices, and her work on crisis outcome measurement has been cited as a national standard. Dr. Balfour is a Distinguished Fellow of the American Psychiatric Association and serves on the APA Council on Quality of Care. She has also served on the boards of the American Association for Community Psychiatry, American Association for Emergency Psychiatry, and numerous expert panels for SAMHSA, the DOJ, and others. A native of Monroe, Louisiana, Dr. Balfour received a BA in Biology at Johns Hopkins University and then her MD and PhD in Neuroscience from the University of Cincinnati. She completed residency and fellowship in Community Psychiatry at the University of Texas Southwestern Medical Center in Dallas.

Host:

Rob Gadomski, DO is the Deputy Medical Director of Psychiatric Services at Project Renewal, Inc and a graduate of the Columbia Public Psychiatry Fellowship in June 2022. He works primarily with homeless and marginalized individuals in the New York City area. He went to the Philadelphia College of Osteopathic Medicine for medical school and completed his psychiatry residency training at Einstein Medical Center in Philadelphia before moving to NYC, where he gathered an interest in working with homeless populations and individuals interacting with the criminal legal system.

Editor:

Daniel E. Carvallo-Ruiz, M.D.

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Dr. Joanna Fried and Dr. Brice Reynolds discuss Janian Medical Care, the Manhattan Outreach Consortium, the NYC311 app, their roles as homeless outreach psychiatrists in New York City, and more!

Timestamps:

00:10 Introductions

00:46 Janian Medical Care

01:46 ACT and IMT Teams

03:02 Manhattan Outreach Consortium

10:20 Typical Week of a Homeless Outreach Psychiatrist

23:50 Advice for Trainees

Janian Medical Care

NYC311 App

Created by the American Association for Community Psychiatry (AACP).

Free AACP Membership for Medical Students, Residents, and Fellows | Instagram | Twitter | Listener Survey | Follow, review, and share!

Guests:

Joanna Fried, MD earned her M.D. at the Columbia University College of Physicians and Surgeons and completed residency training at New York University Medical Center where she was a Chief Resident. She completed fellowship training at Columbia University Public Psychiatry Fellowship and did her clinical placement with Janian/PPOH before joining PPOH as a staff psychiatrist in July 2010. She is a Medical Director for PPOH as well as Medical Director for the Manhattan Outreach Consortium. Dr. Fried is a Clinical Instructor at New York University Medical School. She provides psychiatric care to clients of street outreach teams in Manhattan.

Brice Reynolds, MD is the Assistant Medical Director for Psychiatry at Janian, an NYC-based nonprofit group practice for psychiatry for the homeless. Through Janian, he practices psychiatry on the Harlem-based Goddard ACT team, shelter psychiatry based in Seafarers Safe Haven near Union Square, and street outreach with Breaking Ground as part of the Manhattan Outreach Consortium. He also leads residency recruitment, billing, and is part of the Janian leadership team. Dr. Reynolds was previously a Columbia Public Psychiatry Fellow and served as chief resident at The Mount Sinai Hospital. When he's not biking around the boroughs to meet with patients, he sometimes finds time to learn piano, practice improv comedy, and care for his family’s chickens.

Host:

Angela Liu, MD is a third-year psychiatry resident and Chair of the APA Public Psychiatry Fellowship.

Editor:

Zoe Wyse is a third-year medical student.

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Judge Steve Leifman discusses the intersection of the criminal-legal system and mental health, advocates for systemic changes to reduce the criminalization of severe mental illness, and highlights diversion and treatment programs, including the Miami Center for Mental Health and Recovery.

Timestamps:

00:10 Introductions

03:11 Mental Healthcare and the Criminal System

06:18 Crisis Intervention Teams

09:15 Diversion Programs

13:35 Miami Center for Mental Health and Recovery

22:40 Final Thoughts

Miami Center for Mental Health and Recovery

Judges and Psychiatrists Leadership Initiative

Mental Health Professionals’ Guide to Their Role in the Criminal Justice System

Created by the American Association for Community Psychiatry (AACP).

Free AACP Membership for Medical Students, Residents, and Fellows | Instagram | Twitter | Listener Survey | Follow, review, and share!

Guest:

Judge Steve Leifman is the Associate Administrative Judge of the Miami-Dade County Court Criminal Division. He previously served as Special Advisor on Criminal Justice and Mental Health for the Supreme Court of Florida and currently chairs the Florida Supreme Court’s Steering Committee on Problem Solving Courts. Judge Leifman is the co-chair of the American Bar Association Criminal Justice Mental Health Committee and co-chair of the Judges and Psychiatrists Leadership Initiative. He serves on the Florida Statewide Task Force on Opioid Abuse, the Florida Drug Policy Advisory Council, and the National Institute on Drug Addiction’s (NIDA) Justice Community Opioid Innovation Network. Judge Leifman is a member of the Group for the Advancement of Psychiatry (GAP), a Lecturer in Psychiatry at Columbia University Vagelos College of Physicians and Surgeons and a Voluntary Assistant Professor of Psychiatry and Behavioral Sciences at the University of Miami School of Medicine. Judge Leifman was appointed to serve on the Conference of Chief Justices and Conference of State Court Administrators National Judicial Task Force to Examine State Courts Response to Mental Illness and the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) established by the 21st Century Cures Act. In 2015, Judge Leifman received the William H. Rehnquist Award for Judicial Excellence. One of the nation’s highest judicial honors presented by Chief Justice John G. Roberts Jr., the Rehnquist Award is presented annually to a state court judge who exemplifies judicial excellence, integrity, fairness, and professional ethics. Judge Leifman is also the first recipient to receive the Florida Supreme Court Chief Justice Award for Judicial Excellence (2015). He was named a 2016 Governing Magazine Public Official of the Year. More recently, Judge Leifman was awarded the 2020 Dade County Bar Association (DCBA) David W. Dyer Professionalism Award, the 2018 Pardes Humanitarian Prize in Mental Health, the 2019 Yale-NAMI Mental Health Advocacy Award and a 2019 Presidential Commendation by the American Psychiatric Association. On October 22, 2023, Judge Leifman was bestowed the Papal Medal Benemerenti from Pope Francis by Archbishop Thomas Wenski for his work in the judicial system on behalf of people with mental illnesses. Judge Leifman has authored and published numerous articles and has been featured in many national and local television programs, radio programs, and articles regarding mental health and the criminal justice system. His most recent co-authored article was published in the Atlantic Magazine on May 30, 2022. Judge Leifman is the subject of the Documentary, The Definition of Insanity which aired nationally on PBS on April 14, 2020 - https://doifilm.com/

Host:

Angela Liu, MD is a second-year psychiatry resident and APA Public Psychiatry Fellow.

Editor:

Gabriel Allaf is a fourth-year medical student.

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