UNIQUE CLINICAL SERVICES OF DEPARTMENT OF PSYCHIATRY

John Lauriello, M.D.Professor and Vice Chair

UNM Department of Psychiatry

DEPARTMENT OF PSYCHIATRY IS THE LARGEST PSYCHIATRIC GROUP IN THE STATE

• 70 Faculty members including the university and VA

• Provides Inpatient, outpatient, general hospital services and the only 24hr/7 days psychiatric emergency service in the state

• Child, adult and geriatric services• Addiction Services (both primary and dual)

UNIQUE SERVICES

• ACT• CENTER FOR RURAL & COMMUNITY

BEHAVIORAL HEALTH• CENTER FOR NEUROPSYCHOLOGICAL

SERVICES• MENTAL ILLNESS AND DEVELOPMENTAL

DISABILITY CLINIC (MI-DD)• FIRST and EARLY Programs

THE ASSERTIVE COMMUNITY TREATMENT (ACT)

• (ACT) Team is a clinical service established with the City of Albuquerque in Spring

of 2005. It is the first of its kind in NM

• ACT programs exist throughout the country and have been a model for the

intensive outpatient care of the sickest psychiatric patients (psychotic) for over

thirty years.

• Shown in many studies to reduce hospitalization and other negative outcomes for

these patients

• Multiple team members working with lower number of patients than in standard

clinics

• Direct care versus brokered care. Includes home visits

CENTER FOR RURAL & COMMUNITY BEHAVIORAL HEALTH

• Rural Psychiatry Training Program established in 1993• Critical community and state partnerships, including service,

consultation and training at rural primary care sites• Mission: To address health care disparities through:

– capacity building– training and workforce development – health services research and evaluation – increasing access to quality behavioral health services

• Programs– Rural Psychiatry & Behavioral Health Training– Telepsychiatry and Behavioral Health– Native American Behavioral Health – Behavioral Health Services Research and Evaluation– Integration of Primary Care and Behavioral Health

CENTER FOR NEUROPSYCHOLOGICAL SERVICES

• Clinical program of UNM Hospital and Psychiatry Dept.• Comprehensive inpatient and outpatient neuropsychological evaluation services

for children, adolescents, and adults Epilepsy, Dementia, TBI, Mental Retardation, Cerebral Palsy, Learning Disorders, Dyslexia, ADHD, Autistic Spectrum Disorders

Presurgical & postsurgical neuropsychological and sodium amytal testing for the UNM Epilepsy Surgery Program

• Neuropsychological consultation services for UNM TEASC/Adult Special Needs and Young Enduring Survivors Clinics and NM Office of Guardianship

• Research (including NIH-funded studies) in ADHD, TBI, Schizophrenia, Early-onset Psychosis, Substance Abuse, Juvenile Myotonic Dystrophy)

• Graduate, predoctoral internship, and postdoctoral fellowship training site in adult/pediatric neuropsychology

MENTAL ILLNESS AND DEVELOPMENTAL DISABILITY CLINIC (MI-DD)

• Serves patients who have DSM-IV Axis I conditions and varying severity of intellectual disabilities.

• As the tertiary care center for the state, expertise and breadth of clinical knowledge in intellectual or developmental disorders and neuropsychiatric disorders are an essential component of the comprehensive psychiatric services provided by the Department.

• The MI-DD clinic, provides ongoing care of 270 individuals.• Consultation to colleagues in other outpatient clinics or the inpatient units

are provided on a weekly ad hoc basis. • Consultation is provided to psychiatrists at local hospitals by a short term

clinical evaluation.• The staff reviews records and the clinical presentation of patients at the

request of state offices, such as the Department of Health Improvement or the Department of Health.

EARLY ASSESSMENT AND RESOURCE LINKAGE FOR YOUTH (EARLY)

• Partnership of UNM Psychiatry and MIND Research Network (MRN)– UNM Occupational Therapy– National training & support from RWJ sponsored PIER

project in Portland, Maine

• Earliest possible referral and screening for prodromal or pre-psychosis signs and sxs

• Outreach/Education/Decrease Stigma• Imaging • Early support components

– Multi-family group– Cognitive - Behavioral support– School/employment support– Medication as necessary

FIRST PROGRAM

• Partnership with the MIND Research Network– MGH and UMN

• Early identification, assessment and treatment of psychosis

• Establish optimal medication regimen for each patient

• Follow imaging parameters over the early course of the illness (structural, fMRI, and Spectroscopy)

• Attempt to restore and/or maintain level of functioning

• Follow course of the illness over the critical first years post diagnosis