Top Social Psychiatry Programs

[splik]

If you were looking for a list of programs that you were most likely to get drunk and have sex with your fellow residents or be hazed by senior residents by being forced to fellate a goat and then find your career in ruins after video of said event finds it way on YouTube, this is the wrong thread.

No, this is the rankings for programs in 'Social Psychiatry'.

Social Psychiatry is the branch of psychiatry concerned with the social and cultural determinants of mental health, the treatment of the chronic mentally ill in the community through a model of rehabilitation and recovery, using social interventions and residential alternatives to psychiatric hospitalization, and which advocates for the destigmatization, social inclusion and equality for the mentally ill, in particular those from the most disadvantaged and marginalized populations.

Same caveats apply as to previous rankings!

---

Members don't see this ad.

 

[splik]

Penn does some really fantastic work in mental health services research, health disparities, and health policy. There is also a community psychiatry track allowing for creation of a more social and community based training for those who are interested. Despite being excellent in these respects, too much of the outpatient rotations are at the ivory tower and there is little elective time in PGY-4 to maximize the experience so Penn falls to No. 10 (and could easily be replaced by Brown which also just falls short of the mark)

 

[splik]

New Haven may be a hotbed of crime and addiction, but for the same reasons it is also home to a large population of the seriously mentally ill. Like a Reagan-worshipping neoliberal nutjob they have had a history of doing a big steamy brown one on the poor so they fall to No. 9 but they are making commendable strides to rectify this today. Connecticut Mental Health Center, headed by a passionate and dedicated Director, offers an array of recovery oriented services for the chronically mentally ill, and they offer top fellowships in public psychiatry, addictions and forensics as well as an impressive inclusion of social psychiatry didactics in the curriculum. Not many social psychiatrists on the faculty here, they had to dig one out of retirement for my interview day, and as lovely as he was, he was so old all of the faculty he asked if I knew from my medical school were dead now…​

 

[splik]

Ahh… Longwood, like an overlooked child fighting to be seen over its siblings who are more prone to masturbation and other acts of self-love (MGH/McLean), more rebellious (Cambridge), or suffering from fecal incontinence (Southshore), they also offer exposure to the underserved through an array of innovative services at the Mass Mental Health Center. In addition to services for the homeless mentally ill, they also have a first-episode psychosis service, as well as vocational, rehabilitation and social skills training schemes. Residents get to participate in the Boston Healthcare for the Homeless Project (which admittedly in an MGH thing) which affords unparalleled exposure to the most marginalized group with complex psychiatric, substance abuse and medical comorbidity.

 

[splik]

This tiny program is most famous for attracting brilliant but work-shy medical students into its rank. However San Mateo County picks up the slack for the patients Stanford refuses to see in their clinics (i.e. poor people who actually have something wrong with them), and a tremendous job they do. This is a program that truly understands the meaning of recovery. They also do a wonderful job in advocating for mentally ill, and have an excellent anti-stigma initiative which propels them to No. 7.

 

[splik]

Whilst most of NYC’s psychiatry programs would rather train their residents to pander to the whiny meanderings of the worried well, NYU promises an immersion into the most psychotic, most disenfranchised, most socially excluded members of society. It is hard for even the most idealistic not to get cynical after a while, so it is not a surprise even many of those who started out aroused by social justice and public psychiatry find themselves in private practice. It helps that New York States seems keen on promoting the ideals of the recovery movement and helping the chronically ill back into work and into society.

 

[splik]

The only Ivy leaguer with a mediocre medical school and equally lackluster psychiatry department, Dartmouth leads the pack in innovation for community services in rural areas and increasing access the healthcare. The psychiatric research center does some truly fantastic research looking at psychosocial interventions and vocational rehabilitation for the severely mentally ill, and they have done a commendable job in rolling out mental health care through New Hampshire. Dartmouth is the place to be for those who get a boner thinking about the plight of the rural underserved, but don’t believe in paying taxes…

 

[splik]

UW is the only medical school for 5 states and they take it upon themselves to provide psychiatric services in rural areas, and roll out models of collaborative care. They do some of the best health services research in the country, and the opportunity to carve out tracks in community and public psychiatry, work closely with family physicians, do rural electives, and get involved in telepsychiatry and health services development. They also take health disparities very seriously and some very exciting academic and clinical work in the area. With a large LGBT community, and a strong LGBT mental health movement in the State, UW also has some impressive services for this population at Harborview. Despite being predominantly full of pasty white folk, they do a good line in cultural sensitive services, with a cultural psychiatry track and the opportunity to international electives should medical voluntourism i.e. waving at starving people who need food not psychiatry take your fancy. Washington, being as liberal as it is, has some of the most progressive laws that reduce coercion in psychiatric practice.

 

[splik]

SF has plenty of urban underserved and a high proportion of these disadvantaged souls have serious mental illness. UCSF has a fantastic track record in public and community psychiatry and even have inpatient teams divided by patient ethnicity. In addition to developing strong cultural competence, there are opportunities to develop interests in women’s health, HIV psychiatry and LGBT mental health through the fantastic array of clinical services and more outpatient focus than many residency programs. The Bay Area is home to many critical theorists, social realists and social constructivists.

 

[splik]

UCSD is one of the most biological departments of psychiatry in the country, and yet they still do a phenomenal amount in providing for the underserved and training residents to work with these populations. Through the family medicine/psych residency they have an enduring commitment to training primary care physicians to deal with the burgeoning mentally ill in their clinics. And they have a public psychiatry fellowship. It helps that California is unusual in being comparatively generous in its provision of mental health care to residents, although still short of the mark. Most brownie points goes to their St Vincent's de Paul clinic where they provide treatment to the medically underserved including a burgeoning homeless population. San Diego has been home to many a reengage psychiatrist, most notably Loren Mosher (who was on the UCSD faculty until his death), who famously resigned from the American Psychiatric Association and promoted non-hospital residential alternatives for psychotic crises.

 

[splik]

Cambridge Health Alliance looks like a Freud convention, but you could easily talk about Foucault, Levi-Strauss, or Marx here and be in good company. Physicians are paid based on patient satisfaction ratings, so you can bet even malingerers are treated like maharajas here. There is an enduring commitment to social justice, activism, health disparities, and a promotion of cross-cultural and LGBT health. They have a diverse array of clinical services, and community-based rotations from as early as intern year. The array of patient-oriented clinical services here is phenomenal. Future leaders in public service can avail themselves of an MPH or MPA at Harvard. The doyen of cross-cultural psychiatry, Arthur Kleinman is on the faculty here.

 

[NoNoNoNo]

This was so exciting for me to watch "roll out" one by one. Hah. I never like awards or rankings or lists, but this one was up my alley.

I am going to comment and ask questions about some of them when I get a chance. Which may be now...

 

[NoNoNoNo]

Penn does some really fantastic work in mental health services research, health disparities, and health policy. There is also a community psychiatry track allowing for creation of a more social and community based training for those who are interested. Despite being excellent in these respects, too much of the outpatient rotations are at the ivory tower and there is little elective time in PGY-4 to maximize the experience so Penn falls to No. 10 (and could easily be replaced by Brown which also just falls short of the mark)

Totally agree with those strengths and weaknesses. If anyone is wondering I believe 25% of the general clinics can be based in the community, but still, I do think the residency training is limited in this respect (even if maybe the research isn't).

 

[NoNoNoNo]

New Haven may be a hotbed of crime and addiction, but for the same reasons it is also home to a large population of the seriously mentally ill. Like a Reagan-worshipping neoliberal nutjob they have had a history of doing a big steamy brown one on the poor so they fall to No. 9 but they are making commendable strides to rectify this today. Connecticut Mental Health Center, headed by a passionate and dedicated Director, offers an array of recovery oriented services for the chronically mentally ill, and they offer top fellowships in public psychiatry, addictions and forensics as well as an impressive inclusion of social psychiatry didactics in the curriculum. Not many social psychiatrists on the faculty here, they had to dig one out of retirement for my interview day, and as lovely as he was, he was so old all of the faculty he asked if I knew from my medical school were dead now…​

Definitely one of the only places that forthrightly includes social didactics. There are also various elective courses residents can take in social and community psychiatry (with recovery, anti-stigma, self-disclosure, citizenship elements) etc.

CMHC does have interesting recovery services, and residents not only do various rotations and electives there but also can be 100% based out of there for their outpatient year. Since the VA is another option for a lot of rotations and electives, it is important to know that the West Haven VA has a wealth of recovery and social services (vocational, housing first, etc.). And that VA seems a bit more academic than other VAs (everyone is Yale faculty etc.) and regarded as a good place to train and work.

Interestingly, Yale also has the Program for Recovery and Community Health (worth googling the website) which offers great resources and research, though I'm not sure how much access one could have as a resident. On the other hand, Yale has so much elective time that almost anything can be worked out.

 

[NoNoNoNo]

This tiny program is most famous for attracting brilliant but work-shy medical students into its rank. However San Mateo County picks up the slack for the patients Stanford refuses to see in their clinics (i.e. poor people who actually have something wrong with them), and a tremendous job they do. This is a program that truly understands the meaning of recovery. They also do a wonderful job in advocating for mentally ill, and have an excellent anti-stigma initiative which propels them to No. 7.

Damn, I should have applied...

 

[NoNoNoNo]

The only Ivy leaguer with a mediocre medical school and equally lackluster psychiatry department, Dartmouth leads the pack in innovation for community services in rural areas and increasing access the healthcare. The psychiatric research center does some truly fantastic research looking at psychosocial interventions and vocational rehabilitation for the severely mentally ill, and they have done a commendable job in rolling out mental health care through New Hampshire. Dartmouth is the place to be for those who get a boner thinking about the plight of the rural underserved, but don’t believe in paying taxes…

Good research under Bob Drake's group.

A PhD researcher there just left Dartmouth to lead BU's Center for Psych Rehab.

 

[NoNoNoNo]

UW is the only medical school for 5 states and they take it upon themselves to provide psychiatric services in rural areas, and roll out models of collaborative care. They do some of the best health services research in the country, and the opportunity to carve out tracks in community and public psychiatry, work closely with family physicians, do rural electives, and get involved in telepsychiatry and health services development. They also take health disparities very seriously and some very exciting academic and clinical work in the area. With a large LGBT community, and a strong LGBT mental health movement in the State, UW also has some impressive services for this population at Harborview. Despite being predominantly full of pasty white folk, they do a good line in cultural sensitive services, with a cultural psychiatry track and the opportunity to international electives should medical voluntourism i.e. waving at starving people who need food not psychiatry take your fancy. Washington, being as liberal as it is, has some of the most progressive laws that reduce coercion in psychiatric practice.

Entirely agreed.

Also I think they have both rehabilitation and recovery rotations.

 

[NoNoNoNo]

SF has plenty of urban underserved and a high proportion of these disadvantaged souls have serious mental illness. UCSF has a fantastic track record in public and community psychiatry and even have inpatient teams divided by patient ethnicity. In addition to developing strong cultural competence, there are opportunities to develop interests in women's health, HIV psychiatry and LGBT mental health through the fantastic array of clinical services and more outpatient focus than many residency programs. The Bay Area is home to many critical theorists, social realists and social constructivists.

Agreed about the strong cultural and public focus, though I have a hard time telling how much recovery (no one seemed familiar with the language itself) or empowerment oriented practices there are. I would be interested if anyone knows...? And agreed about the Bay Area being a good home for the critical mind and eye (and hoping it carries into the residency). I wish that there was more community option for outpatient instead of LP 3rd year (you can do 1/2 day of high risk OB)...

 

[NoNoNoNo]

Cambridge Health Alliance looks like a Freud convention, but you could easily talk about Foucault, Levi-Strauss, or Marx here and be in good company. Physicians are paid based on patient satisfaction ratings, so you can bet even malingerers are treated like maharajas here. There is an enduring commitment to social justice, activism, health disparities, and a promotion of cross-cultural and LGBT health. They have a diverse array of clinical services, and community-based rotations from as early as intern year. The array of patient-oriented clinical services here is phenomenal. Future leaders in public service can avail themselves of an MPH or MPA at Harvard. The doyen of cross-cultural psychiatry, Arthur Kleinman is on the faculty here.

Also agreed, though not sure how much - again - recovery oriented, specifically, information there is. I do know that more is trying to be in the works, though they've also lost recent services (like some homeless outreach, I believe) due to funding issues. Overall, this is the one I think in theory I should like the most, but I"m unsure about Boston/Cambridge and find the analytic bent a little odd in combination (though it's probably very good for training).

 

[splik]

Recovery is the new buzzword for what used to be known as 'rehabilitation' - which was based on the idea of working with the strengths that individuals with chronic mental illness had and helping to maximise those functional strengths. For the most part the concept of 'recovery' laudable as it is, is a lot of hot air that promises everything and delivers nothing. People think of recovery as meaning cure or restitution, but the 'recovery movement' defines it as a journey, as if the goal itself is pessimistically unachievable.

 

[NoNoNoNo]

Recovery is the new buzzword for what used to be known as 'rehabilitation' - which was based on the idea of working with the strengths that individuals with chronic mental illness had and helping to maximise those functional strengths. For the most part the concept of 'recovery' laudable as it is, is a lot of hot air that promises everything and delivers nothing. People think of recovery as meaning cure or restitution, but the 'recovery movement' defines it as a journey, as if the goal itself is pessimistically unachievable.

I guess I see the difference between recovery and rehabilitation as....rehab being what you say. But recovery adding a little bit more of a political agenda...anti-stigma, self-disclosure, consumer empowerment. I see rehab as maximizing strengths, yes, through things like vocational skills training etc. but see recovery as a bit more. But that is just my personal sense.