Inpatient Compared to last year there was an of an increased number of admissions and a decreased length of stay. The major initiative on the unit was a project led by Dr. Ewald Horwath to decease the use of restraint and seclusion in favor of less restrictive measures when managing agitated and potentially violent patients. The year 2000 showed a dramatically decreasing trend in the number of patients placed and number of patient hours spent in restraint or seclusion.

Outpatient All four outpatient programs had certification site visits and received the maximum three-year operating certificates. The long awaited Special Needs Plan (SNP) could not be implemented by New York State, and the clinics continue to function largely on a fee-for-service model. About a quarter of WHCS patients remain enrolled in the Prepaid Mental Health Plan (PMHP).

Among the increased programming at the clinics were the establishment of new multiple family and sibling groups, more culturally diverse holiday celebrations, the creation of patient art and handicraft shows, computer classes, and a continuing expansion of the transitional work program.

Two new psychiatrists joined the service, Dr. Melissa Dubroff, as an attending psychiatrist on the PI-4 South community Service inpatient unit and Dr. David Ott, as an attending psychiatrist at the Inwood Clinic. Dr. Peter Bookstein transferred from the inpatient unit to the Inwood Clinic, and Dr. Scott Masters left the Inwood Clinic to become director of the psychiatry residency training program at St Lukes-Roosevelt Hospital. Dr. Gurstin Goldin, a part-time psychiatrist who supervised staff and students for many years at the Audubon Clinic, died of cancer. Several nurses left, including Treena Tan, Elizabeth White, and Margaret White. A new Spanish-speaking social worker, Rosa Sorondo, began work at the Inwood Clinic.

 

WHCS now conducts and/or participates in a large number of research projects. These include the following: early psychosis and substance use (with Carol Caton); health care service use among HIV-infected patients with severe mental illness (with the RAND corporation); interventions to reduce the transmission of HIV and other sexually transmitted infections for men (with Ezra Susser and Dan Herman) and women (with Pamela Collins) who have severe mental illness; smoking cessation in patients with schizophrenia (with Maria Sullivan); olanzapine treatment of marijuana and/or cocaine abusing patients with schizophrenia or schizoaffective disorder (with Evaristo Akerele).

The Columbia University HIV Training Project entered its ninth year and has trained nearly 20,000 mental health care providers about the mental health aspects of HIV/AIDS. Our project also took the lead in developing instruments and protocols for the Center for Mental Health Services multisite evaluation on the quality and impact of HIV/AIDS training. Several grant staff participated in training mental health care providers in South Africa as part of a project headed by Dr. Pamela Collins. Grant staff have also been extensively involved with the American Psychiatric Association on new educational products including the Practice Guideline for the Treatment of Patients with HIV/AIDS. Staff of the Sexual Behavior Clinic provided intensive training for staff throughout New York State who were beginning new programs for adolescents sex offenders. All of the many WHCS student programs continued.