Emergency and Consultation-Liason Psychiatry
Pediatric Emergency Psychiatry and Consultation/Liason Psychiatry
Child psychiatry trainees rotate on the C/L and Emergency Psychiatry service one day per week throughout their fellowship. They also are “on call” for this service from 9am to 5pm one weekend each month. Faculty consists of two Child and Adolescent Psychiatrist (Dr. Ghalib and Dr. Dobroshi) and one Social Worker (Mr. Wendt).
On the C/L service, clinical activities include consultation to medically ill children and their families and liaising with the pediatrics housestaff. Medical diagnoses of patients are wide-ranging; clinical services include general pediatrics, pediatric hematology-oncology, pediatric infectious diseases, and pediatric intensive care.. Psychiatric diagnoses of patients seen on the Consultation/Liaison service include full variety of Axis I diagnoses, including very common incidence of mood disorders, anxiety disorders, posttraumatic stress disorders, adjustment disorders, disruptive behavior disorders, substance use disorders and occasionally psychotic disorders and pervasive developmental disorders. Our residents also may be involved with the evaluations involving gang violence, physical and sexual abuse. They have chance to learn how to approach these challenging situations clinically and legally.
Residents relay relevant clinical recommendations for psychiatric findings and treatment to the primary pediatric team. Residents also provide short term treatment when indicated. Types of treatment provided include acute psychopharmacological management, brief cognitive-behavioral interventions, relaxation techniques, parent education and family counseling. Residents will interact with ancillary professionals including nursing, social workers, physical/occupational therapists, clergy, etc.
Residents in this rotation will have daily supervision and once a week group supervision in order to discuss cases with the whole team and ensure proper follow up. Every patient evaluated and treated on consultation /liaison service is also evaluated by an attending physician of record.
Emergency Service includes evaluations and management of children and adolescents in Pediatric Emergency Room of Harlem Hospital and occasionally in Comprehensive Psychiatric Emergency Services in the same location. The most common presenting problems are suicidal thoughts and actions, disruptive behavior disorders, anxiety and depressive disorders, child abuse and neglect, and school problems. The types of treatment provided include crisis-oriented interventions, psychopharmacological management, supportive therapy, family therapy, and referrals for psychosocial support services. All cases are discussed or seen with the attending prior to disposition. This rotation provides ample opportunities for crisis intervention, managing agitating, and negotiating complex systems of care.
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