Department of Psychiatry

About the Department of Psychiatry

The Department of Psychiatry at Brigham and Women's Hospital, a teaching hospital of Harvard Medical School, is a vibrant team of experts with a mission to advance the care of those suffering with mind-brain disorders through clinical, research and educational innovation and excellence.

Psychiatry is undergoing a tremendous transformation in which underlying mechanisms of mind-brain disorders are being identified, and associated, evidence-based treatments are being enhanced. This reduces the misunderstandings regarding mental illnesses, and increases hope for the large numbers of patients and families who suffer with difficulties in thought, feelings and behavior. It also provides exciting opportunities for fulfilling academic medical careers.

Our Department is helping to define the leading edge of such progress, particularly regarding psychiatric problems associated with medical illness. This tradition of medical psychiatry permeates the Department's evolution, from a hospital-based service within the Department of Medicine to a strong academic clinical department spanning Brigham and Women's Hospital (BWH) and Brigham and Women's Faulkner Hospital (BWFH).

Our department is an integral part of the Neurosciences Center, spanning the departments of psychiatry, neurology, neurosurgery, neuroradiology, and (neuro)pathology; and integrating clinical, research and educational activities at the interface of these fields. The Center has a particular focus on the scientific development of translational, mechanistic diagnostic biomarkers and targeted therapeutics, leading to personalized brain-mind medicine. Patients and families benefit from streamlined access to leading clinical experts and new treatments at the interface of these fields, while the next generation of clinical neuroscientific leaders is trained in a stimulating, collegial academic medical environment that transcends traditional boundaries.

Now the Department is deepening and extending its focused mission, with specific sub-specialty emphases and clinical-research-educational integration across sites and services. They are focused in seven key areas:

Medical Psychiatry

The Medical Psychiatry (Consultation-Liaison) Division, directed by Dr. David Gitlin, is renowned for its mastery of the diagnosis and management of psychiatric problems that occur in the context of the full range of medical and surgical illnesses. These can include the co-occurrence of psychiatric and medical illness, the psychiatric co-morbidity associated with the pathophysiological aspects of medical conditions, and the psychological reactions to medical illness and associated stressors. The Division provides award-winning emergency psychiatry services in the emergency departments of both BWH and BWFH. The Medical Psychiatry consultation service has a major fellowship program with five trainees per year, and provides a key site for residency training.

The Ambulatory (Outpatient) Division, offers contemporary, evidence-based psychiatric evaluations and treatments for patients with psychiatric difficulties in the context of medical illness and care. A multidisciplinary team including psychiatry, psychology, and social work provides balanced, patient-centered care, with psychopharmacology and psychotherapy (including cognitive-behavioral, skills-based, psychodynamic, and group). It also provides a robust teaching environment for our outstanding residents.

There is extensive research concerning medical psychiatry conditions/treatments, clinical trials, somatoform disorders, computer technology/e-behavioral health, and brief interventions.

Collaborative care models are implemented, integrating behavioral health in the primary care medical home.

Neuropsychiatry

The Neuropsychiatry Division includes dual-trained psychiatrists/neurologists and neuropsychiatrists, and is now integrated with Cognitive and Behavioral Neurology, as well as our Neuropsychology program. This combined, highly-expert team is now known as the Brigham and Women's Center for Brain/Mind Medicine (CBBM). The Center performs comprehensive evaluations of complex diagnostic conditions at the interface of psychiatry and neurology. The Center also provides multidisciplinary treatment for psychiatric aspects of neurologic disorders. It has a vibrant educational program for trainees at all levels, including a neuropsychiatry/behavioral neurology fellowship. Associated translational research spans psychiatry, neurology, neurosurgery, neuroradiology and neuropathology, in the context of the BWH Neurosciences Center. Such research includes functional neuroimaging, neuroprotection and repair, neurogenesis, and neuromodulation including transcranial magnetic stimulation (please see departmental research descriptions).

Women's Mental Health

The Division of Women's Mental Health is a broad and encompassing clinical division providing clinical services to women with mental health conditions including management of psychiatric disorders during reproductive life transitions. The Division has affiliated research programs to advance our understanding and treatment of mental health conditions in women. The Division is directed by Dr. Hadine Joffe, a nationally-recognized leader in women's mental health. Dr. Joffe's clinical and research focus is on menopause-related conditions, whether age related or cancer/treatment related, as well as reproductive consequences of psychiatric medications. She treats patients with depression and other menopause-related symptoms and is the Director of the Women's Hormones and Aging Research Program, where she conducts clinical research studies.

The Division of Women's Mental Health has extensive psychiatry services for women during pregnancy and the postpartum period, conducted in close collaboration with the Department of Obstetrics and Gynecology at BWH, one of the top OB/GYN departments in the country with approximately 6,000 births per year. Perinatal psychiatry services include an integrated consultative service to the Maternal Fetal Medicine program, lead by Dr. Leena Mittal, Director of the Reproductive Psychiatry Consultation Service. The Division includes an integrated women's mental health service for primary care and subspecialty female patients seen in the Fish Center for Women's Health at Brigham and Women's Health Care Center in Chestnut Hill. In addition, the Division provides women's mental health services for women planning pregnancies, experiencing mental health problems during and after pregnancy, menopause, and in the context of infertility, hormonal contraceptive treatments, breast cancer therapies, and addiction. Outpatient services are provided at BWH, BWFH, and the Dana-Farber Cancer Institute. The Division offers a Women's Mental Health fellowship, as well as the opportunity to focus on OB/GYN liaison within our Medical Psychiatry (Community-Liaison) fellowship, and other educational rotations for fellows, residents, and medical students.

The Division is affiliated with the BWH Connors Center for Women's Health and Gender Biology and the research arm of the Connors Center, which is directed by Dr. Jill Goldstein, who performs leading research on the neurobiology of sex differences in mental and other health conditions.

Psychosocial Oncology
This program is a leader in clinical, educational and research aspects of psycho-oncology and palliative care. Please see the Psychosocial Oncology Program for further information.
Addiction Psychiatry
Addictions, alone, or in combination with psychiatric and/or medical illness, represent a widespread and difficult problem. Our department has a comprehensive spectrum of addictions services, ranging from an inpatient consultation service at BWH, directed by Dr. Joji Suzuki, within the Medical Psychiatry Division, to inpatient detox, partial (day) hospital, suboxone and day and evening outpatient continuity of care at BWFH. Dr. Joji Suzuki directs addictions and services research, working closely with the clinical teaching services.
Geriatric Psychiatry
In the context of the medical focus, and with the aging population, the department has a strong program in geriatric psychiatry. Drs. Olivia Okereke, Geena Athappily, Catherine Gonzales and Nancy Donovan are all sub-specialty geriatric psychiatrists and Dr. Abby Altman is a geropsychologist. They have additional expertise in geriatric depression, (post) menopausal syndromes, late-life psychosis, and dementia, respectively.
Primary Psychiatric Illness
Patients with primary mood, psychotic and anxiety disorders receive care in the outpatient settings of BWH and BWFH, particularly in the context of concurrent medical illness and treatment. At BWFH, we have an adult inpatient psychiatry clinical/teaching unit, directed by Dr. John Fromson, providing exceptional care for acutely and severely ill psychiatric patients. We also have a partial (day) hospital program that provides associated intensive care for those who are significantly ill and/or in crisis, who do not need hospitalization.
Research

The department's research is vibrant and rigorous, spanning the clinical content areas noted above, and integrating the following approaches:

  • Functional and Structural Neuroimaging
  • Basic Neuroscience
  • Genetics/Genomics
  • Translational Therapeutics (including neuromodulation/stimulation, neuroprotection, neurogenesis, neurorepair and hormone studies)
  • Clinical Services Research
  • Cohort studies

Please see the departmental research section for a description of laboratories, investigators, and programs.

Education

We are a leader in educational programs to train future leaders in psychiatry. Our programs include: Clinical Fellowships in Psychosomatic Medicine, Neuropsychiatry/Behavioral Neurology, Women's Mental Health, and Neuropsychology. We also offer geriatric and addiction fellowships, that we participate in together with McLean Hospital and Massachusetts General Hospital, members of Partners HealthCare.

The Brigham and Women's/Harvard Medical School Psychiatry Residency Program is recruiting for our inaugural residency class, which will begin training in Summer, 2017. Our program begins with an already strong legacy, built on the foundation of the Harvard Longwood Psychiatry Residency Training Program, and has many exciting innovations.

Harvard Medical School students doing their Principal Clinical Experience at BWH receive carefully-crafted psychiatry clerkship training in our department. A new part of the curriculum provides integration with neurology and neuroradiology clerkships at BWH. Electives in our specialty areas are offered as well. Our faculty work with those of our sister departments in other HMS-affiliated hospitals to develop and teach the first and second year courses.

Affiliations

The department is also a charter member of the National Network of Depression Centers (NNDC), a newer organization of leading academic medical institutions joined in a nationwide effort to advance the understanding and treatment of mood disorders. In this context, our BWH Center for Depression in Medical Illness includes faculty from our department as well as many other BWH departments with whom we work closely. The Center focuses upon the enhanced recognition and treatment of mood disturbances in the medically specialized areas outlined above.

We are part of Partners Psychiatry and Mental Health together with our sister psychiatry departments at Massachusetts General Hospital and McLean Hospital.

We also have two Community Mental Health Centers —Brookside Community Health Center and Southern Jamaica Plain Health Center, which provide a full complement of psychiatric services.

Commitment to the Community

The prevalence of psychiatric disorders and substance abuse is great, the suffering is poignant, and the socio-economic consequences are enormous. For this reason, as the department advances the field, it reaches out to the local, national and international community. Activities include:

  • Volunteering at the Native American Mental Health and Addiction Center;
  • Offering post-earthquake and tsunami mental health assistance in Japan;
  • Working with chronically mentally ill and homeless individuals through the Mass Mental Health Center;
  • Working with Massachusetts and other states to develop women's mental health services, and contributing to the BWH Birth Equity Initiative to reduce disparities in pre-term labor and its sequelae;
  • Working as part of the National Network of Depression Centers on national policy and program development regarding depression and bipolar disorder;
  • Leading public policy development on behalf of the American Neuropsychiatric Association;
  • Developing new programming for adolescent cancer survivors;
  • Working with patient/disorder advocacy groups;
  • Providing care in community mental health centers in disadvantaged communities;
  • Collaborating with Partners in Health to develop mental health educational initiatives for health care providers in developing countries.

Department of Psychiatry Video

Learn how the BWH Department of Psychiatry is advancing research to understand and treat mental illness.

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