PSYU-4057 - Mental Health Recovery in Galveston-Houston Area

PSYU-4057 - Mental Health Recovery in Galveston-Houston Area

Elective Type: career
Mental Health Recovery in Galveston-Houston Area
Course Number
Prerequisites: Successful completion of Year 2 
      Additional Requirements:
C-form required & successful completion of the Psychiatry Clerkship or by approval of the course director with recommendation by one other faculty in psychiatry. Contact Maricarmen Gonzalez-Montero (
Responsible Faculty Director:
Michael Miller, MD
Other Faculty:
Location to Report on First Day
7.408 Rebecca Sealy
Periods Offered
1-8,11, 12,14,15
excluding holiday periods 9 & 10
Maximum Enrollment

1. Understand community mental health resources for recovery.
2. Understand the importance of outreach, advocacy, and education about mental illness, developmental disabilities, and stigma.
3. Understand the role of client centered care and motivational interviewing.
4. Self-reflection about personal goals on advocacy and role of physicians outside of the clinical setting.
5. Appreciate the broader non-clinic environment of people with mental illness and development disabilities.

1. Compare and contrast the role of different professionals and patient partners for outreach, advocacy, and education; describe the importance of client-centered care.
2. Describe positive psychological characteristics and how the student can promote these to improve health.
3. Identify resources for future patients to improve quality of life, sense of community, and education about mental illness. Recognize the benefit of referral to these community resources.
4. Describe the stages of change and understand the utility of motivational interviewing.
5. Identify unmet need in the community and develop a project that benefits local mental health community.
6. Describe his or her own values regarding non-clinical, community resources in their future practice; reflect on any changed views about the stigma of mental illness and hope he or she has for patients with a psychiatric diagnosis.
7. Read and hear narratives about mental illness with a non-judgemental attitude.

Description of course activities
Students will actively participate at a minimum of two locations (of their choice) during this rotation: Community Clubhouse (St. Joseph House in mid-town Houston and Dona Marie Clubhouse in South Houston), Sunshine Center (development disabilities on Galveston Island), The Harris Center peer groups (formerly MHMRA), and/or Our Daily Bread (Galveston Island). The total hours per week are 32-40, including group supervision, face-to-face interactions with community centers, reading/research projects, and presentations to the community. AT community centers, students will attend peer groups, attend AA and NA meetings, sit and talk with people about their experiences with mental illness, and discuss with different personnel their role at the centers. Students will keep a journal through the rotation about their experiences, thoughts, and reflections. There will be prompted and unprompted writing assignments. Students are encouraged to put themselves in the shoes of the people they meet and consider the person''s narrative. To foster this, students will read at least one book focused on mental health and recovery. Every student will do at least one project during the rotation. The only requirement of the project is that it benefits the local mental health community. Examples include: presentations, community outreach, computer web design, digital storytelling, development of patient or staff materials about Positive Psychiatry, etc.
Required Reading: Jest, DV; Palmer, BW; Rettew, DC; Boardman, S (2015). Positively Psychiatry: Its Time Has Come; Journal of Clinical Psychiatry 76(6):675-683.
Suggested Text Readings (students can also suggest their own):
1. Darkness Visible, William Styron
2. No Color is My Kind, Thomas Cole
3. Devil in the Details: Scenes from an Obessive Girlhood, Jennifer Traig
4. Girl, Interrupted Susanna Kaysen
5. Jesus the Village Psychiatrist, Donald Capps
6. Gracefully Insane, Alex Beam
7. Another Bullshit Night in Suck City, Nick Flynn
8. The Noonday Demon: An Atlas of Depression, Andrew Solomon
9. An Unquiet Mind, Kay Jamison
10. A Father''s Story, Lionel Dahmer
11. The Book of Job, Old Testament
12. The Center Cannot Hold, Elyn Saks
13. American Psychosis: How the Federal Government Destroyed the Mental Illness Treatment System, E. Fuller Torrey

Type of students who would benefit from the course
1. Any student who is committed to the field of psychiatry or to reducing the suffering of people with mental illness or developmental disabilities.
2. Any student dedicated to improving or understanding community resources for mental illness.
3. Any student interested in learning what happens to patients with mental illness and developmental disabilities outside of the hospital and clinical experience.
4. Any student interested in learning how to promote positive psychosocial characteristics.

Weekly Schedule
  Clinical Activities (estimated schedule)
  Day of Week AM PM
  Monday 8:00am (Student''s Location Choice) 5:00pm (Student''s Location Choice)
  Tuesday 8:00am (Student''s Location Choice) 5:00pm (Student''s Location Choice)
  Wednesday 8:00am (Student''s Location Choice) 5:00pm (Student''s Location Choice)
  Thursday 8:00am (Student''s Location Choice) 5:00pm (Student''s Location Choice)
  Friday 8:00am (Student''s Location Choice) 5:00pm (Student''s Location Choice)
   Average number of patients seen per week: 10+ per peer group, 2-10 per site visit  
   Call Schedule:   None  

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
    Weekly Supervision
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Faculty in charge of the course
  B. Frequency / Duration of Presentation(s)?
    Weekly supervision 2-4 hours per week.
  C. Format - What guidelines are set for the student's presentation?
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    Weekly self-reflection both prompted and unprompted
  B. Format - What guidelines are set for the student's written work?
    To complete reflections and required project during the time of the course.
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Suggested book topics but students may select other with approval of faculty.
  F. Audience - Who assesses the student’s written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    Weekly supervision to discuss reflections. Faculty and students will mutually develop reading list for self-exploration and to teach peers. Other residents and faculty will be invited to hear book discussions review. Students will be expected to develop a service project during their month (educational materials for patients or staff, community outreach, digital storytelling, etc.).

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".

7.  Other Modes of Evaluation
  Please explain below.

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.

Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.

How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?

What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?

An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?

How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?

How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student’s abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.