Residency Program in Psychiatry

History

Psychiatry has played an important role in the long history of The Mount Sinai Hospital. One of the first psychiatry outpatient clinics in a general hospital was opened here in 1913, and a further pioneering venture was the establishment in 1945 of one of the earliest psychiatric inpatient units in a general hospital. The long-standing importance of psychiatric care at Mount Sinai has led to the development of a remarkably large and diverse set of clinical programs in an academic Hospital and Medical School that are committed to education and research.

While the Hospital's psychiatric case records date back to 1852 when the first Jewish immigrants with mental illness were admitted to the Hospital, the real story of the Department of Psychiatry begins 40 years later. In 1893, a young immigrant named Dr. Bernard Sachs was asked to consult on a few cases. Sachs had trained in Vienna and was among the first doctors to share the intriguing new theories of his friend, Dr. Sigmund Freud, with his American colleagues. Sachs was best known for helping describe Tay-Sachs disease, but his family fortune (his brother founded the Goldman-Sachs investment company) allowed for the construction of the Hospital's first neurology wing, boasting 20 beds, at the turn of the century.

Three years later, the Hospital opened the first private outpatient psychiatric clinic in the city. The director was psychoanalyst Dr. Clarence P. Obendorf, one of the founders of the New York Psychoanalytic Society & Institute. Obendorf had trained at Manhattan Psychiatric Hospital, and his mentor, Dr. A. A. Brill, had been among the few who had traveled to hear Sigmund Freud lecture at Clark University in 1909.

Sachs' 20-bed neurology ward treated only an occasional psychiatric patient (many such patients were still being sent either to jail or to state asylums). However, the next neurology chair changed the patient mix. In 1920, Dr. Israel Strauss joined the staff with plans to create a facility for patients with mental illness. He did so, but he located the hospital outside of Manhattan - first in Westchester County, and later in Queens where it continues as the Hillside Hospital of Long Island Jewish Hospital.

Strauss passed the torch to Dr. Israel Wechsler, who decided to expand the role of psychiatry in the neurology department even further. Wechsler brought in Dr. Lawrence Kubie, an analyst trained at Johns Hopkins Medical Institutions in Baltimore, who had plans to use Mount Sinai as a blueprint for psychiatry in general medicine. Thus consultation-liaison psychiatry was born at Mount Sinai, with psychiatrists in the 1930s on the floors of the Hospital helping in the care of cancer and heart patients. Their assigned role was to help patients come to terms with their illnesses and strengthen the bonds with their doctors.

After World War II psychiatrists recognized the need for psychiatry to be separate from neurology in order to flourish as a profession. In 1945, with interest in psychiatry growing nationally, Dr. M. Ralph Kaufman arrived to chair the new Psychiatry Department. In addition to consultations on the medicine and surgical services, a ward for psychosomatics was opened to treat patients with such illnesses as asthma, headaches, and peptic ulcers.

Psychoanalytic theories and treatments were emphasized in the 1960s. However, the success of pharmacological treatments, especially for the most seriously ill, led to an interest in biological studies of psychiatric disorders. When Marvin Stein, M.D. became Chair in 1971, he fostered the research activities of the department, including the recruitment of Kenneth Davis, M.D., who led multi-disciplinary studies of schizophrenia and Alzheimer's disease. In 1987, Dr. Kenneth Davis became Chair himself. His leadership ushered in a period of growth and expansion unparalleled in the Department's history. Space was upgraded, programs enlarged, and the full-time faculty grew to well over one hundred. Dr. Davis' guidance led to the creation of a multitude of internationally respected programs that continue to flourish in schizophrenia, personality disorders, autism, depression, alcohol dependence, attention deficit disorders, impulsive and compulsive disorders, stress disorders, geriatrics, memory disorders, and Alzheimer's disease. In addition, the Department became home to a variety of programs in such areas as molecular genetics, neuroimaging, community psychiatry, health services research, and psychoanalytically-oriented psychotherapy. Due to his outstanding accomplishments in the Department of Psychiatry, in 2003 Dr. Kenneth Davis was named President and CEO of The Mount Sinai Medical Center as well as Dean of Mount Sinai School of Medicine.

More recently, Jack Gorman, M.D. (2003) and then Eric Hollander, M.D. (2006) became Departmental Chairs. Under their leadership, the Department maintained and expanded programs in the many areas listed above. In addition, the Department developed an extensive and innovative program in mood and anxiety disorders research and added new substance abuse treatment programs, including Madison East - a high-quality, inpatient psychiatric amenities unit which is the only service of its kind in Manhattan. In child and adolescent psychiatry, the Department developed programs in eating disorders, health services research, and traumatic stress disorders. Drs. Davis, Gorman, and Hollander developed a formalized affiliation with the New York Psychoanalytic Society and Institute and added core foundation programs in cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT). The Department expanded consultation and HIV psychiatry, adding new faculty and new grants. It has also expanded research in translational neuroscience and neuroimaging. Overall, the Department has opened up new opportunities for medical students and residents in clinical and research programs. The educational programs at Mount Sinai continue to attract the finest medical students, residents and fellows in psychiatry as evidenced by their frequent listing in the roster of national awards.