Back

Active SI/HI or Active Psychosis

Edit

Assess for Active SI/HI or Active Psychosis

For SI, complete the .SUICIDEIMASCREEN in Epic and a PHQ9.

For HI/Psychosis, complete a violence risk assessment and a PHQ9.

If yes to questions 4, 5 or 6, in suicide screen:

  • Preceptor must evaluate patient.

  • If ACTIVE SI/HI with intent and/or plan or recent behaviors OR Active psychosis with imminent danger to patient or others : Call Psych ED: (212) 241-5637 or IMA psychiatrist for guidance on decision to send to ED.

Appropriate for Psych ED Eval

If patient in imminent danger, follow the directions here.

If patient willing to go to ED voluntarily

  • Call security to come up to wait with the patient

  • Have an MA or nursing staff member wait with patient until security arrives.

  • Call Mount Sinai Health System Transportation Office (operated under contract by Hunter Ambulance): 631-777-5600

  • Know: patient’s insurance information (Facesheet under the EPIC tab)

  • Inform RN, MA and front desk

  • Call ED Referral Line: x4-3611 and inform that patient to go to psych ED and will need 1:1 observation

  • Order “Consult to Emergency Medicine”

  • Give a copy of your note to EMS.

  • Document all conversations in note.

  • Schedule follow up with a PCP (visit in 1 week)

  • Consult to IMA behavioral Heath (depression care)

Not Appropriate for Psych ED Eval

  • Document all conversations in note.

  • Complete a Safety Plan with the patient .SAFETYPLANIMA (ENGLISH or SPANISH)

  • Share resources

Nowmattersnow.org National suicide prevention lifeline 1800273talk Textline 741741

  • Start medications if indicated and appropriate

  • Schedule follow up with a PCP (phone call or visit in 1-2 weeks)

  • If the patient current has a mental health provider, please contact that provider. If not:

Consult to IMA behavioral Heath (depression care)

AND

For an IN PERSON Warm Hand-off and an EXPEDITED Appointment with the Behavioral Health TEAM (in person handoffs occur ONLY on Mon-Fri, 9am -4pm)

  • Email the following information to the Depression Care/Psych SWs (make sure your mountsinai.org email is the sender). The oncall SW will get back to you in 5-10 minutes either via phone or email to let you know if they are available to see the patient and when. If the patient is unable to wait in the exam room, patients can wait in your firm waiting room.

IMA Psych-BH Referral

  • After 4pm and on Saturdays, you may just place the behavioral health consult order and a SW will contact the patient within 5 business days, you can still send an email if an urgent appointment is needed (urgent consults will be called within 2 business days).

  • Depending on patients needs, insurance and desire for counseling, patients may be given an appointment for depression care and/or IMA Mental Health Evaluation Clinic, IMA Psych OR and outside referral with the help of IMA Social Work.

  • Appointments for IMA Eval can also be made at the front desk.

Our Team:

Depression Care Social Workers

Psychiatry Social Worker

Administrative Coordinator

MD Leads:

Psychiatry:

  • Dr Iyer, Dr Filipovic

Medicine:

  • Dr. Lauren Peccoralo
  • Dr. Katherine Small

Alternative Mental Health Options

  • IMA SW Triage: assistance in identifying resources and making appointments for mental health and substance use. IMA has Social Work Triage Walk-in hours on Mondays-Fridays 9am-4pm. Services are first come, first serve. Please register at your primary care firm front desk to see Social Work during walk in hours.
  • MSH Outpatient Adult Psychiatric Clinic Diagnostic Evaluations, Medication Management, Individual and Group Psychotherapy; Clozapine Clinic 20 East 106th Street, 9th Floor Or 1160 5th Ave New York, NY (bet. 5th and Madison Ave) http://www.mountsinai.org/patient?care/serviceareas/ psychiatry/areas?of?care/ambulatory?psychiatry?services General information, intake, and referrals: (212) 241- 5947

  • MSH Partial Hospital Program Short term (2-3 weeks) intensive treatment (4-5 days per week) to prevent psychiatric hospitalization or to step down from psychiatric hospitalization 20 East 106th Street, 9th Floor New York, NY (bet. 5th and Madison Ave) http://www.mountsinai.org/patient?care/serviceareas/ psychiatry/areas?of?care/partial?hospital?program For Referrals Contact: Julia Siegel, LCSW Phone: 212 241-3170 Fax: 212-426-5107 Email: phpreferrals@mountsinai.org

  • Mount Sinai St. Luke's Outpatient Adult Psychiatry Diagnostic Evaluations, Medication Management, Individual and Group Psychotherapy; Clozapine Clinic; First Onset Psychosis services 411 West 114th Street, 3rd & 5th Floor New York, NY (off Amsterdam Ave.) http://www.stlukeshospitalnyc.org/Adult_Mental_Health.aspx If you are seeking services for yourself, a friend, or family member, please contact the Access Center at (212) 523-8080. If you are a mental health provider from the Mount Sinai Health System, please call (212) 523-5384

  • The Center for Intensive Treatment of Personality Disorders (CITPD) Short term DBT-based intensive group therapy 1000 10th Avenue, 6th Floor New York, NY (bet. 58th & 59th St) http://www.roosevelthospitalnyc.org/Services/Psychiatry/CITPD/ To arrange for treatment at CITPD, patients, families and providers can call the Comprehensive Assessment Center at 212-523-8080 to schedule an evaluation.

  • Institute for Family Health, Center for Counseling and Family Health Center of Harlem 1824 Madison Avenue 2nd Floor New York, NY 10035 (Ph.) 212-423-4200 , (Fax) 646-770-8401 Center for Counseling of Harlem hours: Monday- Friday: 8:30am-8pm Saturday-Sunday: 9am-5pm Walk-Ins receive same or next day appointment

  • Union Settlement 2089 3rd Ave (at 114th St) NY, NY 10029 212-828-6144 (Intake Coordinator)

  • Upper Manhattan Mental Health Center 212-694-9200 Located on Amsterdam between 145th and 146th For substance use must request Chemical Dependence Program

  • Metropolitan Hospital 1900 2nd Ave 1st Floor New York, NY 10029 212-423-6645 Mon-Fri: Clients seeking individual treatment who are not being referred by an inpatient unit or clinician must walk-in for their initial appointment and arrive by 7:45 am

To explore alternative referral options for this patient one may

  • visit www.hitesite.org

  • call or visit 1888-NYC-well (1-888-692-9355) NYCwell.cityofnewyork.us/en/ and provide insurance info and zip code