Experiences of Parachute NYC: An Integration of Open Dialogue and Intentional Peer Support.

Guided by the principles of Open Dialogue and Intentional Peer Support (IPS), Parachute NYC was designed to provide a "soft landing" for people experiencing psychiatric crisis. From 2012 to 2018, Parachute's teams of clinicians and peer specialists provided home-based mental health care to enrollees and their networks (family, friends), seeking to engage and improve their natural support networks. This qualitative study examined the experiences of enrollees and network members who participated in Parachute. Participants reported that they valued the accessibility and flexibility of Parachute as well as their relationships with, and the lack of hierarchy within, the Parachute team. Responses to the structure of network meetings and Parachute's approach to medication were mixed, with a few participants struggling with what they felt was a lack of urgency and others experiencing the approach as holistic. Many enrollees and network members reported that Parachute improved their self-understanding and relationships with each other.

Metabolic Syndrome Screening and Assertive Community Treatment: A Quality Improvement Study.

Metabolic syndrome defines a collection of cardiometabolic illnesses that predict risk for poor physical health and early death and is highly prevalent among those with serious mental illness. Despite recommendations for routine monitoring, those with serious mental illness frequently do not receive physical health screenings. We conducted a quality improvement (QI) project to increase rates of metabolic syndrome screening in three New York City Assertive Community Treatment (ACT) teams. The project, conducted from December 2010 to May 2011, involved educational sessions for staff and consumers and a systematic screening protocol. We collected complete metabolic syndrome screening measurements for 71% of participating ACT consumers. We found metabolic risk to be nearly universal among participants, with over half diagnosed with metabolic syndrome. We also found high rates of previously undiagnosed hypertension, diabetes, and dyslipidemia. We describe the resources and obstacles we encountered in our QI project to make systematic metabolic screening a routine part of ACT care. This QI project suggests that ACT teams can take a leadership role in screening their consumers for physical health issues, aligning with recent policy trends to better integrate behavioral health and primary care services.

Countertransference and disaster psychiatry: from Buffalo Creek to 9/11.

This article describes issues of countertransference in disaster psychiatry and makes use of specific examples from therapists working in the aftermath of the terrorist attacks of September 11, 2001.

Sharing stories, healing shattered lives.

Because of our capacity to provide crisis-oriented mental health services in the field throughout the city, we have played a role as one element of New York's emergency mental health response system. Our goal in the aftermath of September 11, 2001, is to allow the victims to tell their stories. By sharing their stories, individuals start the process of moving from helpless victims to proactive survivors.