A day in the life of a public psychiatry fellow.

Now in its 29th year, the Public Psychiatry Fellowship of the New York Psychiatric Institute at Columbia Medical Center selects 10 fellows per year for its 1-year program (1). This award-winning fellowship trains future leaders for the public mental health sector. The curriculum (2) employs a combination of a didactic seminar series, management-problem-focused presentations by guest speakers, field trips, and supervision by fellowship faculty to instill the values and skills required for practice and leadership in the public sector. Fellows utilize the framework of the academic curriculum to carry out a series of presentations throughout the year that allow them to organize, implement and evaluate concepts that they learn during the year. The following account, written from bird's eye view, details one fellow's day at his field placement in a State Hospital outpatient clinic setting, with the aim of illustrating how the concepts taught by the fellowship find application in day to day practice.

Recovery as the new medical model for psychiatry.

Treatment grounded in recovery principles is often viewed as not being based on the "medical model." In this Open Forum the author asserts that recovery from mental illness is entirely compatible with concepts of recovery from medical illness and with new approaches to medical treatment. Three ways of conceptualizing recovery are defined: clinical recovery, illness management, and personal recovery. Basing treatment on recovery principles is supported by research that has shown significant remission rates over time among persons with schizophrenia. The author uses examples of public figures and of one family with physical disabilities to illustrate the progress society has made toward accepting and including people with physical illness and disability. Recovery-oriented mental health treatment parallels the move in other medical specialties toward person-centered care. A clinical approach to promote recovery is discussed.

The role of the psychiatrist as advocate.

There are a number of ways in which a psychiatrist or other mental health professional can advocate for mental health issues. The author uses her own involvement in the Association of Gay and Lesbian Psychiatrists (AGLP) as a way to illustrate the advocacy role. Challenges and accomplishments with respect to that role and the organization's work are discussed.