Welcome to Tulane Medical School Forensic Psychiatry.
The Forensic Psychiatry Fellowship at Tulane University School of Medicine offers a comprehensive and diverse range of experiences in Forensic Neuropsychiatry. Our fellows spend time at East Louisiana State Mental Health System (ELMHS), the Orleans Justice Center (OJC), New Orleans Criminal Court, the Forensic Aftercare Clinic, and with various members of our faculty doing private cases which can include civil, criminal, and juvenile issues. We have one of the largest forensic psychiatry faculties in the country with more than 15 members including four faculty members who are board certified in both forensic and child and adolescent psychiatry. In July 2022, we are starting a formal child track to our fellowship. The child fellow will be part of the treatment team at the juvenile justice intervention center (Orleans Parish Juvenile Justice), a private custody clinic, and will be included in private and criminal consultations with faculty members.
ELMHS is located in Jackson, Louisiana, two hours outside of New Orleans. It is a large state institution dating back to 1848 and is a historical landmark. ELMHS currently houses approximately 640 patients who are admitted though the criminal justice system and has multiple levels of care on its grounds from secure forensic group homes to a maximum security unit. Fellows rotate on three different units during their fellowship: a female competency restoration unit, a male competency restoration unit, and a lesser restrictive, chronic unit for patients who have been adjudicated Not Guilty by Reason of Insanity or Irrestorably Incompetent. On the competency restoration units, fellows lead an interdisciplinary team of professionals under faculty supervision. Fellows admit patients, develop and monitor treatment plans, and conduct competency evaluations with an MD or PhD colleague. Fellows write competency reports and on occasion testify in court regarding their recommendation. On the chronic unit, fellows conduct risk assessments to determine community readiness for patients who have been in the hospital for extended periods of time. They participate in Review Panels which make recommendations to the court regarding next steps for care, transfer to lesser or more restrictive settings, and/or discharge for these patients.
The Orleans Justice Center (OJC) is a newly built, 1,438 bed jail in downtown New Orleans which primarily houses pre-trial defendants. Tulane provides psychiatric evaluation and treatment services to inmates at OJC. Fellows work at OJC one day a week for six months alongside faculty members.
Fellows spend one morning a week at New Orleans Criminal Court, evaluating defendants from OJC referred to the Sanity Commission, which consists of two Tulane faculty members. The majority of these evaluations are for competence to stand trial with occasional dangerousness assessments, competence to waive Miranda rights, or other issues. This is a busy rotation and defendants are interviewed, a decision is usually made, and testimony is taken the same day. Fellows are qualified as experts in forensic psychiatry within the first 4-6 weeks of their fellowship and have the opportunity to testify multiple times. The average number of times fellows testify is between 25-30 times by the end of their fellowship.
Fellows spend one afternoon a week for six months at the Forensic Aftercare Clinic in New Orleans. This is a clinic for patients who have progressed through the hospital system and are now in outpatient treatment, as well as patients referred for outpatient competency restoration. Fellows follow 5-6 patients during this rotation and become familiar with community resources, the function of district forensic coordinators, and factors to consider when managing forensic patients in the community.
Fellows attend a custody clinic for several weeks in the fall with a clinical faculty member who has decades of experience in custody issues and a child forensic psychiatrist. Fellows are instructed on Louisiana statute, family court operations, and the logistics of custody litigation. Forensic fellows attend a series of didactic seminars along with Tulane child psychiatry fellows and conduct one custody evaluation with the faculty member. Fellows write up the custody report and present their case in seminar. The opportunity for a second evaluation is possible if desired.
Fellows will work with our chairman, Dr. John Thompson, one day a week for six months doing civil forensic evaluations. Additionally, Tulane has more than 15 forensic faculty members with varying interests who do a variety of private cases. Fellows also have the opportunity throughout the year to work with different faculty members on cases such as juvenile justice, workmen’s compensation, disability, not guilty by reason of insanity evaluations, resentencing, among others, depending on availability and interest.
In addition to the above clinical rotations, we have a comprehensive didactic series which covers all topics to successfully pass forensics boards. A Landmark case seminar is also conducted weekly with faculty members and psychology fellows. Fellows participate in a Journal Club, write a case review for Legal Digest and attend Psychiatry Grand Rounds.
Fellows have weekly individual supervision with the Director and/or Associate Director of the Fellowship program throughout their fellowship, as well as supervision by faculty on specific rotations. Faculty are available and interested to assist fellows to obtain experience with any specific interests they may have.
To apply, complete this form and email it to Carol Neal
Find more information about Forensic Psychiatry by heading to the AAPL site.