Ben Taub Hospital/Harris Health System
Chief of Psychiatry Service
Asim A. Shah, M.D.
Chief of Psychiatry, Harris Health System and Ben Taub Hospital
Associate Professor, Menninger Department of Psychiatry and Family and Community Medicine
Executive Director, Psychotherapy Services and Intensive Outpatient Program
Director, Mood Disorder Program at BTH/Harris Health System
Director, Community Behavioral Health Program
Assistant Director, Psychiatric Residency Education
Psychiatry Clinic: 713-873-4900
Administrative Assistant: 713-873-5270
Dr. Shah is an associate professor in the Menninger Department of Psychiatry and Behavioral Sciences, and is also an associate professor for the Department of Community and Family Medicine, Baylor College of Medicine where he is involved with teaching of the Baylor Psychiatry, Neurology, Internal Medicine, as well as Family and Community Medicine residents and medical students. He is the chief of psychiatry of the Harris Health System/Ben Taub Hospital, and the director of the Community Behavioral Program for Harris Health System. He serves as the medical director of the Intensive Outpatient Program, located at the Neuropsychiatric Center, Ben Taub Hospital. He is involved with the residents in the Clinician Educator Track, and serves as their preceptor in the Ben Taub and Harris County Community Clinics, where he holds outpatient clinics. He sits on numerous hospital wide committees, and is the director of membership for Texas Regional Psychiatry Minority Mentorship Network (TRPMMN ). While working at Ben Taub Hospital he has worked at the psychiatric emergency room and consultation liaison services.
Before joining Baylor, he was assistant clinical professor at the University of Arkansas for Medical Sciences, where he had a very busy private practice. He served as the chief of staff of his local hospital in Arkansas, and was a member of board for the hospital. He was the medical director of inpatient psychiatric unit in Arkansas, where he won the prestigious national medical director of the year award in 2002 and 2003. He was the chief resident of his psychiatry program. He was also involved with the American Psychiatric Association's practice research network, and served as mentor for young and early career psychiatrists. In 2012 he received Fulbright and Jaworski Award for Teaching and evaluation.
Psychiatric Inpatient Unit
Director: John C. Coverdale, M.D.
Staff Psychiatrist: Mollie Gordon, M.D.
Staff Psychologist: Phuong Nguyen, Ph.D.
The Inpatient Unit is a 20 bed unit with a focus on clinical care and documenting efficacy of treatment. It offers both voluntary and involuntary psychiatric treatment. The unit is the only facility capable of providing care for indigent individuals needing psychiatric hospitalization who have concomitant medical conditions that render them ineligible for services at Harris County Psychiatric Center, or other local psychiatric inpatient facilities. Because of the access to expert medical care, the unit also specializes in a rapid medical work-up for patients presenting with new onset or unusual psychiatric symptoms. The medical work-up has resulted in the diagnosis of unsuspected seizure disorders, brain tumors, and infections impacting the brain. This is the only unit that offers ECT for indigent patients.
Since January 2000, the unit has averaged 51.4 new admissions each month, has had an occupancy rate of 84 percent, and has an average length of stay of approximately eight days. Each patient is assigned to a treatment team. Members of the treatment team consist of an attending psychiatrist, resident psychiatrists, medical students, a supervising psychologist and psychology intern, social workers, substance abuse counselors, nurses, psychiatric technicians, and occupational therapists. Treatment is tailored individually to each patient's level of functioning and care needs.
Daily unit activities include goals groups, educational groups, and activity of daily living groups. Neuropsychological testing is available as clinically indicated. Patients' families are involved in meeting with the treatment team to devise an effective treatment plan. There are weekly programs on Domestic Violence provided by a representative from the Houston Area Women's Center, who also provides interventions to patients who are survivors of domestic violence, rape, or sexual abuse. A representative from the Amigos Volunteers in Education and Services facilitates a weekly psychoeducational program on HIV/AIDS related issues and concerns.
Because approximately half of patients admitted to the unit for acute psychiatric conditions have co-morbid substance abuse, a chemical dependency program is fully integrated into unit activities. This program offers individual counseling, group therapy, educational groups, and the development of an outpatient treatment plan to reduce relapse rates.
Psychiatric Emergency Center
Director: Staff Psychiatrist: Anu Matorin, M.D.
Staff Psychologist: Nidal Moukaddam, M.D.
The Psychiatric Emergency Center (EC) is a specialized area for psychiatric care in close physical proximity to the medical and surgical EC. Physicians in the Psychiatric EC evaluate 450 patients per month. The EC is a unique facility in the public mental health system in its capacity to coordinate psychiatric, medical, and surgical treatment for patients. Patients to the EC are self-referred, brought by the Houston Police Department, and brought by ambulance. Physicians, nurses and social workers staff the Psychiatric EC 24 hours a day, seven days a week, providing a multi-disciplinary treatment team that works together to provide rapid diagnostic assessment and treatment plan implementation. Patients can be evaluated either in the specialized Psychiatric EC unit, which provides a safe environment for individuals at risk of harming themselves or others, or in the Medical or Surgical EC.
The patient evaluation includes a thorough assessment of medical, neuropsychiatric, and psychosocial factors involved in a patient's presentation. Because substance abuse is a primary factor in frequent EC utilization, chemical dependency issues are addressed in the EC with a multidisciplinary treatment plan, and with the involvement of an on-site licensed chemical dependency counselor.
In the EC, it is determined whether patients can be acutely stabilized and referred for outpatient care or whether hospitalization is required. Approximately 22 percent of patients presenting to the Psychiatric EC require further inpatient care, reflecting the high acuity of our patient population. This complete evaluation, decision about disposition, and transfer to an inpatient facility must be done within 23 hours to comply with state regulations. Because of the specialized care and diagnostic acumen provided, and the wide range of medical, chemical dependency, and psychiatric conditions presenting with psychiatric symptoms, the BTH Psychiatric EC provides a rich training experience for medical students, residents, psychology interns, and social work trainees, and is an invaluable resource to Houston and Harris County.
Adult Psychiatric Consultation/Liaison Services
Director: Elizabeth David, M.D.
Staff Psychologist: Araceli Flores, Ph.D.
The Adult Psychiatric Consultation/Liaison Service provides psychiatric services for patients admitted to the acute medical and surgical units of BTH, including Internal Medicine, Family Practice, Obstetrics/Gynecology, Neurology, and Surgery and its subspecialties,. Our team consists of two attending psychiatrists, psychiatry residents, medical students, and a neuropsychologist. With an average of 90 consults per month, Ben Taub provides the opportunity to see the broadest range of psychiatric illness in the most diverse population of patients. Because of the complexity of the medical problems in our patients, the consultation/liaison service allows us to work at the interface of medicine and psychiatry, focusing on the biopsychosocial spiritual aspects of our patients' lives. Treatment modalities include pharmacological, psychotherapeutic, and social interventions. Since approximately 30 percent of our patients have co-morbid substance use disorders in addition to their medical and psychiatric illnesses, we work closely with the licensed chemical dependency counselors.
Child Psychiatric Services
Director: Sophia Banu, M.D.
Because of the Pediatric population at Ben Taub, a child psychiatrist is available for consultations to pediatric units. There is also a specialty psychiatry clinic operating within the pediatric clinic one full day a week, seeing approximately 40 children with concomitant psychiatric and pediatric conditions per month. Child and adolescent psychiatry services and training experiences at Ben Taub Hospital emphasize the role of child and adolescent psychiatry in a community based general hospital. The consultation/liaison service responds to psychosocial and mental health needs of infants, children, adolescents and their families experiencing acute hospitalization.
Consultations focus upon the influence of acute trauma, serious pediatric or neonatal illness and preexisting emotional and behavioral disorders upon children simultaneously experiencing poverty, family disruption, social disadvantage and other risk factors for poor developmental outcome.
Ambulatory clinics at the hospital provide child and adolescent psychiatric care for children with significant emotional and behavioral disorders and for children with problematic reactions to trauma, family violence and chronic pediatric illness and handicapping conditions. Training experiences emphasize assessment of risk and sources of resilience, appreciation of the child's family and community context, recognition of the influence of class and culture upon children, and use of contextually based and pragmatic interventions both on pediatric wards and intensive care units and in outpatient clinics. Training experiences are combined with educational experiences for pediatric residents, enhancing the psychiatric trainee's ability to collaborate effectively throughout his or her career.
Ben Taub Psychiatric Outpatient Clinic
Director: Britta Ostermeyer, M.D.
The Adult Outpatient Psychiatry Clinic is designed to provide services to patients with the full range of psychiatric diagnoses, but is specifically tailored toward patients with concomitant medical and psychiatric illnesses. Although it serves these populations well, the clinic has seen increasing numbers of individuals who were discharged from services elsewhere due to having a dual diagnosis of a psychiatric and substance abuse condition, or due to being indigent. The clinic also specializes in the care of individuals with anxiety disorders, milder forms of depression, personality disorders and psychiatric disorders due to general medical conditions. Referrals to the clinic come from the Psychiatric Emergency Center, Inpatient Unit, consult/liaison team and specialty and primary care clinics throughout the Harris Health System.
The clinic offers physician appointments for medication management. It also has limited individual psychotherapy, offered by resident psychiatrists and psychology interns. Social Work staff offer goal oriented time-limited process groups, ongoing therapy groups (focused on relationship, life changes, or women's issues), and case management. Because a substantial percentage of clinic patients have co-morbid substance abuse issues, there is focused chemical dependency education and treatment groups for individuals with psychiatric illness. In July 2000, with its move to the Ben Taub Mental Health Services facility, the clinic was able to extend its hours to three full days and two half days a week, and to accommodate almost 900 clinic visits in May 2002. As outpatient care resources for indigent individuals with severe and persistent mental illness are further reduced, greater demands will be placed on the clinic, making it an ever more valuable resource in the public mental health system.
Community Behavioral Health Program
Director: Asim A. Shah, M.D.
As anticipated, the 2004 pilot project turned out to be very successful and in July 2005, the Harris Health System Community Behavioral Health Program CBHP was founded. Between July to November 2005, CBHP placed a team of psychiatrists, psychotherapists, substance abuse counselors, residents, and students into all of Harris Health System 11 centers, five partner centers, the center for the homeless, and one school-based center. Centers have one to two days of psychiatric services, three to five days of individual and group psychotherapy services, and two to four days of social work services per week. Within 2006, CBHP plans to staff the six additional school-based centers with behavioral care services.
At CBHP, our goal is "Building A Healthier Community." Presently, CBHP is focusing on the following four areas: 1) Patient Care, 2) Education, 3) Training, and 4) Research. In terms of patient care, CBHP provides appointments for initial evaluations, medication management, individual and group psychotherapy, substance abuse screening, and brief substance abuse treatment at the community centers. The appointment templates of our psychiatrists, psychotherapists, and substance abuse counselors permit our behavioral health providers to see additional walk-in patients who are visiting with their primary care physicians or those who are in crisis.
CBHP's education focuses on furthering the scope of psychiatric and behavioral interventions by the community primary care team. We highly encourage curbside consultations by primary care physicians while they are seeing their patients. We have implemented case conferences for primary care physicians at the centers and Abbott Laboratories sponsored a series of formal lectures on major psychiatric topics. The lectures focused on disease recognition and on how to use psychiatric medications. Each lecture was televised to primary care physicians at the community centers and copies of the lectures are available for individual review. In order to educate our primary care center staff about mental illness, we have taped presentations on key psychiatric issues for center staff. Our training efforts focus on rotations for primary care and psychiatry residents, psychology interns, and medical as well as nursing students. Lastly, our research endeavors are presently concentrating on treatment outcome data. In the near future, we plan to undertake substance abuse research projects as well.
Since CBHP's goal is to get patients involved with behavioral care services early, eligible patients can be directly referred to the psychiatrist or the therapist at the patient's primary care center by all disciplines within Harris Health System. Our psychiatrists operate like other medical subspecialties, e.g. cardiologists. Cardiologists evaluate patients, stabilize them, and then return them to primary care physicians for ongoing care. Likewise, our psychiatrists stabilize patients and then return them with recommendations to their primary care physicians for maintenance care. Our psychiatrists are "integrated consultants" and at all times, the primary care physician remains the master of the patient's care.
Intensive Outpatient Program (IOP)
Medical Director: Asim A. Shah, M.D.
Staff Psychologist: Araceli Flores, Ph.D.
To break the cycle of repeated Psychiatric Emergency Center visits and re-hospitalization, an IOP was implemented in July 2000. It serves non-psychotic individuals with illnesses and life issues too severe to allow for independent community living, but not so acute as to require inpatient hospitalization. Its goal is to rehabilitate these individuals into more stable outpatient functioning. It utilizes treatment modalities proven to be efficacious in this population, and is open to Harris Health System patients without regard to their financial status. The program is time limited (typical patient involvement is two months) and includes individual and group psychotherapy, medication management, and case management. Occupational therapy groups explore vocational pursuits. A chemical dependency program is integrated into the IOP due to the frequent co-morbidity of psychiatric and chemical dependency diagnoses in all Harris Health System psychiatric services. This program is for complex mood, personality, and related disorders. M, W, F: 8:30 a.m. – 12:15 p.m. Requirements: 30 days sobriety prior to admission; no primary psychotic disorders; no uncontrolled violence.
Mood Disorder Clinic
Director: Asim A. Shah, M.D.
Located on the 2nd floor of the NPC building, this clinic is for our diagnosis and management of mood disorders. Patients who have uncertainty about their diagnosis, and need management recommendations are the target population.
Survivors of Torture Clinic
Director: Sophia Banu, M.D.
Located in the Le Franco Clinic of Harris Health System in the Alief area, this Clinic serves the patients who are survivors of torture.
Director: Asim A. Shah, M.D.
Group Programs: All Groups are OPEN
• Mindfulness DBT group: Advanced DBT Group, for people who have completed basic Social skills for DBT
• DBT Skills Group: for regulating emotions, improving interpersonal relationships, and reducing stress. Thursdays 1:15 - 2:15 p.m.
• Substance Abuse Group: Mondays 1:45 - 2:45 p.m.
• CBT Group: for depression and anxiety. Thursdays 9:45 - 10:45 a.m.
• Spanish CBT group: for depression and anxiety in spanish. Mondays at 1.15 -2.15 pm
• Weight Management (nutrition/exercise): Thursdays 1 - 2 p.m.
• Men's Group: support group for men only. Wednesdays 1:15 - 2:15 p.m.
• Vocational Group: preparatory skills for entering or returning to the work force. Mondays 10 - 11 a.m.
• Cognitive Group: enhances cognitive skills for entering or returning to the work force. Mondays 10 - 11 a.m.
• Women's Group: support group for women only. Fridays 1 - 2 p.m.
Individual Therapy available by Psychologist/Psychology interns and/or Psychiatry Residents.