CARES staff from left to right: Chang (Betty) Wang, MD (child and adolescent psychiatry fellow); Aliza Grossberg, MD (PGY-2); Margaret Rauen, PhD (psychologist).
The Comprehensive Adolescent Rehabilitation and Education Service (CARES) at Mount Sinai Morningside integrates intensive psychological treatment with a complete high school education through the New York City Department of Education’s ReStart Academy (District 79), and it is the only one of its kind in the country.
In recognition of Transgender Day of Remembrance and with input from students, the CARES community put together events celebrating transgender and gender diverse identities. Students and staff had discussions throughout the week on the significance of Transgender Day of Remembrance, followed by an optional viewing of Disclosure, a documentary highlighting how transgender people have been represented in film and television. Students were also able to opt-in to watching a shorter video on Schuyler Bailar, the first openly transgender NCAA Division I swimmer. During the week, students and staff wore Transgender Pride Flag stickers, as well as individual pronoun stickers, and the CARES team hung a Transgender Pride Flag that will remain up throughout the year.
Much needed back-to-school supplies were recently donated to children of incarcerated women and other community members by HOLA, the Heritage of Latinx Alliance Employee Resource Group at the Mount Sinai Health System. HOLA made the donations in collaboration with Hour Children, a nonprofit organization that supports incarcerated women and their children.
“We were very happy to be able to give back in such a time of need,” says Kelley Gonzalez, an Information Technology trainer, who organized the event with Awanda Canelo, a billing coordinator and fellow HOLA member, and Kellie Phelan, the program coordinator of Hour Children. HOLA members collected school supplies such as pens, pencils, books, crayons, and hand sanitizer, which were dropped off at the Corporate Services Center on 42nd Street. HOLA also provided an Amazon wish list link so that those who were not onsite could participate in the donation. On Tuesday, September 7, HOLA members passed out the donations, which had been loaded into colorful backpacks, at the Hour Children Community Pantry in Long Island City.
“It was a pleasure personally having the opportunity not only to collect donations, but in partnership with Hour Children and our Mount Sinai colleagues, we were able to hand out all of these supplies,” Ms. Canelo says. “Seeing the smiles on the children reminds us that our children are our future leaders.”
The organizers of the event expressed sincere thanks to those who donated supplies and to staff members, including billing coordinator Yvette Robles, who took out time of their schedules to help hand out supplies.
On the evening of Tuesday, September 11, 2001—with fires burning at the site of where the twin towers had stood that morning and several thousand people still unaccounted for—a group of physicians from the Mount Sinai Selikoff Centers for Occupational Health met to discuss a plan of action for treating survivors and first responders who had rushed in to help.
Protégés of the late Irving Selikoff, MD—a pioneering researcher who was the first to definitively link asbestos exposure to lung cancer—these physicians knew how dangerous the air was at the site of the attack, which had been reduced to 1.8 million tons of burning rubble. The toxic stew of chemicals would later be found to include major hazards to human health, such as lead and other heavy metals, benzene, dioxin, and asbestos. The physicians also knew that serious illnesses could develop decades after an individual’s initial exposure, lessons they had learned from Dr. Selikoff and his groundbreaking research in the 1960s.
Over the course of their first meeting and several subsequent ones that included colleagues such as David Prezant, MD, Chief Medical Officer of the Fire Department of the City of New York (FDNY), the Mount Sinai physicians established a blueprint for what is now the World Trade Center (WTC) Health Program.
Today, 20 years later, the WTC program continues to receive new patients. It consists of six New York City-area medical centers, including Mount Sinai, and a separate treatment center exclusively for FDNY members. Together, the centers treat more than 80,000 emergency responders—firefighters, police, recovery and cleanup workers—as well as 30,000 people who worked, lived, or went to school near the disaster zone in lower Manhattan. Their medical care will be funded through 2090, under the federal James Zadrogra 9/11 Health and Compensation Act, which was signed into law in 2011.
“The Selikoff Centers had exceptional doctors and they worked their fingers to the bone getting this program off the ground,” says Michael Crane, MD, MPH, who joined Mount Sinai in 2006 as Director of the World Trade Center Health Program Clinical Center at Mount Sinai. “Their incredible dedication got this going. It was hardscrabble, making phone calls and asking people to speak out about the program. They were helped by community and civic leaders and members of Congress who got behind this. Their story is really an inspiration.”
Dr. Crane, whose program at Mount Sinai cares for roughly 23,000 responders, was medical director of Con Edison’s health program on 9/11. Immediately following the attacks, he was down at the site making sure Con Edison’s recovery workers had proper masks and breathing protection. But that was not the case for many other responders. The filters on their masks clogged up after an hour and workers were either too busy to replace them or could not find extra masks.
Sandra Lowe, MD, talks about what we’ve learned about trauma and resilience from treating responders. Her answers have implications for COVID-19 and beyond. Dr. Lowe is Medical Director at the World Trade Center Mental Health Program Clinical Center of Excellence at Mount Sinai.
“You’d see the masks hanging off their faces,” says Dr. Crane. “They were running in to save people’s lives. They ran in without appropriate equipment and suffered the consequences.”
The dedication of the recovery workers was inspiring, says Dr. Crane. “So many of them had friends or relatives or people they knew or had trained with down there. Guys who ran down there had built the towers. So it was a tremendous emotional shock. They were energized by this passion to do something about it. So many of them said the same thing: ‘It’s family. I want to find them.’ It was deep and personal and real.”
Michael Crane, MD, MPH, left, and Julia Nicolaou Burns, Administrative Director, Selikoff Centers for Occupational Health
On 9/11, Craig L. Katz, MD, was the newly appointed Director of The Mount Sinai Hospital’s Psychiatry Emergency Room. But it was his leadership of the nonprofit organization, Disaster Psychiatry Outreach, which he had founded during his medical residency, which led to his direct involvement with the families of the victims, survivors, and responders. Almost immediately, Dr. Katz helped organize volunteer psychiatrists who met informally with these groups down at Ground Zero or at the Family Assistance Center that New York City had established downtown.
At the time, lung screenings for responders were being funded by the National Institute for Occupational Safety and Health (NIOSH), but no federal funding had been allocated for mental health. Yet the psychological effects of the troubling rescue and recovery mission were beginning to show.
A few months after the attacks, Dr. Katz says Mount Sinai’s Psychiatry Department received a phone call from the late Stephen Levin, MD, then Medical Director of the Mount Sinai Selikoff Centers for Occupational Health, who said, “ ‘I have all these rescue and recovery workers coming into my office and they’re crying. I don’t know what to do with them. I’m looking at lung exposures and they’re crying.’”
Craig L. Katz, MD
Looking to assist the workers, Dr. Katz, currently a Clinical Professor in the departments of Psychiatry, Medical Education, and System Design and Global Health, at the Icahn School of Medicine at Mount Sinai, wrote a three-page grant proposal to the private Robin Hood Foundation requesting funding for mental health. “That was the birth of the mental health program for recovery workers,” he says.
The Robin Hood Foundation would go on to provide the program with more than $6 million until 2011, when the Zadroga Bill was enacted, according to Dr. Katz. “Robin Hood typically funds underserved populations,” he says. “They agreed the rescue and recovery workers were an underserved population. They were largely men who don’t readily seek help for mental health issues. These blue collar guys were not our usual customers.”
Today, Mount Sinai’s World Trade Center (WTC) Mental Health Program actively treats close to 700 individuals under the leadership of Sandra M. Lowe, MD, Medical Director. “The people involved in the recovery and restoration operations were exposed to so much trauma,” says Dr. Lowe. “Some individuals developed post-traumatic stress disorder (PTSD), major depressive disorder, all kinds of anxiety disorders, and some developed substance misuse problems because that was one of the ways they tried to manage the symptoms they had.”
These mental health conditions, combined with the aero-digestive disorders, lymphoma, or lung cancer, which also stem from their work at Ground Zero, have created a complicated set of issues for this aging cohort of responders, many of whom are now in their 50s.
Sandra M. Lowe, MD
“Some members of the public may question the relevance of the WTC Health Center 20 years later,” says Dr. Lowe. “It is very relevant and needed. People are not aware of the ongoing physical or psychological struggles. We see an increased number of patients coming in for help. They have developed worsening physical conditions or now they’re retiring from the New York City Police Department. They may have been suffering PTSD for 20 years, but now they’re no longer afraid of the stigma associated with seeking help. They’ll say, ‘Doc, this is the first time I’ve told anyone about my nightmares.’ We hear the appreciation from the patients and their families.”
As time goes on, Mount Sinai’s clinical team also sees new health issues arising among responders, including the possibility of early cognitive decline. NIOSH is funding studies to determine whether exposure to toxins at Ground Zero is actually associated with this decline and whether there is a need for an early intervention program.
Kathryn Marrone, LCSW, Director of Social Work for the World Trade Center Mental Health Program, joined Mount Sinai in the summer of 2002 for what she was told at the time would be a one-year job monitoring and assessing the needs of responders. Almost two decades later, she is still working with these men and women. Only now, she says, they are aging and require a shift in services.
The responders “recovered bodies, saw people jumping from buildings, and watched the buildings collapse,” she says. “The level of trauma these individuals experienced was quite severe. They were completely confused about how to manage that emotionally.” But over the years, in their dealings with social workers, doctors, and other colleagues in the program, “Mount Sinai has become a lifeline for so many individuals. It is a place where they can turn because no one else quite gets what they’re experiencing.”
Staff from Mount Sinai Morningside, from left: Ruby Guzman, Maytal Rand, and Amy Bush
Mount Sinai Morningside, in collaboration with Mount Sinai South Nassau, participated in Harlem Week’s “A Great Day in Harlem” event on Sunday, August 8, at the Ulysses S. Grant National Memorial.
In partnership with One Hundred Black Men, Mount Sinai premiered a series of videos featuring members of the community and local celebrities encouraging people to protect themselves and their loved ones against COVID-19 by getting vaccinated.
“Thanks to Mount Sinai South Nassau’s vaccination mobile unit—the Vaxmobile—and the incredible staff from Mount Sinai Morningside, we were able to engage residents of Harlem in conversations about the vaccine, and we even provided the vaccine onsite to those ready to roll up their sleeves,” said Amy Bush, Director, Volunteer Services, Mount Sinai Morningside. “In line with the mission of the event, we were honored to have the opportunity to educate attendees, and also give hope to Harlem by spreading immunity in the community.”
In July, Mount Sinai Health System’s leadership offered staff the opportunity to receive a Commemorative COVID-19 Challenge Coin to recognize their selfless dedication and commitment during the height of the COVID-19 pandemic in 2020 and 2021.
Challenge Coins, as they have become known, are an important tradition, particularly within the crisis-response community, symbolizing a catastrophic event and recognizing the teamwork and individual sacrifice needed to overcome such events. In the past, they have been given to front-line workers after historical events of importance, such as 9/11 and Hurricane Maria relief efforts in Puerto Rico.
Click here to see three Mount Sinai employees reflecting on challenge coins they received for crisis responses.
In that tradition, this coin is designed to recognize the teamwork and partnership that characterized Mount Sinai’s response to the COVID-19 pandemic. Inscribed on one side of the coin are those exact two words. The opposing side bears a representation of how Mount Sinai’s eight hospitals (marked by eight stars) and hundreds of ambulatory sites—bolstered by clinical, ambulatory, administrative, and operations staff, trainees, and students—united as a system that, together in service, gave and continues to give everything to those who need us most.
Many sites across Mount Sinai hosted events or had managers make rounds to distribute the coins with letters of gratitude. Many other sites are still distributing the coins.
“We offer this small but meaningful token of our deep appreciation. We hope that it will serve as one way to memorialize the remarkable efforts you have made as individuals and as members of a team that met and countered this disastrous pandemic” says Kenneth L. Davis, MD, President and Chief Executive Officer of Mount Sinai Health System.
The Seaver Autism Center for Research and Treatment partnered with Centro Ann Sullivan Del Perú to serve children with autism spectrum disorder and their families. Above, Pilar Trelles, MD, Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, conducting an evaluation with a family in Lima, Peru.
Genomic research is now an integral part of the study and treatment of autism spectrum disorder (ASD) and related neurodevelopmental disabilities, so it is crucial to include more ethnically and racially diverse populations, said Pilar Trelles, MD, a psychiatrist and researcher at the Seaver Autism Center for Research and Treatment, who was the featured speaker for a virtual talk. The session, “Forming Community Ties to Improve Diversity in Autism Genomic Research,” is available here.
The talk was part of the Raising Disability Awareness Virtual Talk Series, which featured speakers from around the Mount Sinai Health System and the community to raise awareness and promote an inclusive and equitable work place and health care environment for people with disabilities.
“Data contained in the National Human Genome Research Institute and European Bioinformatics Institute Genome-Wide Association Studies Catalog indicate that most of the individual genetic samples—78 percent—come from individuals of European descent,” said Dr. Trelles, Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai. “And this is translating into clinical practice, because we are learning less about individuals of diverse ancestry.”
Pilar Trelles, MD, is a psychiatrist and researcher with the Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai.
Dr. Trelles and other staff at the Seaver Autism Center are dedicated to caring for people of all ages with ASD, leading clinical trials, and furthering research into drug development, molecular targeting, neurology, and genomics. She said that disparities and barriers exist overall for people with ASD who belong to minority groups. Some of these barriers include lack of trust in research—often based on historic inequities in science and health care—limited representation of minorities in science, a lack of cultural competency among physicians and scientists, and a lack of infrastructure.
To combat disparity and increase the accessibility to care, Dr. Trelles collaborated with families and children with ASD in Peru, creating an international partnership between the nonprofit Centro Ann Sullivan Del Perú and the Seaver Autism Center. The partnership is intended to “promote family and caregiver empowerment, educational programs, and collection of bio-specimens for genetic analysis and clinical information,” she said. The goal for the future of health care for people with ASD and their families is to develop a strong partnership where there is a clear and direct benefit to the community.
“It cannot be a one-time thing, it has to be a sustainable model that will last over time,” Dr. Trelles said. As a result of increasing accessibility where possible, her team found that compared with 2016, there has been a significant increase of Asian, Black, mixed ancestry, and Hispanic people in research participation.
Dr. Trelles ended her talk on a hopeful note. “The idea is to work with communities that could benefit from the expertise that we have, where we can actually bring a clear benefit, and provide better care and education for families,” she said. “So that we can build trust and transparency moving forward.” For more information, visit the Seaver Autism Center site.
