Program Information

Program Learning Objectives


Graduates of the Forensic Psychiatry Fellowship will demonstrate advanced knowledge, skills, and professional values in the following areas:

Professionalism & Ethics

  • Uphold the highest standards of professionalism and ethical principles in psychiatry and forensic psychiatry.

Patient Care

  • Provide high-quality, patient-centered care for adults and juveniles in correctional settings that is compassionate, equitable, appropriate, and effective.

  • Manage and treat justice-involved individuals with conditions such as mental illness with elevated violence risk, malingering, personality disorders, self-injurious behavior, problematic sexual behavior, and severe or persistent mental illness.

Clinical Practice & Systems Integration

  • Integrate telehealth and electronic health records into forensic assessment and treatment.

  • Provide culturally responsive care and apply legal and regulatory principles in forensic evaluations and treatment.

Forensic Psychiatry Knowledge

  • Demonstrate expertise in key areas including:

    • Assessment of malingering and problematic sexual behavior

    • Rights of incarcerated individuals

    • Ethical, administrative, and legal issues in forensic psychiatry

    • Evaluation and treatment of incarcerated persons

    • Inequities in mental health treatment and legal outcomes

    • Legal regulation of psychiatric practice

    • Competency to stand trial, criminal responsibility, disability, sexual harassment, and civil competencies

    • Violence risk assessment and management

    • Forensic report writing

    • Maintaining professional well-being and addressing vicarious trauma

Legal System & History

  • Understand the historical and current relationship between psychiatry and the legal system, with attention to both civil and criminal law.

Scholarly Inquiry & Lifelong Learning

  • Evaluate and improve patient care through self-assessment, critical appraisal of evidence, and ongoing professional development.

Interpersonal & Communication Skills

  • Communicate effectively with patients, families, and healthcare professionals to foster collaboration and improve outcomes.

Systems-Based Practice

  • Recognize and respond to the broader healthcare system, including structural and social determinants of health, and coordinate care using available resources to optimize patient outcomes.

 

 

Program Goals


The Forensic Psychiatry Fellowship at TTUHSC El Paso is designed to advance clinical training, scholarship, and community impact. Program goals include:

Training & Recruitment

  • Recruit and train 1–2 forensic psychiatry fellows each academic year from the initiation of the program.

  • Increase interest in forensic psychiatry among general psychiatry residents, leading to a stronger applicant pool for the fellowship.

  • Grow and retain a workforce of board-certified forensic psychiatrists in El Paso and across Texas.

Clinical Experience

  • Ensure each fellow conducts at least four independent forensic evaluations, including competency to stand trial, criminal responsibility, conditional release, civil commitment, right to refuse treatment, violence risk assessment, criminal recidivism, or guardianship.

  • Require each fellow to prepare at least four forensic reports for the courts and provide expert testimony at least once; if testimony opportunities are unavailable, fellows will participate in a mock trial.

  • Provide opportunities for fellows to care for at least ten acutely ill psychiatric patients under criminal and civil commitments in inpatient, outpatient, or correctional settings each academic year.

Professional Development

  • Require attendance at the American Academy of Psychiatry and the Law (AAPL) Annual Meeting during the fellowship year.

  • Require attendance at the AAPL Annual Review Course to prepare for the ABPN Forensic Psychiatry Board Exam.

  • Support fellows in producing at least one scholarly or research product, such as a publication, quality improvement project, academic presentation, or participation in workshops, councils, or committees.

Educational Impact on Residents

  • Improve general psychiatry residents’ comfort with forensic psychiatry topics and patients.

  • Enhance resident performance as reflected in myEvaluations and PRITE exam scores.

Community & System Impact

  • Expand the number of general and forensic psychiatrists working in local mental health authorities (LMHAs), state hospitals, and correctional facilities.

  • Improve the quality of mental health care and forensic evaluations in correctional facilities and state hospitals in El Paso and surrounding areas.

  • Reduce the average time for competency restoration to stand trial in the region.

  • Reduce costs to local and state courts by providing high-quality forensic evaluations and expert opinions compared to relying on private evaluators.

  • Decrease repeat admissions to the state hospital through enhanced Assisted Outpatient Treatment (AOT), lowering costs to the state.

  • Decrease incarceration rates by diverting individuals with mental illness from correctional facilities to appropriate and least restrictive treatment settings.

 

Course Descriptions


The Forensic Psychiatry Fellowship at TTUHSC El Paso offers a diverse set of clinical and didactic experiences across multiple settings. Fellows gain direct exposure to forensic evaluations, competency restoration programs, correctional psychiatry, and private practice, while also engaging in interdisciplinary learning opportunities.

TTUHSC Forensic Evaluations

Fellows participate in a variety of court-ordered forensic evaluations, including:

  • Competency Evaluations

    • Western District of Texas (Federal)

    • El Paso Psychiatric Center (EPPC)

  • Chapter 55 Juvenile Evaluations

    • 65th District El Paso County Juvenile Court

  • Other Forensic Evaluations

    • Criminal responsibility, guardianship, asylum, civil mental health evaluations (CMEs), and more

Assisted Outpatient Treatment (AOT) Clinic & Round Table – EHN

The AOT Program provides community-based treatment to individuals under civil court commitment who have serious mental illness and a history of non-adherence to care. Services address barriers such as cognitive deficits, transportation and financial challenges, limited support systems, or prior negative treatment experiences.

  • Clinic (8:00 a.m.–12:00 p.m.) – Outpatient psychiatric care

  • Case Management Evaluations (1:00–2:00 p.m.)

  • Round Table (2:30–5:00 p.m.) – Multidisciplinary case review and treatment planning

Fellows engage in intensive case management, medication management, skills training, substance use disorder interventions, and support for housing and employment.

Competency Restoration Programs – EHN

Outpatient Competency Restoration (OCR)

  • Provides treatment and rehabilitation for individuals found incompetent to stand trial.

  • Offers psychiatric services, case management, substance use treatment, and social support (housing, utilities, food).

  • Reduces incarceration and inpatient hospital stays while improving legal and treatment outcomes.

Jail-Based Competency Restoration (JBCR)

  • Delivers competency restoration services to incarcerated adults deemed incompetent to stand trial (IST) under Texas law.

  • Reduces reliance on state hospital beds while providing cost-effective, clinically appropriate treatment.

  • Offers timely access to psychiatric care, rehabilitation, and substance use interventions for eligible participants.

Jail Mental Health Clinic – El Paso County Jail Annex (EHN)

The clinic provides comprehensive psychiatric services to state and federal inmates, including:

  • Medication management

  • Psychiatric evaluations and intake assessments

  • Crisis intervention and psychosocial rehabilitation

  • Individual and group therapy

  • Substance use treatment

Fellows provide direct psychiatric medication management while collaborating with jail and medical staff.

Juvenile Probation Department (JPD)

Fellows work alongside Child and Adolescent Psychiatry Fellows under the supervision of a board-certified specialist. Training focuses on assessment, treatment, and management of juveniles in correctional settings.

Forensic Psychiatry in Private Practice

Fellows gain exposure to community-based forensic psychiatry by working with private practitioners. Training includes evaluations for competency, guardianship, and other civil or criminal matters.

Forensic Neuropsychology for Forensic Psychiatrists

Virtual Monthly Didactic
Fellows participate in interactive sessions led by a forensic psychologist, focusing on:

  • Foundational principles of forensic neuropsychology

  • Ethical considerations

  • Multicultural issues in forensic assessment and treatment

 

Sample Fellowship Schedules


Fellows participate in a structured weekly schedule of clinical rotations, didactics, and supervision. Schedules are divided into two semesters: July–December and January–June.

Fellow 1

Time Monday Tuesday Wednesday Thursday Friday
July–Dec OCR/JBCR Private Practice Rotation (9:30–12:30) TTUHSC AOT Clinic Texas Didactics
        AOT Roundtable Group Supervision Ortiz (1–3 PM)Forensic Psychologist Didactic (3–5 PM, 3rd Friday)
Jan–Jun OCR/JBCR JPD TTUHSC Texas Didactics  
          AOT RoundtableGroup Supervision Ortiz (1–3 PM)Forensic Psychologist Didactic (3–5 PM, 3rd Friday)

Fellow 2

Time Monday Tuesday Wednesday Thursday Friday
July–Dec OCR/JBCR JPD TTUHSC Texas Didactics  
          AOT RoundtableGroup Supervision Ortiz (1–3 PM)Forensic Psychologist Didactic (3–5 PM, 3rd Friday)
Jan–Jun OCR/JBCR Rivera (9:30–12:30) TTUHSC AOT Clinic Texas Didactics
      Private Practice Rotation (3–5 PM)   Group Supervision Ortiz (1–3 PM)Forensic Psychologist Didactic (3–5 PM, 3rd Friday)