From an early point in his career, Dr. Jonathan Zimmerman has gravitated toward leadership, heading up the departments in which he worked. The Floating Hospital is no different. Since January, he has been our behavioral health director, heading its group of licensed psychologists, social workers, case managers, board-certified psychiatrists and psychiatric nurse practitioners, who work together to deliver an essential component of patient care. “I really buy into the lifelong learning model of medicine. I feel like being in supervisory roles helps you stay educated in what you need to know and stay connected to an academic mindset,” he said. “It’s because you’re teaching, but also being challenged by people with new ideas and responding to that.” Before he started at the Floating Hospital, he worked for seven years at Mount Sinai Morningside as the medical director for their personality disorder treatment program as well as an assistant professor of psychiatry, where he still teaches on a voluntary basis. He made the switch because he wanted a new opportunity grounded more in general psychiatry, and The Floating Hospital’s mission to expand access to care appealed to him. “Especially recently, with the increased need of people who don’t have the resources to access it as readily, leading up a behavioral health department that works with this population was appealing,” he said. He saw an opportunity to deliver effective care most efficiently to a large population that was both enticing and rewarding.

Treating the patients

Regarding his approach to care, he said, “I’m very interested in personality and how it develops in terms of understanding people.” His career has reflected that whether at Mount Sinai or at Staten Island University Hospital, where he supervised psychiatry residents as the director of its outpatient psychotherapy program. He has seen “how we all perceive the world differently and how important relationship building is to mental health.” He has also witnessed the “kind of things that can interfere with that,” and the therapeutic value of “learning to understand each other through talk therapy.” This is based in his study and use of psychodynamic therapy, which looks at how past experiences shape the unconscious and current behavior. As clients learn self-awareness, they can increasingly rely on themselves to address problems in a healthy way. Addressing a recent influx of Spanish-speaking migrants has been a top priority. “Our biggest demand is from Spanish-speaking patients, children and families, and that’s what we most want to work on now.” The department is made up of five psychotherapists, two-full time prescribers and a part-time child psychiatrist as well as a part-time therapist at the Floating Hospital’s satellite clinic at the Help Morris transitional housing facility in the Bronx. The child psychiatrist and two of the therapists speak Spanish. The newer arrivals are having “a lot of difficulty with adjustment, culture shock.” They are experiencing “the stress and anxiety that provokes, along with uncertainty about getting their needs met,” he said. As a result, the clinicians see many patients with anxiety disorders. In addition, “We work with domestic violence shelter populations, so we’re working with people who have a lot of trauma in their history and are dealing with the effects of that.” Add to that the general psychiatric conditions that are seen across the broader population, and it’s a full and varied case load.

A philosophy of care

He brings a philosophy to the hospital of “creating a stable, predictable therapeutic environment for our patients and a place that they feel comfortable coming in, knowing that the staff is responsive and there is a stable presence here for them,” he said. “It’s about engagement from the beginning. We’re trying to build a therapeutic alliance and demonstrate that we’re working towards the same goal, so patients have a reliable partner and feel comfortable coming back.” Providing behavioral healthcare while removing barriers to it, such as transportation, language and the ability to pay for it, is part of the hospital’s holistic approach to addressing the needs of its patients. Having the behavioral health department on the same floor as the primary care providers encourages easy communication and rapid response when they see someone in crisis or with an urgent therapeutic need. He was impressed early on with the amount of connection and interdepartmental support evident within the walls of the clinic. He also acknowledged the role of community outreach, “because the real way to improve mental health is to bring it into the community, not wait for people to come to you.” Representatives of the hospital “engage very closely with the community and with our shelter populations to start a connection and make people aware of our services as an option.” They’re also encouraged to “recognize issues that can be addressed early, so they don’t progress to something more complicated down the line.”