Bipin Subedi, MD, explores how health systems can better care for patients with severe mental illness who cycle between hospitals, homelessness, addiction, and the justice system. He argues that acute inpatient treatment, while essential, is rarely sufficient on its own. Preventing the revolving door of repeated hospitalizations requires psychiatry to extend beyond hospital walls and build integrated systems that follow patients into the community.

Drawing on his leadership at NYU Bellevue and his background in forensic psychiatry, Dr. Subedi describes a model of care built on sustained relationships, flexibility, and continuity. He reflects on how programs like transitional housing and mobile post-discharge support can provide the “scaffolding” patients need when insight and executive function are impaired by psychosis. The conversation closes with practical guidance on strengthening medication adherence—particularly through thoughtful use of long-acting injectables—and on meeting patients where they are to advance more humane, effective care.

Bipin Subedi, MD, is Associate Professor of Psychiatry at NYU Grossman School of Medicine and Chief of Psychiatry at NYU Bellevue Hospital. He is a forensic psychiatrist with prior leadership experience in New York City’s jail system.

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01:36 Bellevue’s Mission and Rising Clinical Complexity
04:43 Extending Care Beyond the Hospital Walls
05:15 Bridge to Home and Transitional Stabilization
10:44 Forensic Psychiatry and the Justice System
14:17 Psychosis and Impaired Insight
15:53 Post-Discharge Scaffolding and Critical Time Intervention
18:47 Preventing Relapse with Long-Acting Injectables
22:36 Meeting Patients Where They Are

This episode is intended for psychiatrists, mental health clinicians, and health system leaders interested in serious mental illness and innovative models of integrated community care.

This discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.

Senior Producer: Jon Earle

Katlyn Nemani, MD, explores how autoimmune and inflammatory brain disorders can present as first-episode psychosis—and why some patients diagnosed with schizophrenia may actually have a treatable immune-mediated illness. She explains the clinical features that should prompt suspicion for autoimmune psychosis, including subacute onset, subtle neurologic signs, and poor response to antipsychotics, even when standard imaging and antibody tests are unrevealing.

Dr. Nemani also discusses the limits of current biomarkers, how to think clinically when diagnostic certainty is incomplete, and why early immunotherapy can dramatically alter outcomes. The conversation closes with a forward-looking discussion of emerging research suggesting that a meaningful subset of schizophrenia-like illness may ultimately be reclassified as autoimmune in origin.

Katlyn Nemani, MD, is a Research Assistant Professor in the Departments of Psychiatry and Neurology at NYU Grossman School of Medicine and a graduate of NYU’s combined Neurology-Psychiatry residency program.

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00:00 When Psychosis May Be an Autoimmune Disease
01:18 Early Psychiatric Symptoms of Autoimmune Encephalitis
02:47 Why Subtle Neurologic Clues Matter
04:00 A Case of Rapidly Reversible Psychosis
06:37 The Limits of Antibody Testing
07:51 Why Early Treatment Changes Outcomes
08:18 Rethinking the Heterogeneity of Schizophrenia
09:31 How Common Is Autoimmune Contribution to Psychosis?
10:48 Network-Level Brain Effects and Open Research Questions

This episode is intended for psychiatrists, neurologists, and other clinicians interested in psychosis, neuroinflammation, and complex diagnostic presentations at the psychiatry–neurology interface.

This discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.

Senior Producer: Jon Earle

Lindsey Gurin, MD, discusses how clinicians can approach patients whose symptoms fall at the intersection of psychiatry and neurology. Drawing on her work with traumatic brain injury, PTSD, and persistent post-concussive symptoms, she explains why attempts to separate psychological trauma from neurological injury often obscure what patients actually need.

The conversation explores identity disruption after brain injury, the unintended effects of rigid recovery timelines, and the importance of continuity in understanding symptoms over time. Dr. Gurin also discusses how neurodevelopmental traits such as ADHD shape vulnerability and treatment response, when stimulant medications can be appropriate after concussion, and why breaking complex presentations into treatable components often matters more than assigning a single diagnosis.

Lindsey Gurin, MD, is Assistant Professor in the Departments of Neurology, Psychiatry, and Rehabilitation Medicine at NYU Langone Health, and Director of the Neurology/Psychiatry Residency Program.

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00:00 Brain Injury and Identity
01:27 What Is the Psychiatry–Neurology Double Board?
02:41 Why PTSD and TBI Overlap
03:28 What “Shell Shock” Really Means
06:00 When Concussion Symptoms Don’t Go Away
07:25 Life Before vs After Brain Injury
08:46 ADHD as a Hidden Risk Factor
10:28 Using Stimulants After Brain Injury
12:40 Rethinking “Post-Concussion Syndrome”
13:27 The Future of Neuropsychiatric Care

This episode is intended for psychiatrists and other clinicians caring for patients with complex neuropsychiatric presentations at the intersection of psychiatry and neurology.

This discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.

Senior Producer: Jon Earle