Professor of Psychiatry J. Richard Ciccone, M.D. Honored with Kaiser Medal

Jun. 3, 2016

The Rochester Academy of Medicine recently bestowed its highest honor—the Albert David Kaiser Medal—upon J. Richard Ciccone, M.D., professor of Psychiatry and founding director of the Psychiatry and Law Program at the University of Rochester School of Medicine.

The medal recognizes him for more than four decades of distinguished service and contributions to the medical community as a clinician, teacher, and leader. He is best known for his trailblazing work to bring modern forensic psychiatry into the American courtroom.

Ciccone is the fourth psychiatrist to receive the Kaiser Medal in the academy’s 85-year history. The first was his mentor and friend John Romano, M.D. (1908-1994), the inaugural chair of the Department of Psychiatry. During Ciccone’s psychiatric residency at the University of Rochester from 1969 to 1972, Romano was a major influence on his progression as a forensic psychiatrist.

As a medical student at the University of Pittsburgh, Ciccone initially planned to become an internist, following in the footsteps of his uncle, but became intrigued with the connection between psychiatry and medicine.

“In my rotations, I encountered many patients who had emotional problems that influenced the presentation of their physical problem,” said Ciccone. “So I asked one of my professors for some guidance, and he said, ‘you’ve got to go to Rochester to study with John Romano and George Engel.’ And, so I did.”

In Rochester, Ciccone was struck by the fact that Romano opened the doors of Strong Memorial Hospital to provide compassionate psychiatric treatment to prisoners—even those under armed guard—who would previously have been sent to a state institution.

Romano also reached out to the community to create a court clinic that provided psychiatric consultations to the legal system.

It was one of those court clinic rotations in his third year of residency that awakened in Ciccone a latent interest in the law.

 “I saw for the first time the very real possibility of creating an academic discipline of forensic psychiatry, and I knew that’s what I wanted to do.”

For Ciccone, it was a chance to follow a passion for justice that his father, a first-generation Italian immigrant, instilled in him while growing up in their multigenerational home in Brooklyn in the 1940s.

Ciccone’s career was also nurtured by the teachings of Rochester psychiatrist George Engel, M.D. (1913-1999), who created a consultation liaison service to provide psychiatric consultation across the Medical Center, in such areas as obstetrics/gynecology, orthopaedics, and intensive care.

“From Dr. Engel I learned the principles of consulting to another system,” he says. “For example, if I’m going to consult with a doctor about an orthopaedic patient, I have to know the language of that floor. I have to understand the issues the providers are confronting and the culture they’re working in, so that I can understand what they’re asking, conduct a thoughtful evaluation, and provide them an answer in terminology they can use.”

The ability and desire to bridge two distinctly different worlds proved essential to his life’s work, and helped to elevate psychiatry to a critical place of usefulness within the legal system.

“In order to have a meaningful impact, you have to know the language of the legal system, understand the questions they’re asking, why they’re asking them, the context in which our answers are going to be used, and be able to speak in the language that’s meaningful to them,” he says. “If I talk in my own psychiatric jargon, it’s not going to mean a whole lot to an attorney or a judge.”

Romano and Engel fostered an environment that was “fertile soil” for the development of forensic psychiatry, says Ciccone. Most widely known for its criminal applications—such as the insanity defense and competency to stand trial—forensic psychiatry is also relevant in civil law and can be used to determine psychiatric damages from injuries, or settling custody matters.

Under Ciccone’s leadership, the UR was among the first to offer a Psychiatry and Law program, and its fellowship program—which accepts two trainees a year—was one of the first eight accredited in the country in 1986. The program also recently became the first to offer a training track in child and adolescent forensic psychiatry.

“Despite his numerous accolades and achievements, Richard speaks with humility, shows compassion to trainees, and is quick to spread credit to his colleagues,” says associate professor of Psychiatry Robert Weisman, D.O.Weisman, who today co-directs the Fellowship in Psychiatry and Law, is one of more than 45 doctors who completed their fellowships during Ciccone’s tenure.

“Richard has selflessly shared his principles for excellence in practice with me since my fellowship days in 1995, and continues to share numerous gifts and teachable moments with me,” says Weisman.

Ciccone earned his bachelor’s degree from Columbia University with dual concentrations in Chemistry and History, before earning his medical degree at the University of Pittsburgh and completing his residency in Rochester. He also served two years in the U.S. Navy, rising to the rank of Lieutenant Commander, where he was head of Psychiatry at the Pensacola Naval Hospital. Among his many career achievements, he is past-president of the American Academy of Psychiatry and Law (AAPL), and founded APPL’s Forensic Psychiatry course. He is also past-president of the Association of Directors of Forensic Psychiatry Fellowship, and chaired the American Psychiatric Association (APA)’s Commission on Judicial Action from 1993 to 2000, where he provided amicus briefs to the Supreme Court and chaired the Commission on Public Policy, Litigation and Advocacy.

A national and international lecturer, he has authored more than 100 papers and book chapters. His many awards for contributions to forensic psychiatry and patient advocacy include the APA Special Presidential Commendation in 2002, the AAPL Golden Apple Award in 2005, and the APA Isaac Ray Award in 2013.