Dr. Caine served from 1996-2017 as John Romano Professor and Chair, URMC Department of Psychiatry. He founded with colleagues the UR Center for the Study and Prevention of Suicide (CSPS) in 1998, served as its Co-Director through 2021, and now as one of its Senior Faculty. The Department of Psychiatry grew clinically during his tenure from 58,000 to 200,000 outpatient visits, 1700 to 2600 inpatients admissions, and 12,000 emergency assessments annually, with the Chair functioning as the clinical, academic, and administrative lead. During this time, the Department initiated diverse, innovative clinical programs, including among others: primary care and inpatient medical services for persons with serious mental and substance use disorders; mental health services for persons with deafness; forensic assertive community treatment teams for individuals with serious mental disorders and legal jeopardy; unique clinical and supportive care for victims of intimate partner violence; daycare services for children of families using the Monroe County Courts; and bilingual ambulatory care for Spanish speaking patients and families. More broadly, it developed an array of collaborative community clinical, research, and training activities under the umbrella of “public health and preventive psychiatry.”
International: From 2001-2020, Dr. Caine served as PI/PD for a series of NIH Fogarty International Center (FIC) training programs devoted to building collaborative infrastructure and preparing early career Chinese researchers devoted to suicide research and public health-population approaches to prevention – first funded as D43 “ICOHRTA” programs and more recently as a D43 NCD-LIFESPAN. He also was the recipient of an R25 from FIC to develop mHeath training and research, which ended in 2020. Collaborations with colleagues in Asia continue.
Clinical: Dr. Caine has deep experience in the evaluation, management, and aftercare of seriously ill psychiatric patients, including acutely suicidal individuals, dating to the 1970s. In the past, he worked as a year-round inpatient hospitalist for nearly a decade and as an outpatient psychiatrist for more than two decades. He participated in nearly 200 psychological autopsies as part of a team that worked with the Office of the Medical Examiner, Monroe County, NY. As part of his clinical oversight of the Department of Psychiatry, Dr. Caine reviewed all institution-related suicides from 1993-2017.
Moving to part-time Emeritus status, Dr. Caine has continued to teach psychiatrists-in-training, mentor early-career faculty and select postdoctoral fellows, participate in research, publish, and continue policy-related consultation.
I joined the Medical Center and the Departments of Psychiatry and of Neurology in July 1978, served as Acting Chair of the Department of Psychiatry from 1993-1996, and as John Romano Professor and Chair from October 1996-August 2017. Since moving to part-time Emeritus status in July 2020, I have continued to work on specific priorities: mentoring and research involving "public health and preventive psychiatry" as it relates to suicide, attempted suicide, and deaths such as overdose fatalities that arise from common risk factors. I continue exploring the social and community factors that contribute to suicide and risk-related deaths, seeking to integrate this understanding with perspectives gained from past work as an inpatient psychiatrist, an outpatient clinician, and a leader of patient-care services. Together with lessons learned from visiting other countries that effectively reduced rates of suicide, my major efforts involve 'rethinking suicide prevention' for the United States.
Dr. Caine’s initial research focused on neuropsychiatry, neuropsychology, and geriatric psychiatry. Subsequently, he has focused for nearly three decades on public health, and health system approaches to preventing suicide, suicide attempts, and risk-related adverse outcomes, in great measure by addressing “upstream” (aka, “distal”) risk and protective factors. Dr. Caine led three major research centers, including the CDC funded Injury Control Research Center for Suicide Prevention (ICRC-S; 2012-2020), the NIMH funded CRC for the Study of the Psychopathology of the Elderly (1986-1995), and a NIMH/NIDA developing suicide prevention research center, the Center for Public Health and Population Interventions for Preventing Suicide (PHP-Center; 2004-2010) – the latter serving as a foundation for the later ICRC-S. Each comprised a diverse multidisciplinary group of investigators, with the latter two built as a center-without-walls. Dr. Caine was PI of a collaborative consensus process on public health approaches to suicide prevention, funded from 2001-05 by a coalition of NIMH, NIAAA, NIDA, NINR, NICHD, SAMSHA, and CDC. He was PI/PD for a NIMH Research Education Grant (R25) from 2005-10 that supported the training and development of multiple graduate and post-graduate suicide researchers, as well as community partnership teams, and the PI/PD for a NIMH NRSA from 1988-1992/1993-2013. The NIMH/NIDA funded PHP-Center spawned a wide variety of ongoing grants, as well as the VA VISN 2 Center of Excellence on Suicide Prevention. The ICRC-S, the only such center in the United States devoted specifically to suicide prevention, merged injury prevention and mental health perspectives to forge new public health, community-oriented approaches to preventing suicide, attempted suicide, and their antecedent risks. It provided the foundation for the “Colorado National Collaborative,” which has worked with state and community leaders to build an ongoing community-integrated approach to preventing suicide and related premature deaths. During Dr. Caine’s tenure as Acting Chair and Chair, the Department successfully sponsored 30 NIH K-awards.