By Helen K. Kelley
Georgia physicians are at the forefront of developing innovative programs and research in the field of psychiatry. Here, we explore how they are increasing the knowledge and skills of new doctors, improving the lives of an underserved population with mental illness and more.
Peer Specialist Has Important Role in Training Medical Students and Junior Doctors
The Department of Psychiatry at Medical College of Georgia (MCG) at Augusta University has developed a unique program that helps people with mental illness in their recovery while, at the same time, training residents and medical students in treating mental illness. According to Dean Peter F. Buckley, M.D., the program is modeled on the recovery peer approach, which is based upon the premise that an individual with a “lived experience” is uniquely able to contribute to the rehabilitation and recovery of a person needing services.
Citing the New Freedom Commission on Mental Health established by President George W. Bush in 2002 to conduct a comprehensive study of the United States mental health service delivery system and make recommendations for improvements, Buckley says it is vital that doctors receive training that will sensitize them to become more holistic in their views of people with mental illness.
“We posed the question, ‘If it is so important in our nation to have policies to guide how we treat people for mental illness, shouldn’t we be training our doctors in that way?’” he said. “Our program has incorporated people who have experienced mental illness, but are more stable and far along in their recovery, to help others in their recovery. And then we took this model a step further by introducing it into the arena of training doctors and medical students. They now have the opportunity to care for people with mental illness with the benefit of guidance from a peer support specialist.”
Buckley adds that departments of psychiatry at other schools around the country have shown interest in MCG’s model.
“We’ve written and published about our philosophy and model,” he said. “Today, the peer support specialist, to us, is no longer unique and has been mainstreamed into what we do.”
Competency Restoration Program Helps Jail Inmates
A partnership between Emory University, the state of Georgia and Fulton County is helping inmates with mental illness move forward through the justice system.
Some inmates remain locked up for months because they have been deemed incompetent to stand trial, yet they cannot proceed to trial until they receive the medication and/or therapy they need to become competent. It’s the ultimate Catch-22.
According to Peter Ash, M.D., a professor in Emory’s Department of Psychiatry and Behavioral Sciences who serves as director of the Fulton County Jail program, many of these inmates haven’t committed serious offenses.
“They’ve been arrested on relatively minor offenses, but they’ve gotten caught up in the system due to their mental illness,” he said. “It’s better to get these people effective treatment so that they don’t keep repeating their actions.”
The Fulton County Jail, the state and Emory worked together to set up an intensive psychiatric unit inside the jail, where a team of medical professionals evaluates inmates for needed treatment and therapy. The program has eased the burden in several ways. Previously, mentally ill inmates often lingered in jail, having been placed on a long wait list to get into Georgia Regional Hospital for evaluation. Now, with onsite evaluation and treatment, the backlog is disappearing and many inmates have been stabilized.
Ash says that research on the efficacy of the restoration program has shown excellent outcomes, sped up the recovery of those treated and saved money.
“Right now, the program is primarily for men. We’re also doing outcome studies and piloting a new program aimed at helping women with mental illness who are in the criminal justice system,” he said. “We’re always looking at how we can deliver a more careful assessment of the person’s level of problem and tailor their treatment to their level of need.”
Behavior Therapy Could Benefit Children with Autism
More young children 2 to 5 years of age receiving care for attention-deficit/hyperactivity disorder (ADHD) could benefit from psychological services – including the recommended treatment of behavior therapy, according to The Centers for Disease Control and Prevention (CDC). The CDC’s latest Vital Signs report urges healthcare providers to refer parents of young children with ADHD for training in behavior therapy before prescribing medicine to treat the disorder.
The American Academy of Pediatrics recommends that before prescribing medicine to a young child, healthcare providers refer parents to training in behavior therapy. However, according to the Vital Signs report, about 75% of young children being treated for ADHD received medicine, and only about half received any form of psychological services, which might have included behavior therapy.
The report looks at healthcare claims data from at least 5 million young children (2-5 years of age) each year insured by Medicaid (2008-2011) and about 1 million young children insured each year through employer-sponsored insurance (ESI) (2008-2014). In both groups, just over 75% of young children diagnosed with ADHD received ADHD medicine. Only 54% of young children with Medicaid and 45% of young children with ESI (2011) received any form of psychological services annually, which might have included parent training in behavior therapy. The percentage of children with ADHD receiving psychological services has not increased over time