A New Conceptualization of Community Psychiatry

The Fellowship in Community Psychiatry / Public Health, within the Department of Psychiatry and Behavioral Sciences at the Emory University School of Medicine, aims to expand traditional definitions of community psychiatry, public mental health, and social psychiatry.  Rather than focusing solely on the characteristics of clients with whom community psychiatrists work (such as those with severe and persistent mental illnesses), or the sources of funding for community mental health programs (predominantly public monies), we challenge Fellows to consider community psychiatry along the following four dimensions.  These dimensions present what may appear to be opposing dichotomies, but they are interlinked in the Fellowship.

1.  The medical model and the public health model.

We encourage Fellows to combine the medical model with the public health model in nontraditional ways in order to become leaders in community psychiatry.  From a medical point of view, community psychiatrists treat mental illnesses using a biopsychosocial perspective.  The public health approach couples bolstering individuals’ mental health with prevention of mental illnesses, minimizing the impact that a mental illness has on one’s quality of life and on society as a whole.  The public health perspective also provides a foundation in epidemiology; health behavior theories; and administration, management, and policy.

2.  Individual treatment and community participation.

We propose that the journey in community mental health is just as important as the destination.  Fellows embrace the following aspects of this expanded definition of community psychiatry:

• Meeting clients where they are.  Whether it is a physical location—like a homeless shelter or a jail ward—or an ideological state of mind, trainees are encouraged to tailor interventions and resource utilization to clients’ needs and expectations.
• Cultural competence.  Appropriate and compassionate mental health care begins with knowledge and appreciation of clients’ individual, familial, cultural, and community experiences.
• Involvement in the community from which clients come.  From participation in community events to championing health policies that benefit these communities, client and public advocacy occupy a key position in community mental health.

 

3.  The content and the process of community psychiatry.

Fellows work with both process and content components of the continuum of mental health care.  Content of care (for example, the specific type of psychosocial rehabilitation in which a client participates) is molded by the processes that provide that care (how clients access that rehabilitation, who pays for it, what constraints shape the delivery of care).  Clients of any age, socioeconomic group, diagnosis, or location must maneuver within the system to secure appropriate mental health services.  We intend to train community psychiatrists in negotiations of the health care system.

4.  Treatment of mental illnesses and promotion of mental health.

The Fellowship values promotion of mental health and prevention of mental illnesses equally with treatment of mental illnesses.  From understanding community resilience through efforts to reduce social stigmatization of mental illnesses to facilitating individuals’ personal recovery, we expect that Fellows will develop a niche in promoting mental health in addition to treating individuals with mental illnesses.

The Fellowship also aims to train leaders to reduce fragmentation within the public mental health system, promote recovery (positive adaptation to illness and disability), engage families in the process of recovery, reduce disparities in mental health care, and diminish stigma.  It is no coincidence that the Emory University Fellowship in Community Psychiatry / Public Health aims to create its own community.  Through clinical care, education, organizational management, political advocacy, and public involvement, we charge members of our academic community to positively impact other communities.  The Mission and Vision of the Fellowship follow this new conceptualization of community psychiatry, and guide Fellows’ experiences to develop into outstanding leaders in community psychiatry.

 

Fellowship Mission: To train future leaders in community psychiatry

Fellowship Vision

Mental illnesses and substance abuse in adults and children/adolescents are leading causes of disability in the United States and globally.  Approximately half of those with serious mental illnesses do not seek treatment due to social stigma, financial obstacles, fragmentation of services, and the pitfalls of a service system that often neglects the special needs of individuals belonging to racial, ethnic, and other minority groups.

The Emory University Fellowship in Community Psychiatry / Public Health aims to train leaders in community psychiatry, who will then serve as administrators, advocates, clinicians, program developers, researchers, and teachers in the community psychiatry and public mental health arena.  The program emphasizes combining the medical model and the public health model, individual treatment and community participation, the content and the process of community psychiatry, and the treatment of mental illnesses and the promotion of mental health.

Fellowship Goals

 

• To train future leaders in areas central to community psychiatry and public mental health, including advocacy, mental health administration / management / policy, clinical practice, program development, and research.
• To train future leaders in local, regional, national, and international organizations relevant to the practice of psychiatry in community-based settings.
• To promote and maintain excellence in advocacy, administration / management / policy, clinical care, program development, and research for disadvantaged populations including under/uninsured, indigent, and homeless persons.
• To encourage and support the process of interdisciplinary collaboration among various agencies, institutions (both public and private), and health care providers.
• To expand and promote specialized training in community psychiatry and public health by serving as a model definition, curriculum, and training experience for other interested institutions.

Program Description

The Emory University Fellowship in Community Psychiatry / Public Health is a unique two-year training program for psychiatrists dedicated to pursuing a career in community psychiatry.  The Fellowship provides integrated experiences in community mental health settings at Grady Health System and other designated sites, a course of study leading to a Master of Public Health (M.P.H.) degree, and longitudinal administrative, didactic, and mentoring experiences.  Fellows begin the program during their fourth post-graduate year (PGY-4) of psychiatric residency training with an additional year of fellowship training (PGY-5), or in two years after residency training (PGY-5 and PGY-6).  The following three components of the Fellowship occur concurrently.

 

1.  Community mental health activities at Grady Health System or other sites:

The first year of the Fellowship offers a broad-based community mental health experience, including providing clinical services as well as administration and program development.  Fellows spend half of their time at these clinical/administrative rotation sites.  Possible areas of clinical experience include working with a multi-agency collaborative to provide social services and mental health care to homeless individuals, following patients involved in a "clubhouse" model day treatment program, providing care for those with mental illnesses who are incarcerated, or working to further develop state-of-the-art holistic treatment programs at private community mental health centers. Administrative activities may include participation in local, state, and national community psychiatry and public health association activities and development of new programs, evaluation tools, or research projects at the Fellow’s clinical sites.

Prior to the start of the second year of the Fellowship, each Fellow meets with his/her mentor to develop a clinical project for the second year in a particular area of interest consistent with the goals of the Fellowship.  This project culminates in a special studies project or thesis in collaboration with advisory faculty at the school of public health.

2.  Rollins School of Public Health / M.P.H. Degree:

At the Rollins School of Public Health (RSPH) of Emory University, students learn to identify, analyze, and intervene in contemporary public health issues.  RSPH is located in Atlanta, “the public health capital of the world," which is home to the Centers for Disease Control and Prevention (CDC), the national home office of the American Cancer Society (ACS), the Carter Center, numerous state and regional health agencies, and the clinical, teaching, and health-related research programs of Emory University's Woodruff Health Sciences Center.  This setting is ideal for hands-on research, collaborations with the world's leading public health agencies, and interdisciplinary work with national and international organizations.  Students join the RSPH community from all 50 states and over 40 foreign countries to contribute to the school's mission, which is to acquire, disseminate, and apply knowledge to promote health and prevent disease in human populations.

Fellows are required to complete 42 credits and a special studies/research project focusing on a community mental health issue.  The Fellowship provides tuition for 42 credits, and it is expected that Fellows complete all coursework by June 30th, two years after matriculation into the Fellowship.  In addition to the four regular semesters of coursework available over the course of these two years, Fellows may take classes during up to four short summer sessions.  The Fellowship prospectively pays for the Fellow’s Master of Public Health degree, with the assumption that the Fellow completes the Fellowship in the course of two years.  However, if during the two years of training, the Fellow decides to discontinue the Fellowship program, the Fellow would be responsible for the tuition and fees paid toward the degree.  Fellows are encouraged to take all relevant and beneficial mental health courses offered at RSPH, and to complete any other requirements of the Mental Health Concentration.  It is recommended that the applicant apply to either the Behavioral Sciences and Health Education (BSHE) department or Health Policy and Management (HPM) department at RSPH.  If the applicant has a special interest in biostatistics, epidemiology, global health, or other areas of public health, alternative curriculum options may be considered.  To facilitate registration and processing, Fellows are required to select a major track at RSPH by February 1st before the July 1st matriculation into the Fellowship.  Please visit the RSPH website at:  www.sph.emory.edu.

3.  Longitudinal administrative, didactic, and mentoring experiences:

• Fellows participate in a longitudinal didactic series that focuses on a variety of topics, including the public mental health system in Georgia, prevention of mental illnesses, advocacy, service models (e.g., assertive community treatment, crisis intervention services, psychosocial rehabilitation), and other topics that are not specifically included in the Master of Public Health curriculum.
• Fellows conduct site visits to community mental health-related agencies in the Metropolitan Atlanta area, in conjunction with the didactic series.
• Each Fellow meets regularly with a selected mentor for career development activities.
• Fellows are strongly encouraged to: (1) prepare for and sit for the American Board of Psychiatry and Neurology board certification examination, (2) join the American Association of Community Psychiatrists, (3) attend the annual symposium sponsored by the Carter Center Mental Health Program, (4) participate in all meetings and activities of the RSPH Mental Health Concentration, and (6) participate in at least one community agency or organization relevant to community mental health.

 

Eligibility Requirements

Applicants to the Fellowship must have completed at least three years of a psychiatry residency training program accredited by the Accreditation Council for Graduate Medical Education (ACGME), and be very interested in pursuing a career in community psychiatry.  Applications to both the Emory University Department of Psychiatry and Behavioral Sciences and the Rollins School of Public Health of Emory University are required.  These must be submitted as far in advance as possible in order to be considered for entry into the Fellowship, which begins in July of each year.  See below for information about the application process.  Selected applicants are invited to interview with faculty and staff and to tour the Rollins School of Public Health, Emory School of Medicine Department of Psychiatry and Behavioral Sciences, Grady Health System, and other program sites.

Fellowship Directors

Michael T. Compton, M.D., M.P.H.
Raymond J. Kotwicki, M.D., M.P.H.

Fellowship Faculty

Michael Compton, M.D., M.P.H.
Benjamin Druss, M.D., M.P.H.
Kaney Fedovskiy, M.D., M.P.H.
Patrice Harris, M.D.
Karen Hochman, M.D.
Nadine Kaslow, Ph.D.
Carol Koplan, M.D.
Raymond Kotwicki, M.D., M.P.H.
Ruth Shim, M.D., M.P.H.
Keith Wood, Ph.D.

Fellowship Advisory Committee

Benjamin Druss, M.D., M.P.H.
Nadine J. Kaslow, Ph.D.
Carol Levy, M.S.N., M.P.H.
Steven Levy, M.D.
Keith Wood, Ph.D.

Salary and Benefits

The salary is the standard Emory University School of Medicine salary for the respective postgraduate year.  Customary benefits are provided, as well as tuition for the M.P.H. degree and reimbursement for select other educational activities.

Inquiries

Fellowship program inquiries may be directed to:

Michael T. Compton, M.D., M.P.H.
Emory University School of Medicine
Department of Psychiatry and Behavioral Sciences
49 Jesse Hill Jr. Drive, S.E., Room #333
Atlanta, GA 30303
tel:  404-778-1486 / fax:  404-616-3241
e-mail:  Michael.Compton@emory.edu

OR

Raymond J. Kotwicki, M.D., M.P.H.
Medical Director, Skyland Trail
1961 N. Druid Hills Road
Atlanta, GA 30329
tel:  404-315-8333 X 5968 / fax:  404-315-0105
e-mail:  Raymond.Kotwicki@emory.edu

The Application Process

Applications are accepted from October 1st through December 1st of each year.  Interviews are scheduled upon review of application materials, and acceptance for an interview is contingent upon verification of the applicant’s good standing in an ACGME-accredited general psychiatry residency training program.  The application packet should include the following information:

1. Current Curriculum Vita, including all contact information;
2. Contact information for current or past psychiatry residency training program director(s), along with a signed statement allowing the Fellowship directors to contact this training director for reference;
3. Two letters of reference that specifically address the candidate’s potential as a successful Fellow in the Emory University Fellowship in Community Psychiatry / Public Health, and as a future leader in community psychiatry; and
4. An essay on the applicant’s conceptualization of community psychiatry, reasons for pursuing specialized training in this field, and future career goals.

Fellowship Graduates

Michael T. Compton, M.D., M.P.H.

Education:
Mary Washington College; Fredericksburg, Virginia (Religion, Biology)
University of Virginia School of Medicine; Charlottesville, Virginia (Medicine)
Psychiatry Residency Training Program; Emory University School of Medicine
Preventive Medicine Residency Training Program; Emory University School of Medicine
Rollins School of Public Health of Emory University (Behavioral Sciences)

Rotations During the Fellowship:
FOCUS Partial Hospitalization Program; Atlanta City Detention Center / Atlanta Community Court (a post-booking jail diversion program); Fulton Collaborative Crisis Services System (FCCSS) Mobile Crisis Unit; Metropolitan Atlanta Recovery Residences and St. Jude’s residential recovery programs; DeKalb County Board of Health Center for Public Health Preparedness

Current Employment / Appointments:
Assistant Professor, Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences; Inpatient Psychiatrist at Grady Memorial Hospital; Co-Director of Emory University Fellowship in Community Psychiatry / Public Health; Assistant Professor, Emory University School of Medicine, Department of Family and Preventive Medicine; Assistant Professor, Rollins School of Public Health of Emory University, Department of Behavioral Sciences and Health Education; Adjunct Professor, Georgia State University, College of Health and Human Sciences, Institute of Public Health

A Leader in Community Psychiatry…

• Dr. Compton primarily works as an inpatient psychiatrist and clinical researcher at Grady Memorial Hospital.  This position involves patient care for individuals with severe and persistent mental illnesses as well as teaching medical students, residents, and psychology interns.  Dr. Compton considers himself to be a “community-oriented hospital psychiatrist” and he teaches this community orientation to trainees.  This involves focusing on the social circumstances of patients’ decompensation and hospitalization, paying particular attention to enhancing outpatient treatment engagement, and sometimes visiting patients in their community settings (e.g., treatment programs, personal care homes, homeless shelters, private homes) following hospital discharge.
• Dr. Compton is involved in a number of research projects that are informed by the community psychiatry / public health approach that he learned during the Fellowship.  His current research projects primarily deal with the following topics: (1) determinants of and outcomes related to the duration of untreated psychosis (treatment delay) among patients hospitalized for a first-episode of a schizophrenia-spectrum disorder; (2) substance use before and during the early course of schizophrenia; (3) officer-level outcomes of the Crisis Intervention Team (CIT) model, a program for training police officers and implementing pre-booking jail diversion; and (4) schizotypy in non-psychiatric samples and the measurement of schizotypy.
• As part of his National Institute of Mental Health grant funding, Dr. Compton spends a substantial portion of his professional time writing research articles, review articles, and book chapters.  He has published a book written specifically for police officers with Dr. Kotwicki (Compton & Kotwicki, Responding to Individuals with Mental Illnesses, Jones & Bartlett), in addition to a psychoeducational book for patients being evaluated for first-episode psychosis and their families (Compton & Broussard, The First Episode of Psychosis: A Guide for Patients and Their Families, Oxford University Press), and a text on prevention for the psychiatric community (Clinical Manual of Prevention in Mental Health, American Psychiatric Publishing, Inc.).

Monica Taylor-Desir, M.D., M.P.H.

Education:
Yale University; New Haven, Connecticut (Psychobiology)
University of Cincinnati College of Medicine; Cincinnati, Ohio (Medicine)
Psychiatry Residency Training Program; Emory University School of Medicine
Rollins School of Public Health of Emory University (Health Education)

Rotations During the Fellowship:
(1) A mental health advocacy rotation with Patrice Harris, M.D. provided Dr. Taylor-Desir with the opportunity to observe the process of how bills are generated and debated within the state legislature.  (2) A rotation at LifeWorks Partial Hospital Program with Lolita Rhone, Ph.D., M.B.A. allowed Dr. Taylor-Desir to practice her clinical and supervisory skills and mentored her in program development, financial planning, and hospital management.  (3) A rotation with HeadStart and Sandra Sexson, M.D. allowed Dr. Taylor-Desir to learn the federal regulations and requirements of HeadStart. (4) A rotation at the Grady Health System child and adolescent psychiatry clinic provided Dr. Taylor-Desir with supervisory experience and many opportunities for community outreach.

Current Employment / Appointments:

Staff Psychiatrist with the Salt River Pima-Maricopa Indian Community, Scottsdale, Arizona

A Leader in Community Psychiatry…
Dr. Taylor-Desir is the only full-time psychiatrist hired directly by the Salt River Pima-Maricopa Indian Community.  She provides psychiatric services for a community of 8,700 members. Dr. Taylor-Desir serves as a liaison between the community’s department of health services, social services, the justice department, and the police department.  She also advocates for mental health care for her patients within the state system of mental health. Many of the classes that she took at RSPH have helped her to understand the various stakeholders and components of the mental health system in which she now works.  The courses Dr. Taylor-Desir attended at Rollins School of Public Health have trained her to communicate with community and organization leaders and to go about systematically evaluating the needs and strengths of the mental health services that she provides.
The Salt River Pima-Maricopa Indian Community has been a sovereign nation since 1879 with its own laws and health codes.  Dr. Taylor-Desir is currently working with the justice system and health and human services to improve the access to mental health care through the community’s mental health code.
Dr. Taylor-Desir previously served on the advisory committee for the development of the only acute adolescent psychiatric treatment facility on the Navajo Indian Reservation during her work at the Winslow Indian Health Care Corporation.  An important part of this work involved assessing community needs and families’ perceptions of the mental health care that they were receiving.  Out of this work, Dr. Taylor-Desir developed an adolescent aftercare program that has proven effective in preventing rehospitalization of adolescents and improving communication between adolescents, their families, and their mental health providers.  This model has now been presented and adopted throughout the Navajo Nation. She is now working to translate this program to the Salt River Pima-Maricopa Indian Community.
Dr. Taylor-Desir has had multiple speaking engagements and invitations to provide training for community organizations within the Salt River Pima-Maricopa Indian Community, including training the entire police department on interacting with individuals with mental illness, training tribal prosecutors on civil commitment, and presenting to a women’s group on self-esteem and to a caregivers support group on caring for children of parents struggling with substance abuse.

 

Raymond J. Kotwicki, M.D., M.P.H.

Education:
University of Wisconsin – Madison; Madison, Wisconsin (History of Science)
University of Wisconsin Medical School; Madison, Wisconsin (Medicine)
Internship in Internal Medicine; Cambridge Health Alliance, Harvard Medical School
Psychiatry Residency Training Program; Boston University School of Medicine
Psychiatry Residency Training Program; Emory University School of Medicine
Rollins School of Public Health of Emory University (Health Policy and Management)

Rotations During the Fellowship:
Task Force for the Homeless:  Dr. Kotwicki established a liaison relationship with this large, downtown homeless overflow facility, including group therapy, individual psychotherapy, and psychopharmacologic management.  Dr. Kotwicki also participated in health policy advocacy work at the Georgia state capitol and local health boards.

Current Employment / Appointments:
Assistant Professor, Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences; Assistant Professor, Rollins School of Public Health, Health Policy and Management; Medical Director and Vice President for Clinical Affairs, Skyland Trail; Adjunct Professor, Georgia State University, College of Health and Human Sciences, Institute of Public Health; Co-Director of Emory University Fellowship in Community Psychiatry / Public Health; Director of Medical Student Education for the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine

A Leader in Community Psychiatry…

• Dr. Kotwicki leads a multidisciplinary clinical team of psychologists, nurses, social workers, case managers, recreational therapists, vocational rehabilitation specialists, horticultural and movement therapists, and peer specialists at one of the nation’s premiere mental health and primary care medicine treatment facilities, Skyland Trail (www.skylandtrail.org).  This private, community treatment facility provides respectful, recovery-oriented care to adults with mental illnesses, and was awarded the American Psychiatric Association’s Gold Medal Service Award for treatment in 2004.  In addition to treating mental illnesses and promoting mental health, Skyland Trail links physical wellness to recovery from mental illnesses, concurrently involving clients in physical wellness tracks in the on-site primary care clinic.
• Every medical student at the Emory University School of Medicine must complete a six-week psychiatry clerkship.  Dr. Kotwicki has developed this clinical curriculum and supports students as they work with community clinicians during this experience.  Moreover, Dr. Kotwicki leads the corresponding didactic series that covers topics including medical ethics, diagnosis and treatment of mental illnesses, and social justice in psychiatry.  In his education role within the School of Medicine, Dr. Kotwicki has a seat on both the Progress and Promotions Committee as well as the Executive Committee within the Department of Psychiatry and Behavioral Sciences.  Training in health policy and management through Dr. Kotwicki's Fellowship experience prepared him for these administrative and educational roles.
• Dr. Kotwicki’s clinical responsibilities are inextricably linked to local and state health policy advocacy.  He intends to impact health policies and the organizational health care delivery system in a way that encourages appropriate, timely, and evidence-based care for everyone.  Clinical experiences provide data with which Dr. Kotwicki lobbies for improved public funding of mental health initiatives, and compassionate care for individuals with mental illnesses.  A significant component of Dr. Kotwicki’s position includes legislative and policy advocacy work for which he received training during the course of his Fellowship studies to earn the M.P.H. degree.
• Treatment plans for the people for whom Dr. Kotwicki cares include biological interventions, psychological therapies, and social wrap-around services aimed at improving clients’ quality of life.  Dr. Kotwicki leads a health outcome division at Skyland Trail through which symptom reduction measures, quality of life indicators, and functional assessment data inform such treatment and are used to replicate Skyland Trail’s excellent care in other locations.
• Dr. Kotwicki and Dr. Compton published a book, specifically for law enforcement officers and other public safety and criminal justice professionals, about mental illnesses and responding to people with mental illnesses (Compton MT, Kotwicki RJ, Editors (2006) Responding to Individuals with Mental Illnesses. Sudbury, Massachusetts: Jones and Bartlett Publishers, Inc., 228 pages, ISBN-13: 978-0-7637-4110-5 (pbk.).

Kaney Fedovskiy, M.D., M.P.H.

Education:
Stanford University; Stanford, California (Human Biology)
Case Western Reserve University; Cleveland, Ohio (Medicine)
Psychiatry Residency Training Program; Emory University School of Medicine
Rollins School of Public Health of Emory University (Global Health)

Rotations During the Fellowship:
(1) In her two years of mental health work with Latino patients at the Grady International Medical Clinic (IMC), Dr. Fedovskiy initiated development of a culturally and linguistically appropriate mental health presence, as well as research collaborations with other medical specialties in this primary care clinic.  (2) Through her work at the IMC, Dr. Fedovskiy received the APA/Pfizer Minority Research Fellowship to study intimate partner violence as it impacts the mental health outcomes and perceived barriers to health care access of immigrant Latino women.  (3) Dr. Fedovskiy also worked with individuals with severe mental illnesses in such community settings as the O’Hern House and Grady’s Community Outreach Services (COS) program.

Current Employment / Appointments:
Assistant Professor, Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences; Medical Director, Community Outreach Services at Grady Health System

A Leader in Community Psychiatry…
Dr. Fedovskiy aims to work to address the mental health disparities existing in various communities, including immigrant Latinos, individuals who are homeless, and people with serious mental illnesses.  She strives to improve existing programs and collaborate on the development of new programs to address the mental health care needs of diverse communities in culturally and linguistically appropriate ways. Dr. Fedovskiy has helped develop a collaboration between the Fellowship and the Atlanta United Way Regional Commission on Homelessness to train leaders in addressing homelessness from mental health and public health perspectives.

Leesha Ellis-Cox, M.D., M.P.H.

Education:
University of North Carolina at Chapel Hill; Chapel Hill, North Carolina (Biology)
University of North Carolina School of Medicine; Chapel Hill, North Carolina (Medicine)
Psychiatry Residency Training Program; Emory University School of Medicine
Child and Adolescent Psychiatry Residency; Emory University School of Medicine
Rollins School of Public Health of Emory University (Health Policy and Management)

Rotations During the Fellowship:
(1) Through the Georgia Crisis Intervention Team (CIT) training program, Dr. Ellis-Cox educated law enforcement officers about common emotional and behavioral disturbances in children and adolescents and appropriate ways to intervene. (2) She worked with the DeKalb Community Service Board to examine the effectiveness of a new central intake service. (3) Dr. Ellis-Cox engaged in a partnership with the Department of Juvenile Justice to evaluate the provision of psychiatric services for children and adolescents with mental health needs in the criminal justice setting. (4) She also worked with Georgia Regional Hospital in Atlanta and Georgia’s Division of Mental Health, Developmental Disabilities, and Addictive Diseases to examine mental health policy and patient care at both the local and state levels.

Current Employment / Appointments:
Staff Psychiatrist in Psychiatric Emergency Services at the Behavioral Health Center, Carolinas HealthCare System in Charlotte, North Carolina

A Leader in Community Psychiatry…
Dr. Ellis-Cox aspires to develop a culturally competent and comprehensive, integrated health care services delivery model for children with serious emotional and behavioral disturbances through education, advocacy, program development, and outcomes research.  She wishes to work with policy makers to implement policies to improve access to care and eliminate health care disparities.

 

Ruth Shim, M.D., M.P.H.

Education:
The College of William & Mary; Williamsburg, Virginia (Psychology)
Emory University School of Medicine; Atlanta, Georgia (Medicine)
Psychiatry Residency Training Program; Emory University School of Medicine
Rollins School of Public Health of Emory University (Health Policy and Management)

Rotations During the Fellowship:
(1) Task Force for the Homeless: Dr. Shim worked with staff and clients in a large overflow shelter in downtown Atlanta, to improve access to mental health services.  (2) Dr. Shim consulted with members of the Georgia House of Representatives to create legislative policy aiming to improve the lives of people with mental illnesses.  (3) Dr. Shim served on the Executive Board of Positive Impact, a program providing mental health and prevention services for people affected by HIV, to further develop her administrative and management skills. (4) Georgia Department of Human Resources Suicide Prevention Project: Dr. Shim designed a training curriculum that focused on equipping emergency department personnel to better identify, manage, and treat patients at risk for suicide.

Current Employment / Appointments:
Assistant Professor, Morehouse School of Medicine, Department of Psychiatry and Behavioral Sciences; Assistant Professor, Morehouse School of Medicine, National Center for Primary Care; Medical Director, Grady Adult Outpatient Intake Service

A Leader in Community Psychiatry…

• As medical director of the Grady Adult Outpatient Intake Service, Dr. Shim works in an administrative capacity to create and implement an effective entry point into Grady Health System’s adult community mental health center’s outpatient services.
• Dr Shim works with the National Center for Primary Care at Morehouse School of Medicine to address issues of mental health in primary care settings.  This includes research on the integration of primary care and behavioral health care, mental health disparities, and stigma reduction.

 

Current Fellows

Allison Nitsche, M.D.

Education:
University of North Carolina at Chapel Hill; Chapel Hill, North Carolina (Biology)
Louisiana State University Health Sciences Center; New Orleans, Louisiana (Medicine)
Psychiatry Residency Training Program; Baylor University School of Medicine; Houston
Child and Adolescent Psychiatry Residency; Emory University School of Medicine
Rollins School of Public Health of Emory University (Health Policy and Management)

Rotations During the Fellowship:
(1) Dr. Nitsche plans to work with key leaders in the Georgia state legislature and professional organizations to learn about the political process of passing a bill and how to become an effective lobbyist. (2) She also hopes to work with organizations providing care to specific populations such as children in foster care and homeless persons with serious and persistent mental illnesses to design programs and implement policies that would improve services. (3) In the summer of 2009, Dr. Nitsche is working in the Carter Center’s Mental Health Program on issues pertaining to mental health reform in the state of Georgia (researching best practices for children’s mental health, including what services exist, what evidence supports them, and how much they cost).

A Leader in Community Psychiatry…
Dr. Nitsche aspires to serve children and families in underserved areas by providing clinical care for those affected by mental illnesses as well as designing and advocating for programs to meet their needs.  She hopes to become a voice for this population, lobbying at state, national, and international levels with policymakers to improve care, especially for children in foster care and homeless persons with serious and persistent mental illnesses.

Tiffany Cooke, M.D.

Education:
Florida Agricultural & Mechanical University; Tallahassee, Florida (Biology)
Meharry Medical College; Nashville, Tennessee (Medicine)
Psychiatry Residency Training Program; University of Miami/Jackson Memorial Hospital, Miami, Florida
Rollins School of Public Health of Emory University (Health Policy and Management)

Rotations During the Fellowship
(1) Dr. Cooke plans to work on advocacy rotations in order to learn more about the legislative and lobbying processes. (2) She also hopes to work with organizations that provide mental health interventions for minority and underserved populations.

A Leader in Community Psychiatry…
Dr. Cooke aspires to advocate for new legislation and policies, and to partner with existing networks, to help eliminate disparities in minority mental health care. She also hopes to implement new programs in the community to eliminate unmet mental health needs of minorities. Dr. Cooke also wishes to engage in community-based participatory research regarding cultural perceptions of mental illnesses.

Liz Frye, M.D.

Education:
University of North Carolina at Chapel Hill; Chapel Hill, North Carolina (Biology)
University of North Carolina at Chapel Hill; Chapel Hill, North Carolina (Medicine)
Psychiatry Residency Training Program; Emory University School of Medicine
Rollins School of Public Health of Emory University (Global Health)

Rotations During the Fellowship
(1) Dr. Frye plans to work with the United Way of Metropolitan Atlanta’s Regional Commission on Homelessness to provide psychiatric treatment and to coordinate care with other service providers to improve the quality of life for homeless individuals with mental illnesses in Atlanta. (2) She also hopes to learn about the social issues that create and sustain mental illnesses and global solutions that can be applied to ameliorate these community problems.

A Leader in Community Psychiatry…
Dr. Frye aspires to improve quality of life in a way that is meaningful for homeless individuals with mental illnesses in her community and develop a model for psychiatric treatment in this area. She hopes to study barriers to attaining psychiatric treatment within this community and learn how communities can provide better care for this underserved population. She also plans to engage in qualitative research to determine the effect this treatment model on hospitalization, substance use, engagement in risky behaviors, and arrests of homeless individuals with mental illnesses.

Program Evaluation

Ongoing evaluation is an important aspect of monitoring the success of the Fellowship and its trainees.  Several levels of evaluation include:

1. Evaluation of the Fellowship in attaining its goals
1. The Fellowship Directors meet at least monthly;
2. The Fellowship Directors meet as needed with the Fellowship Advisory Committee; and
3. The Fellowship Directors maintain contact with Fellowship graduates and track their impact in the field of community psychiatry / public health.
2. Evaluation of the Fellows in attaining their training goals
1. Matriculating Fellows semi-annually develop an academic/training plan with the Fellowship Directors and the designated mentor;
2. Fellowship Directors meet at least quarterly with each Fellow;
3. Designated mentors meet at least monthly with each Fellow; and
4. Graduating Fellows review their training plan with the Fellowship Directors and the designated mentor.
3. Evaluation of Fellowship rotations, site visits, didactics, and faculty
1. Each rotation site evaluates Fellows’ performance in terms of relevant knowledge, attitudes, and skills;
2. Fellows evaluate rotation sites; and
3. Fellows evaluate the relevance and educational value of each site visit and each didactics presentation.