David Lieb
December 20, 2000
This summer I have been working on the Public and Community Psychiatry Training Project at the University of Virginia. This project was developed through monies from the Hammond Fund, intended to improve community mental health in Virginia. The impetus for the project began with Dr. Anita Everett, the Inspector General for Mental Health in the Commonwealth of Virginia. While performing her duties as Inspector General, she noticed that there was room for improvement in the community training of psychiatric residents in the state. As a result she asked each of the teaching facilities in Virginia (the Medical College of Virginia, Eastern Virginia Medical School, the University of Virginia, and our sister program in Roanoke) to develop a program that would better train residents in public and community mental health issues, as well as provide these residents with a chance to experience community psychiatry first hand. Each facility appointed a Gilmore Faculty Fellow, whose role would be to organize and oversee a Public and Community Psychiatry- oriented project at their respective location. The University of Virginia designated my summer mentor, Dr. Edward Kantor, as its Gilmore Faculty Fellow, and he began working on the project at UVa. The program at UVA will incorporate public and community mental health care issues into the general resident curriculum. Certain individuals will also obtain a stipend from the state, and will perform rotations in selected community/under-served settings throughout our region of Virginia. For each year that these residents obtain a stipend, they will perform one year of work in an under-served area of the State's choosing. We currently have two residents signed on for the 2000-2001 academic year, and I have been involved in locating settings which might be good rotation/work sites.
This is the first year that a program of this nature has been set in place. Therefore, much groundwork had to be laid in order to create a solid foundation for the project. My duties were oriented toward starting the project off properly, and were primarily focused on community relations-type activities. I began the summer by learning a great deal about public mental health in Virginia, as I previously knew very little about the subject. Dr. Kantor offered small lectures on various aspect of community mental health, ranging from how community services boards function (out-patient care clinics in the Commonwealth) to how legal issues affect the care of patients staying on the psychiatry floor at UVa.
Once I had a better understanding of many of the issues involved in community psychiatry, I was able to begin contacting and informing others. One of my duties with this project has been to make the community aware of what we are doing at UVa. This means that I have written letters and made phone calls to significant community members who have a direct relation with public and under-served mental health. This includes local psychiatrists, the executive directors of many community services boards in and around Charlottesville, and individuals involved in patient advocacy, such as the National Alliance for the Mentally Ill and the Mental Health Association. By contacting such a varied population, I have been able to tell many groups about the importance of community and public psychiatry, and have also shown public health advocates and care-givers in Charlottesville that the University is committed to helping them achieve their common goals.
I had many opportunities to meet and speak with community individuals associated with public mental health. In June I attended a meeting between University officials and community services board representatives, wherein they discussed issues that were relevant between the two parties. I also met with the medical director of Charlottesville's local community services board, Region Ten. Between Dr. Kantor, the medical director, and myself, we discussed issues that will affect residents who might want to spend time at Region Ten.
I shadowed a number of physicians in the area during my summer, and in doing so learned much about community and ambulatory psychiatry. I followed a doctor at the local community services board, Region Ten, and ______. Watching electro-convulsive therapy at Martha Jefferson Hospital introduced new forms of therapy to me. I enjoyed seeing how the procedure worked, and also appreciated the opportunity to see the Martha Jefferson location, where many UVA students and residents spend their time. My experience with telemedicine was enjoyable and informative, as I watched Dr. Kantor help a woman in far Southwestern Virginia. This experience helped me to understand the role of computers and telecommunication in medicine. I shadowed various psychiatrists on Five East in the new hospital, and was able to see how physicians approach very similar diseases and situations in very different ways In my hospital shadowing experience I met with many different residents, as well as third and fourth year medical students. This gave me a better understanding of the hierarchy which exists in medical education, and I learned a great deal about the course of my own future.
Currently I am organizing a meeting between the Gilmore Faculty Fellows and residents at each school in Virginia. Dr. Everett asked that I pull the meeting together, and specifically mentioned Halifax County, Virginia as a possible location. The Halifax Chapter of the Mental Health Association has shown great interest in having us meet there, and I have been in contact with that chapter’s president. We hope to have the meeting some time in October.
This summer experience enabled me to learn about administrative medicine, curriculum reform, and various bureaucratic processes in the state. In the past I have had exposure to scientific research, as well as exposure to clinical medicine. Until now, though, I had never worked in a medical department office, and had never seen how things run “behind the scenes.” I had also never been involved in curriculum reform, and community relations in regards to medicine. These experiences have broadened my understanding of medicine, as well as my visions for my own future.