Five Years of Progress: Highlights from 2013-2018
The Department of Psychiatry, University of Maryland School of Medicine is competitively ranked 18th out of all U.S. medical school departments of psychiatry by way of National Institutes of Health (NIH) funded research. This is a dramatic improvement from 30th in 2013. Currently, we are ranked in the top 10 of all public health institutions. Additionally, the Department of Psychiatry is one of only three departments within the University of Maryland School of Medicine that reports an impressive total of 25% of faculty with NIH funding.
This year, the Department’s PA Faculty Practice ranked in first place in the FY18 patient satisfaction report with a mean score of 97.7, or 99th percentile ranking as compared to competing FPI ambulatory practices. The Department was additionally awarded the Dean Reece Cup, an esteemed award within the School of Medicine that noted our outstanding performance on the PA Revenue Cycle Scorecard. Importantly, all revenue cycle targets were achieved for the first time in Department history.
Presently, we stand as one of the largest collaborative teams on campus, and are composed of competitively funded researchers, top-tier clinicians, and closely knit educators. Our team is located within the heart of Baltimore City, and we are a key player in west Baltimore, as well as positioned within an hour of the NIH and Washington D.C. This prime location provides us with direct access to our community for impactful, hands-on research and patient care, as well as with the ability to converse with and influence public policy and leaders.
During the past five years, the Department has reported tremendous success on all fronts, experiencing one of its most successful periods, and has made tremendous progress in research, clinical, and educational initiatives – from the establishment of the competitively funded Silvio O. Conte Center at the Maryland Psychiatric Research Center (MPRC) in advancing treatments for schizophrenia to the debut of the new 24,000 square-foot adult inpatient behavioral health unit at the Midtown Campus.
We continue to rapidly expand and monitor our growth and, in doing so, thought to share our most notable highlights over the past five years to both reflect on past successes and articulate strategic plans for our upcoming five-year mission. Thanks all for your steadfast dedication in building upon one of the best departments of psychiatry in the nation.
The Department of Psychiatry’s externally funded research portfolio continues to rapidly grow, and our Divisions and Centers represent one of the most comprehensive programs of research on psychotic disorders in the world. Our Divisions include the Maryland Psychiatric Research Center (MPRC), Division of Psychiatric Services Research (DPSR), Translational and Basic Research Laboratories, Clinical Neurobehavioral Center (CNC), The Maryland Center of Excellence on Problem Gambling, and the Brain Science Research Consortium Unit (BSRCU). Although we have many highlights to share, we included main, notable achievements by fiscal year.
2014: July 1, 2013 to June 30, 2014
The Maryland Psychiatric Research Center (MPRC) is an internationally renowned research center that is dedicated to providing treatment to patients with schizophrenia, a devastating disease that affects one percent of the world’s population. In May of 2014, Dr. Robert Schwarcz and fellow collaborators were awarded a $10.7 million grant for their proposal, “Kynurenic Acid and Cognitive Abnormalities in Schizophrenia.” The subsequent award and establishment of the Silvio O. Conte Center is founded upon the pioneering and central hypothesis that cognitive deficits afflicting individuals with schizophrenia are causally related on an increase in the brain levels of kynurenic acid. This extremely important award and recognition continue the MPRC tradition of integrating preclinical and clinical research to produce innovative, high impact proposals, which have had a high funding success rate and have led to important new findings in schizophrenia and related disorders.
In January, the MPRC additionally led the Department to a request for submissions from the State of Maryland Department of Health and Mental Hygiene to enhance innovative programs for adolescents and young adults at high risk for psychosis. In September, we received $1.2 million through the Governor’s Supplemental budget to establish the Maryland Early Intervention Program, a novel initiative designed to support clinical and research programs that are focused on the treatment of people at increased risk for developing psychosis or who are in the early stages of a psychotic disorder. This integrated approach equips individuals and their families with tools to manage illnesses to advance overall wellbeing.
The University of Maryland Center for Brain Imaging Research (CBIR) is a leading research designated MRI center for advanced imaging research that attracts heightened, ongoing interest from within the industry and, particularly, for pharmaco-imaging research. The collaborative center is open to all researchers in the Baltimore area, and CBIR noted a substantial uptick in growth of the number of investigators who utilized the facility to advance imaging grant applications to the National Institutes of Health (NIH) – a primary goal of the center. The CBIR supported nine major NIH research grants and ten smaller projects, and usership expanded to include investigators from UMBC, as well as Departments of Neurology, Medicine, Radiology, and Rehabilitation.
The Maryland Center of Excellence on Problem Gambling continues to promote healthy and informed choices regarding gambling and problem gambling. This year, the Center coordinated an extensive public relations campaign and produced a documentary, “Understanding Joy: The devastation of gambling addiction,” which debuted on Maryland Public Television.
Additionally, this fiscal year, the Division of Psychology transitioned leadership: Long-time Division director, Dr. Alan Bellack, retired in December 2013, and Dr. Melanie Bennett was named as Interim Director of the Division. Dr. Bennett has been working with the Chair to reconfigure the Division toward a focus on neurocognitive deficits in brain injury (TBI and mild TBI). The highlighted focus will uncover brain function and the etiology of deficits in brain injury, as well as develop and test rehabilitation strategies to improve cognitive functioning and functional capabilities in these patients. Dr. Bennett has been working on developing partnerships with colleagues at UM (Shock Trauma, Rehabilitation) and the VA (Rehabilitation, GRECC) to move this forward.
Philanthropic yields: The Department continued to facilitate ongoing relationships with its alumnae and donors, and received a generous gift from the Taylor family, who endowed the position of the Chair of Psychiatry with The Irving J. Taylor Professor and Chair. This was the first endowed professorship in the history of our Department and the largest single gift received to date, and the Department is tremendously grateful.
Finally, the formation of the Brain Science Research Consortium Unit (BSRCU) at the start of this year marked the collaborative efforts of the SOM to unite key research faculty members across various disciplines – which includes 25 departments and 20 centers, programs, and Institutes. The BSRCU will facilitate cross-departmental dialogue and encourage joint, transdisciplinary research initiatives in neuroscience research, with the end goals being to vie for grants and answer the challenges set forth by the federally funded BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative. To partake in this national research program, members of the BSRCU have already applied for $9 million in Federal NIH grant funding to explore brain networks and disorders, molecular makeups of diseases, and other discovery-based efforts. The RCU is spearheaded by our Department of Psychiatry Chair Bankole A. Johnson, DSc, MD.
2015: July 1, 2014 to June 30, 2015
The tremendous success of our research programs continued with an impressive 32% in growth of grants and contracts, and a 34% growth in NIH funding during FY15. We reported four new R01 awards during this fiscal year, as compared to six in FY14. The MPRC reports the total awarded direct costs for all contracts and grants as $8,816,902, and total all costs as $11,695,044, which serves as a 13% increase from last year. A sampling of these grants and renewals include the following:
The Consultation Liaison (CL) Division was awarded $468,000 in service grants and contracts, as well as $667,000 in federal grants, which totaled to $1,135,000. As part of the Women’s Health Initiative with the state, Catherine L. Harrison-Restelli, MD, served on and participated with the Women’s Health, Maternal and Child Health Bureau Task Force Intimate Partner Violence, as well as on the Women’s Health Surveillance and Quality Initiatives with Anique K. Forrester, MD. Additionally, through the HIV/HCV Initiative, the CL Division established STIRR-IT and HEART2HAART. STIRR-IT provides HIV/HCV testing, Hepatitis A & B immunization, and risk reduction counseling for people with severe mental illness who are attending outpatient mental health clinics. HEART2HAART provides smartphone intervention to increase adherence to antiretroviral medications for people with HIV who have co-occurring substance use disorders.
The Division of Psychiatric Services Research (DPSR) was awarded six new grants in FY15, which totaled to more than half a million dollars.
The Memorandum of Understanding with the Department of Health and Mental Hygiene and The Maryland Center of Excellence on Problem Gambling was renewed for another three-year period for approximately $5 million. The Center co-hosted the Annual Conference on Problem Gambling, and was honored with achievement awards for its website and social media campaigns. Additionally, the Center developed the Disordered Gambling Integration (DiGIn) Pilot Project within five county health departments and two residential treatment programs in Maryland to address gambling as a co-occurring issue among those in treatment for substance use and mental health disorders.
The state approved the budget request for the Maryland Early Intervention Program (MEIP) in FY 2016 for $1.224 million.
Melanie Bennett, PhD, and Amy Drapalski, PhD, both of the Division of Psychology, obtained grant funding from the NIH to conduct motivational interviewing with individuals with HIV who are medication noncompliant, as well as for two large projects funded by the VA to treat negative symptoms in schizophrenia and assist families of veterans with TBI – amounting close to $2 million.
The newly established BSRCU, directed by Professor Johnson and coordinated by Annabelle (Mimi) Belcher, PhD, continued its momentum: to date, members have received funding for three grants (a total of $2,191,240), and are submitting or have submitted a total of eleven more grants for close to $40 million. The BSRCU held its inaugural retreat on October 8, 2014, and themes were segmented according to defined workgroups: 1) Focused Ultrasound, 2) Neuroinflammation, and 3) Neuropsychiatric and Substance Abuse Disorders. Two new workgroups are in formative stages that will focus on Sleep Disorders research, and Inflammation and Psychiatry research; members of the consortium have been meeting in small groups. Come fall, the BSRCU will begin its monthly seminar series to serve as a conduit for discourse on topics, of which ideas will serve as unifiers. Finally, on December 11, 2015, the BSRCU will help spearhead the 2015 Festival of Science to highlight “Understanding Disorders of the Brain,” featuring renowned keynote speakers and UMSOM presenters.
Combating the ongoing epidemic: This year, Professor Johnson was honored and appointed as a member of The Maryland Heroin and Opioid Emergency Task Force by Governor Larry Hogan and Lieutenant Governor Boyd Rutherford. The team is comprised of law enforcement, elected officials, and substance abuse experts to address Maryland’s growing heroin and opioid crisis, and members are segmented into workgroups. Christopher Welsh, MD, was also appointed as a workgroup member, and the team drafted recommendations to increase the quality of care for affected individuals and improve collaborative communication platforms among traditionally siloed state resources, ranging from law enforcement to physicians to pharmacists.
2016: July 1, 2015 – June 30, 2016
For FY16, the Department reported continued growth in our grants and contracts portfolio, which totaled to an 11% increase and a 5% increase in NIH funding – an impressive total that includes five new R01 awards.
This year, Professor Johnson and Dr. Welsh continued serving on the Quality of Care and Workforce Development Workgroup for The Maryland Heroin and Emergency Opioid Task Force, an initiative set forth by the Governor. The workgroup drafted recommendations and proposed the establishment of the Maryland Center of Excellence for Prevention and Treatment (MCEPT). The Task Force released its interim report on August 24, 2015, and the final report on December 2, 2015, both of which can be found at http://bit.ly/2asq8lu.
The BSRCU also continued its endeavors and formed the core of the presentations at the Festival of Science on December 11, 2015. Psychiatry faculty members Laura Rowland, PhD, and Robbie Schwarcz, PhD, represented our Department wonderfully, and the event was exceedingly successful, with high remarks from the esteemed Scientific Advisory Council. Additionally, in the last year, projects supported by the Dean’s seed funds began to bear fruit. Thanks exclusively to this support, and led by two of the BSRCU work groups, the Consortium has two new technologies on campus that did not otherwise previously exist. One is a home-built Ca2+-imaging scope, capable of recording Ca2+ spikes from neurons in awake, freely behaving rodents, and is a methodology that will be put to use immediately to greatly enhance currently available models of addiction. The other project yielded the generation of the first rat with green fluorescent protein-labeled Iba1, allowing us to visualize a proteinous marker of neuroinflammation. Although this transgenic work has been carried out with mouse models for several years, the rat possesses a much larger repertoire of social behaviors and cognitive capacities, rendering it a much more sufficient model for human brain function and dysfunction. These two bold projects represent a victory for the Consortium. The BSRCU also continues its work to encourage basic and clinical interactions with the monthly Seminar Series that was established last year, and which kicks off again in October. Finally, the BSRCU has driven multiple other inaugural forums in the past year, including spearheading platforms on sleep disorders and addiction.
The Center for School Mental Health (CSMH), of the Division of Child and Adolescent Psychiatry, released its School Mental Health National Quality Initiative, which establishes standardized national census and performance measures and can be found at: www.theSHAPEsystem.com.
The Division of Psychiatric Services Research (DPSR) reports ~$3.7 million in new grants for FY16. Additionally, the Training Center sponsored and organized 104 training events, with a total of 4,595 participants this year for the Maryland Behavioral Health Administration (BHA). The Systems Evaluation Center, in collaboration with the BHA, launched an online outcomes reporting system for the Assertive Community Treatment teams, and is developing an online Naloxone Administration and Tracking Reporting System (NTARS). Its Family-Informed Trauma Treatment (FITT) Center reached 3,522 participants through face-to-face trainings and workshops, and worked with more than 80 family and youth advisors. Finally, FITT partners and The Zanyvl and Isabelle Krieger Fund led a Breakthrough Series Collaborative (BSC) to make Baltimore a more trauma-responsive, resilient city; the initiative included 90 participants in a year-long effort.
The Maryland Center of Excellence on Problem Gambling began its fifth year of operation on July 1, 2016, continuing on its ~$5 million competitively awarded grant with a strong focus on community education and outreach. As part of its prevention initiative, the Center completed its second year of the Maryland Smart Choices Program with the CSMH, working directly with six Baltimore City schools and 106 students. The Center also led training and education efforts by holding its 4th Annual Maryland Conference on Problem Gambling for several hundred attendees, as well as established an online training and webinar series this year, with sessions drawing in 240 and 300 participants, respectively. The Center also concluded its first year of the Disordered Gambling Integration (DiGIn) Pilot Project in partnership with seven county health departments/organizations and two residential treatment programs to address the impact of gambling on those in treatment for substance use and mental health disorders. It further launched its help-seeker website, www.helpmygamblingproblem.org, which has tracked more than 9,000 visits. This upcoming year, the program will expand to five additional health departments and organizations. Finally, the Center authored “Daily Fantasy Sports Guidelines” and delivered testimony in Annapolis on gambling and fantasy sports legislation.
2017: July 1, 2016 to June 30, 2017
The Department reported another strong year in expanding its research portfolio: investigators received 22 new federal, foundation, and pharmaceutical company grants and contracts, as well as three NIH supplements, totaling to $2,852,878. Awards with direct and indirect costs included the following breakdown: $13,050,977 from NIH, $3,742,549 from research grants, and $13,693,802 from grants and contracts.
The Clinical Neurobehavioral Center (CNC) continued ongoing research on addiction use disorders, including the R01 award led by Professor Bankole Johnson and Melanie Bennett, PhD. The team will conduct a clinical trial to research the efficacy of the pharmacotherapy treatment topiramate on reducing drinking and lessening the symptoms of PTSD in subjects with a distinct genetic makeup. The CNC worked to recruit Dan Roche, PhD: his recruitment will be finalized shortly, and he will establish a human lab in the near future. Finally, the Center continued its search for a new scientific director.
Seth Himelhoch, MD, MPH, the former Division Director of Consultation-Liaison (now Chair of Psychiatry, University of Kentucky), collaborated as PI with the DPSR on the R01 grant, entitled “Optimizing Smoking Cessation Treatments in Smokers Living with HIV/AIDS,” which was funded for an impressive ~$2.3 million.
In addition to its establishment, The Maryland Center of Excellence on Problem Gambling was awarded $1.15 million by the state to fund six peer support specialists. This newly formed role will provide gambling treatment engagement, outreach, and training, as well as coordinate awareness campaigns. The Center continued to evaluate the success rate of incorporating problem gambling evaluation and treatment into centers that conduct Screening, Brief Intervention, and Referral to Treatment (SBIRT) procedures, with the over-arching goal to reduce the statistics of problem gambling disorders.
The BSRCU, by way of the STRAP initiative, recruited Dr. Tracy Bale with a pledge of $750,000. Dr. Bale boasts an extensive background in neuroscience and psychiatry, and her research interests include uncovering the mechanisms and genetic heritability for neurodevelopmental disorders through genetic and prenatal manipulations. The Department is very enthusiastic to welcome such a notable researcher on board.
Finally, the Research Executive & Recruitment Committee was expanded this past year to include recruitment efforts. The Committee met monthly to establish a focused research direction. Transdisciplinary members convened in workgroups to prioritize research areas and establish infrastructure-driven guidelines and goals, and the results of these collaborations directed the investment of Department research funds and grant submissions throughout the past year.
2018: July 1, 2017 to June 30, 2018
During FY18, the Department reported substantial growth with an 8.8% increase in federal funds for grants and contracts, and a 13.4% increase in competitively awarded NIH funding. Most notably, researchers were awarded an S10 and four new R01 awards, which indicates the pioneering success of the Department initiatives and programs.
The Clinical Neurobehavioral Center (CNC) continued research on addiction use disorders and personalized pharmacotherapy treatments. Professor Bankole Johnson and Melanie Bennett, PhD, conducted an ongoing clinical trial to research the efficacy of topiramate on reducing drinking and lessening PTSD in subjects with a distinct genetic makeup. This year, Professor Johnson and Chamindi Seneviratne, MD, were awarded an R01 to study the genomic predictors of placebo response in Phase II AUD trials. The CNC also formally welcomed Dan Roche, PhD, and we look forward to launching these initiatives to explore treatment options.
The Maryland Center of Excellence on Problem Gambling was awarded a Letter of Agreement for $10.5 million in funding for the next five years, an impressive testament to its ongoing success. The Center also collaborated with the Behavioral Health Administration and Beacon Health Options to train providers in problem gambling disorders, and assisted more than 70 practitioners to offer “no cost” treatment. Finally, the Center’s training and education initiatives reported more than 2,200 individuals in attendance – a 35% increase from FY17, a notable metric to support increased awareness and interest in treatment.
The Division of Psychiatric Services Research (DPSR) reported $1.6 million in new funding this year.
The BSRCU, by way of the STRAP initiative, recruited Dr. Tracy Bale, who is now the Director for the Epigenetic Research in Child Health and Brain Development. Dr. Bale boasts an extensive background in neuroscience and psychiatry, and her research interests include uncovering the mechanisms and genetic heritability for neurodevelopmental disorders through genetic and prenatal manipulations. The BSRCU also hosted the Research Retreat on Opioid Use Disorders. Wilson Compton, MD, MPE, Deputy Director, NIDA, and Linda Porter, PhD, Director, Office of Pain Policy, NINDS, were welcomed as the key note speakers. The first half of the day highlighted the range of current Opioid Use Disorder clinical patient treatment and research activities conducted across the School of Medicine. Drs. Eric Weintraub, Leo Tonelli, Dan Roche, and Emerson Wickwire were among the featured faculty from the Department. The latter half of the day was organized in a working group format to encourage attendees to collaborate in thematic sessions, with the end goal being to apply for funding on a transdisciplinary level. The retreat brought in close to 100 attendees, and the BSRCU looks forward to serving as the launching pad for unique responses to increased federal funding mechanisms.
The clinical operations within the Department of Psychiatry encompass seven major Divisions: Acute Care Adult Psychiatry (formerly termed “Adult), Alcohol and Drug Abuse (ADA) – recently rebranded as the Division of Addiction and Research Treatment, Child and Adolescent, Community, Consultation-Liaison, and Geriatric; as well as Employee Assistance Programs (EAP) and PA Faculty Practices.
Clinical Divisions continue to coordinate with the missions of UMMC, UMMS, and UMB – while also focusing on population health initiatives, new challenges of the global budget, and increasing demands for mental and behavioral health services.
2014: July 1, 2013 to June 30, 2014
This year, the Department of Psychiatry partnered with the University of Maryland Medical Center (UMMC) in considering strategies and approaches to population health management for all Maryland hospitals. It also exceeded its collection budget, primarily due to payment for previously uninsured adult inpatients, beginning on January 1, 2014 and serving as a result of the Affordable Care Act implementation.
The Division of Alcohol and Drug Abuse (currently renamed the Division of Addiction Research and Treatment) continued spearheading a comprehensive array of addiction treatment programs that are both hospital and community based. These include methadone and buprenorphine programs for heroin-dependent patients, an intensive outpatient program, and special services for the medically ill, pregnant, and deaf and hard of hearing individuals. This year, the Division received 13 clinical service grants with funding of $1.7 million dollars to provide treatment to patients with substance use disorders in Baltimore City, all in an effort to combat the ongoing epidemic and address the needs of our neighbors. This awarded total included a $561,000 grant from the state’s Alcohol and Drug Abuse Administration to provide unique, specialized addiction treatment services to the deaf and hard of hearing individuals. In addition, the Division continued to receive approximately $150,000 in grant dollars as part of the city’s Health Department Buprenorphine Initiative, an innovative program to provide buprenorphine treatment to heroin-addicted individuals in Baltimore City. Finally, the University of Maryland Medical System (UMMS) Substance Abuse Consultation Service provided services to more than 3,000+ individuals who had been hospitalized with substance use disorders. These services included comprehensive addiction assessments, acute management of withdrawal syndromes, and brief treatment interventions and patient referrals for outpatient treatment. The service had approximately 3,000 patient contacts in FY 2014, which is a notable feat.
Additional highlights include those of the Division of Child and Adolescent Psychiatry, which piloted the implementation and evaluation of the school transition program with the University of Maryland Medical System (UMMS) and Sheppard Pratt health systems.
Additionally, the Division of Community Psychiatry expanded the Integrated Care Program to include a first-time state-certified Behavioral Health Home, providing onsite direct primary health care services – in addition to coordinating primary care – to all health home clients. The Division was also awarded an outreach grant by BHSB to reduce ER visits to city Emergency Departments among individuals with serious mental illness through coordination of care and connectivity to community resources. Additionally, trauma-informed care has been implemented in all community and second floor adult clinic programs. This year, the Division ended on an accomplished note with $2,188,193 in the black.
2015: July 1, 2014 to June 30, 2015
This year, the ADA Division, now known as the Division of Addiction Research and Treatment, continued its momentum in helping to treat individuals with substance use disorders, and expanded its efforts internationally. Drs. Eric Weintraub and Christopher Welsh, Jewell Benford, LCSW-C, and Denisha Pendleton, RN, opened the first methadone clinic in Kenya, which is successfully providing Medication Assisted Treatment. The team has made several trips to Africa, and also hosted a delegation from Kenya for two weeks. In addition, the Division – with the assistance of the Telemedicine team – set up a contract to provide Suboxone Treatment via telemedicine to patients at the Wells House in Frederick, Maryland.
The Divisions of Psychology and Community Psychiatry, Psychiatric Services Research, and MPRC are collaborating on the provision of early intervention for young adults with psychosis through Recovery After Initial Schizophrenia Episode Implementation and Evaluation Study (RAISE IES). The aim is to observe outcomes within two years of onset of a schizophrenia-type illness to improve social and occupational functioning, recovery, and quality of life among individuals. In recognizing the tremendous efforts of our team, SAMSHA identified the new initiative as the “Gold Standard” for new programs, and we look forward to its continued success.
The Division of Child and Adolescent Psychiatry coordinates telepsychiatry services and has begun to spearhead a state-wide effort as ambassadors of the Department. In specific, the team has begun to direct clinical services to seven Baltimore City schools, and provide services to the Garrett County Health Department, twenty-six Baltimore City PRIDE Program schools, and rural pediatric primary care at three sites. In addition, the Behavioral Health in Pediatric Primary Care (BHIPP) provided 322 telephone consultations in the past year, and its Maryland Medicaid Peer Review Program provided child psychiatrist telephone consultations for pediatric antipsychotic treatment authorization, and has approximately 4,500 youth enrolled.
This year, the Division also: (1) Established www.MDBehavioralHealth.com, an online training platform developed in partnership with the Maryland Department of Health and Mental Hygiene as well as the Mental Hygiene Administration, which trains individuals interested in supporting the behavioral health of youth and their families. (2) Provided direct clinical services in 52 schools through the Center for School Mental Health, which was awarded a new three-year contract to provide comprehensive services to 33 schools in southwest Baltimore City. (3) Responded to recent Baltimore unrest with its “Look for Helpers” program to provide support to young children. Finally, the Center for School Mental Health developed resources and consulted to Baltimore City Public Schools and the U.S. Department of Education.
The Clinical Neurobehavioral Center (CNC) was formally opened on September 12, 2014, and will serve as a cutting-edge facility to focus on alcohol use disorders as a subset of brain disorders, substance use, and gambling disorders. The Center will host its first clinical grant, the Ondansetron Alcohol Pharmacogenetics study, which is a multi-site study conducted with the University of Pennsylvania.
Community Psychiatry established a Behavioral Health Home, which is accredited by The Joint Commission (upon completion of a separate survey). Additionally, the Academy of Independent Living reported that its first graduate level program was completed by six clients and its undergraduate program is in its second round of classes.
The Division of Psychology, under the leadership of Dr. Bennett, continues to pave the way in reshaping its mission, and recently created a smoking cessation program for veterans with serious mental illness as part of the SMI Patient Aligned Care Team (PACT). This program also provides care for veterans with comorbid trauma and stress-related disorders and/or substance use disorders, as well as develops programs to provide psychological, health, and other resources to homeless veterans in Baltimore communities and beyond.
Finally, since December, the Department has been involved with the initiation of the establishment of psychiatric and substance abuse expertise to Upper Chesapeake and Union (Elkton) Hospital. Specific deliverables would include moonlighting fellows, video broadcasting of Grand Rounds, assistance with recruitment of psychiatrists, and tele/video consultation to specific primary care and specialty care sites.
2016: July 1, 2015 – June 30, 2016
Alcohol and Drug Abuse (ADA), now termed the Division of Addiction Research and Treatment, and Director Eric Weintraub, MD, Christopher Welsh, MD, and the telemedicine team – continued to provide Buprenorphine treatment to patients at the Wells House Treatment Center in Hagerstown. Since its inception in late August 2015, the center has treated more than 150 patients and has provided access to treatment to those who ordinarily would not have been able to receive care in traditional settings. The Division of Addiction Research and Treatment has also expanded the Wells House by one-third of its initial establishment, and will continue to expand in the fall of 2016, as part of an agreement with the Garrett County Health Department to provide Buprenorphine treatment to individuals via telemedicine. The Division was also awarded funds from the state and hospital to form a multidisciplinary team to identify and treat Emergency Department patients with substance use disorders. This effort will help address the underlying issue of patient visits, as well as help to reduce the number of patients being admitted into the ED.
Child and Adolescent Psychiatry reported a high annual volume in clinical services, with 8,000 ambulatory visits, 350 inpatient admissions, 100 day hospital admissions, 80 consults, and more than 9,000 billable service visits through the School Mental Health Program (SMHP). The UMSOM Center for Infant Study (CIS) and SMHP recently achieved the Commission on Accreditation of Rehabilitation Facilities (CARF) for their child and adolescent Outpatient Mental Health Center. In addition, the Center for School Mental Health (CSMH) sponsored the 20th Annual Conference on Advancing School Mental Health in New Orleans, and helped to lead the 15th annual School Health Interdisciplinary Program (SHIP) conference to advance all levels of health care within schools. Finally, pioneering international efforts include School Mental Health Training in Bahrain and Jordan, as well as training collaborations in China and Costa Rica.
Substantial increase in clinical services: Community Psychiatry reports a ~$1.2 million gain in provided clinical services and an approximate total of $500,000 in service grants.
Consultation Liaison (C/L) established its transdisciplinary Women’s Mental Health Program with OB/GYN, Child Psychiatry, and the Division of Addiction Research and Treatment to provide clinical, educational, and research expertise in support of women’s mental health and wellbeing. CL launched its Integrated Care Initiative (ICI) to provide embedded psychiatric services for the inpatient medical service, which employs proactive consultations to reduce hospital length of stay and readmission. Efforts proved successful: individuals receiving ICI services had half of the length of hospital stays. Total clinical services included 1,331 inpatient consultations, and 2,356 outpatient consultations.
Stephanie R. Knight, MD, was appointed Chief of Psychiatry of the Midtown Campus at UMSOM, and the Department thanks her tremendously for her ongoing, tireless efforts. In continuing to promote leadership opportunities, Ann Hackman, MD, was named as the Director of Community Psychiatry this year.
Psychology continues to develop new assessment tools to examine factors that contribute to poor social functioning in the community, and leads with an active portfolio of NIH and VA research grants to further advance effective treatments for drinking, drug use, smoking cessation, and more. Services to families and communities include the ongoing development of psychosocial interventions to improve functioning, enhance mental health recovery, and increase community engagement among Veterans with serious mental illness. Other initiatives include the smoking cessation programming for veterans with serious mental illness as part of the SMI Patient Aligned Care Team (PACT), as well as its Maryland Early Intervention Program, which serves as a collaborative learning network that provides training to clinicians who work with young adults experiencing early psychosis.
Finally, Eric Weintraub, MD, Medical Director of the Clinical Neurobehavioral Center (CNC), and David Gorelick, MD, PhD, DLFAPA, Scientific Director, will commence work on the Center’s first multi-site clinical grant, “Ondansetron Alcohol Pharmacogenetics Study.”
2017: July 1, 2016 to June 30, 2017
This year, clinical initiatives included strengthening population health management strategies. The Department created the role of peer specialists, which connected patients who received hospital-based psychiatric services to outpatient care services. These individuals provided in-person assistance and encouraged patient follow-through and accountability, and played an important role in decreasing the need for repeat service. The Department also focused on enhancing rapid access to care, and implemented same day/next day appointments at the Fayette Clinic.
In addition to these new initiatives, our team established the Women’s Mental Health Program: an expansive collaboration with the Departments of Family Medicine, OB/GYN, and Pediatrics; and Divisions of Alcohol and Drug Abuse (now named the Division of Addiction Research and Treatment), Child and Adolescent, Community, and Consultation-Liaison. Four satellite practices currently operate.
BHIPP (Maryland Behavioral Health Integration in Pediatric Primary care) was noted as another rapidly expanding endeavor, and clinicians provided consultations and referrals to PCPs in areas involving child mental and behavioral health. BHIPP is supported by funding from the Maryland DHMH and led by the Division of Child and Adolescent Psychiatry, and operates as a collaboration among UMSOM, Johns Hopkins Bloomberg School of Public Health, and Salisbury University. To date, BHIPP has enrolled 780 PCPs and provided 5,450 consults to support the effort of primary care clinicians, and assess and manage the mental health needs of patients from infancy through the transition of young-adulthood.
The Division of Consultation-Liaison continued to coordinate the Integrated Care Initiative (ICI), which was recently expanded to the Midtown Campus, and provided psychiatric services on the inpatient medical service and consultations to reduce hospital length of stay and readmission.
An important achievement for the Department this year included the establishment of Midtown as a Division and service line. Stephanie Knight, MD, was chosen to serve as Chief of Psychiatry at Midtown, with the Department now assuming management of all behavioral health and inpatient programs. This year, the $9 million project was funded to create two new state-of-the-art adult psychiatric units with single room occupancy, with partial adult services to be transferred to Midtown. Additionally, Midtown, Consultation-Liaison, inpatient, and emergency psychiatry medicine have collaborated to offer psychiatric emergency services.
The School Mental Health continued its success again this year, and was awarded competitive service grants and contracts in three key areas, involving interventions for school clinicians, supportive learning environments, and promotion of student resiliency; the program noted 7,431 encounters state-wide. The Child Psychiatry Service Line of the Center for School Mental Health noted 8,143 outpatient visits and 360 inpatient admissions.
In FY17, Telemental Health was established as a new Division and named under the leadership of David Pruitt, MD, Division Director of Child and Adolescent Psychiatry. The Division has been rapidly expanding since its inception, and has entered into agreements with Caroline, Garrett, and Worchester counties for adult and addiction services.
Finally, the clinical Divisions of the Department house exceptional leaders who are currently combating the heroin and opioid epidemic with overdose and treatment methods. The Division of Alcohol and Drug Abuse, now named the Division of Addiction Research and Treatment, led the way:
- ED buprenorphine initiative: established to initiate treatment in ED settings in Baltimore City; by the close of 2016, four EDs (inclusive of UMMC) implemented the program, with the plan to establish the setup in all Baltimore City EDs by the close of FY 2018.
- SBIRT ED: was launched on September 1, 2016. SBIRT (Screening, Brief Intervention, and Referral to Treatment) team members screen patients admitted to the ED for substance use disorders and recommend treatment routes. Members provided interventions to 2,210 patients and referred 569 for substance abuse treatment.
- Wells House Treatment Program: assisted with the provision of buprenorphine treatments to patients via telemedicine.
The research efforts within the clinical spectrum continued to encourage collaborative partnerships and provide career development paths through clinical-scientist career tracks. During FY17, important research initiatives included that of Nithin Krishna, MBBS, of Adult Inpatient Service. Dr. Krishna was awarded funds to study the use of cranial electric stimulation to modify suicide risk factors in psychiatric inpatients. This notable endeavor is the first clinical intervention trial at the UMMC inpatient units in more than 20 years.
Additionally, Nancy Lever, PhD, and Gloria Reeves, MD, of the Division of Child and Adolescent Psychiatry, were invited to join the ABCD (Adolescent Brain Cognitive Development) study team as Co-Investigators of the largest pediatric neuroimaging study of brain development to date.
2018: July 1, 2017 to June 30, 2018
The clinical operations within the Department of Psychiatry continued to coordinate with the missions of UMMC, UMMS, and UMB – while also focusing on population health initiatives, new challenges of the global budget, and increasing demands for mental and behavioral health services. Program and service highlights encouraged transdisciplinary collaborations among clinical Divisions, providing for the highest level of personalized patient care; as well as nurtured ongoing and future relationships with city, state, and federal entities, ultimately building upon a comprehensive mental and behavioral health service network.
In regard to ongoing population health management strategies, the role of peer specialists expanded and continued to connect patients receiving hospital-based psychiatric services to outpatient care services. Rapid access to care initiatives also continued with the implementation of same day/next day appointments at the Fayette and Carruthers Clinic, and integration of the Midtown Outpatient Clinic with Carruthers, a remarkable accomplishment in improving patient care initiatives.
The newly established Women’s Mental Health Program continued to expand upon its collaborative satellite practices with developments in Integrated Care in UMMC Obstetric services. The team also expanded teaching to all PGY years and medical student teaching, and Rebecca Vivrette, PhD, was appointed as Associate Director for Clinical Research, Center for Epigenetic Research in Child Health and Brain Development.
The Division of Child and Adolescent Psychiatry, the largest Division of the Department, noted ongoing success with its endeavors, as well. The Center of Excellence in Early Childhood Mental Health provided multidisciplinary consultations and training throughout the state. Dr. Vivrette completed rostering requirements as a Child Parent Psychotherapy Supervisor, and Kay Connors, LCSW-C, was selected to lead the Maryland team at the 2018 ZERO TO THREE Policy Convening to advance state policy related to social and emotional health of babies and toddlers. Gloria Reeves, MD, and Heidi Wehring, PharmD, were appointed to the SAMHSA Expert Committee on the Implementation of Best Practices in Antipsychotic Prescribing for Children and Adolescents. Finally, the UMMC Child Ambulatory Clinic provided more than 6,300 clinical services.
The Integrated Care Initiative (ICI), led by the Division of Consultation-Liaison, was expanded to Midtown this year. In addition to this expansion, ICI reported impressive numbers: the team reviewed 2,236 cases and directly assessed 705 individuals to provide psychiatric services for the inpatient medical service, reducing the overall hospital length of stay and readmission rates. Due to this tremendous success, ICI is now working across UMMC, including with Transitional Care and Hematology/Oncology.
Stephanie Knight, MD, Chief of Psychiatry at Midtown, assumed management of all behavioral health and inpatient programs. Consultation-Liaison and behavioral services are projected to increase by two-fold, adult services will expand, and the Division will welcome three competitively recruited faculty. The $9 million project created two new adult psychiatric units with single room occupancy, and partial adult services were transferred to Midtown. The team coordinated a tremendous effort to combine two sites, the Midtown Campus and Downtown Campus, into one program to deliver high quality care. Additionally, two resident teaching services will transfer to Midtown in January 2019.
School Mental Health provided 3,000+ outpatient clinical services to 26 Baltimore City schools; 8,000 teacher consultations; 1,000 group and classroom presentations; and 150 teacher trainings and family activities. Notably, team members consulted to help with traumatized children in west Baltimore schools in an effort to expand community outreach efforts.
Telemental Health recently expanded services to the Maryland Department of Juvenile Services to cover Maryland’s committed facilities, streamlining care and reducing wait time for initial evaluations from six weeks to six days.
In addition, the clinical Divisions house exceptional leaders who continued to combat the heroin and opioid epidemic. The Division of Addiction Research and Treatment led the way:
- ED buprenorphine initiative: initiated treatment in Emergency Department (ED) settings in Baltimore City. At the close of FY18, UMMC and most Baltimore City EDs implemented the program, and state-wide expansion efforts continue.
- MACS (Maryland Addictions Consultation Service): established in October 2017, and provided peer-to-peer phone consultations to support prescribers with the identification and treatment of substance use disorders. MACS is funded by the Maryland Department of Health and enrolled 207 prescribers and provided 108 consultations.
- SBIRT ED: SBIRT (Screening, Brief Intervention, and Referral to Treatment) team members screened patients admitted to the ED for substance use disorders and recommended treatment routes; four peer recovery coaches worked in this capacity. In 2019, the program will expand to acute inpatient medical units.
- The Overdose Survivors Outreach Program (OSOP) was newly created to connect peer specialists with overdose survivors in the community, linking them to treatment. Members screened 35,443 patients, provided 3,778 interventions to patients, and referred 1,172 for substance abuse treatment.
- Christopher Welsh, MD, and Dr. Weintraub: provided consultations to hospital leadership, as well as city and state leadership, to help manage the opioid crisis. Additionally, the team provided certifications for city hospitals issuing treatment to individuals with substance use disorders.
- Wells House Treatment Program: assisted with the provision of buprenorphine treatments to patients via telemedicine. Since its establishment in 2015, the program has tripled its hours and serves as a training site for Addiction Fellows. Services have expanded to Caroline, Dorchester, Garrett, Talbot, and Worcester counties, and grants were submitted to CareFirst, HRSA, and SAMSHA.
Finally, during FY18, Cindy Schaeffer, PhD, and Sharon Hoover, PhD, were awarded $3 million by the National Institute of Justice for “Evaluating promising school staff and resource-office approaches for reducing harsh discipline, suspensions, and arrests.”
We have one of the largest and competitive psychiatry residency programs in the nation, which stands in partnership with the University of Maryland Medical Center (UMMC), Sheppard Pratt Health System, State of Maryland Mental Hygiene Administration, and the VA. Our program has recruited and successfully filled positions with high quality residents for many years, and psychiatry residency program graduates repeatedly maintain a 100% pass rate on the ABPN Board Exam – a statistic much higher than the average national standard.
2014: July 1, 2013 to June 30, 2014
Dr. Mark Ehrenreich, the residency training director, became the Chief of Medical Education over this past academic year. The residency program revised and implemented a new neuroscience course for the PG2 residents and, in collaboration with the Division of Consultation-Liaison Psychiatry, the Education Division began a new Psychosomatic Medicine Interest Group, open to both residents and medical students.
2015: July 1, 2014 to June 30, 2015
This year, a notable highlight included the development of an international elective based at the Centre for Resolution of Intractable Conflicts of the Harris Manchester College at Oxford University for the PGY4 residents. The first residents will rotate there during the 2015-2016 Academic Year.
Additional highlights included:
The 3-year renewal of the Sheppard Pratt contract (~$1.5 million per year).
The transition to the Next Accreditation System; the program received approval from the ACGME with no citations.
The establishment (with the Division of Child and Adolescent Psychiatry) of the Costa Rica training collaboration, which was the first international case conference, and rotation began during the last two weeks in June 2015.
2016: July 1, 2015 – June 30, 2016
International electives continue to expand for the Department’s Education efforts: four PGY-4 residents were the first to rotate on the newly established elective with Lord John Alderdice at the Centre for Resolution of Intractable Conflicts of the Harris Manchester College at Oxford University; and, with the help of Robert Schwarcz, PhD, a new research elective was created at the Medical University of Vienna.
Additionally, the Division created a specialized Physician-Scientist track for individuals entering the program with a PhD and with an interest in academia. The program will ensure protected time for research and mentorships, and promises the ultimate goal of developing a future faculty academic psychiatrist.
2017: July 1, 2016 to June 30, 2017
This year, the Physician-Scientist track was further developed, and emphasized its goal of a strong Return on Investment. The newly established track will fund up to $50,000 to support the tenure of residents who are focused on neuroscience-based research; the Department recruited its inaugural candidate this year. Over the next five years, the Department projects to recruit five to nine candidates and invest a total of $450,000. After training, these individuals are required to join the Department faculty and contribute R01 grants. This investment will yield an impressive return: the average cost of recruiting a PI is ~$750,000, and the Department will invest a mere $450,000 to achieve what would traditionally require $6.5+ million. Further, an average R01 approximates to $1.5 million – with full fulfillment, the Department will foresee a Return on Investment of 30:1.
Trending Electives: Six PGY-4 electives were created to meet growing demands: University of Maryland College Park Student Health, Women’s Mental Health, Regulatory Medicine at the FDA, Correctional Psychiatry at the Maryland Correctional Institution for Women (MCIW), Telepsychiatry to the Eastern Shore at UMMC, and Research at the Clinical Neurobehavioral Center (CNC).
2018: July 1, 2017 to June 30, 2018
A two-year contract was established with the Sheppard Pratt Health System and with an annual budget of $1.6 million.
Trending Electives: Four PGY-4 electives were created to meet growing demands: Integrative Medicine, Women’s Mental Health, Regulatory Medicine at the FDA, and Correctional Psychiatry at the Maryland Correctional Institution for Women (MCIW) in Jessup. Two new electives, paired with an increase in resident stipend, were created for the 2018-19 academic year at the Institute of Neuroscience, University of Barcelona, and European Medicines Agency.
In conclusion, the Department of Psychiatry would like to congratulate all its faculty and staff for their very hard work and dedication. We look forward to developing our upcoming Vision 2025 Strategic Plan, and establishing a launching pad for future growth and development. Thank you to all!