What follows is a partial listing of recent and ongoing faculty and resident projects:
We have started to catalogue the numerous international projects within the Department.
- The well-received 2003 MGH Psychopharmacology Spring Lecture Series was on “Cross-Cultural Psychiatry.” A book entitled “Perspectives in Cross-Cultural Psychiatry” by Anna M. Georgiopoulos, MD and Jerrold F. Rosenbaum, MD grew out of this lecture series.
- The “African Diaspora” meeting has already spawned a number of projects and working relationships. For example, David Henderson will be collaborating with attendees on disaster psychiatry training.
- Chester Pierce has begun a follow-up to the November 2002 African Diaspora meeting focused on the nature of racism and its possible inclusion in DSM-V. A distinguished panel of experts led by Carl Bell met to begin drafting a scientific statement that will be vetted at national meetings.
- We have established a chief residency in public and international psychiatry here at the Massachusetts General Hospital Department of Psychiatry. This chief residency is designed to provide the opportunity for hands on experience, practical training and individualized learning in community and social psychiatry and public mental health policy. Focus will be on learning and applying specialized skills and knowledge to help meet mental health needs in the developing world.
- Also on the education front, the addition of a course on leadership in public and international mental health to the PGY-II curriculum will complement the integrated socio-cultural PGY-III course. We have worked with the residency training directors to develop dedicated time for international electives in the PGY-III and PGY-IV years.
Australia: Gregory Fricchione and John Brayley, Director of Mental Health in South Australia, have collaborated to develop exchange opportunities for residents allowing MGH senior residents to work for one to three months on the Remote and Rural Health Service of South Australia and Australian registrars to be clinical observers at MGH. Amy Bauer spent the month of May 2006 in South Australia as part of her PGY-III community psychiatry experience. *Trip Report*
Belize: Paolo Cassano, PGY-II is developing a collaboration with Dr. Claudina Cayetano, Belize's Chief Psychiatrist, providing teaching and consultation to psychiatric nurses. *Trip Report*
Bosnia: See Harvard Program in Refugee Trauma, below.
Brazil: PGY-IV Marketa Wills visited Salvador, Brazil to attend a conference in 2004. *Trip Report*
In 2005, John Palmieri visited Sobral, Brazil as part of his PGY-III community psychiatry experience. *Trip Report*
Cambodia: See Harvard Program in Refugee Trauma, below.
Canada: See IMPACT Program, below.
Chile: In collaboration with Hector Parada, Trina Chang developed a four week elective in Santiago, Chile as part of her PGY-III community psychiatry experience. *Trip Report*
China: Lawrence Park, Jonathan Worth and Albert Yeung are developing ties with the Shanghai Mental Health Center. Four years ago, in association with a Fogarty Grant and the University of Hong Kong, a Mental Health Services Research Training program began in Shanghai and Beijing with research in Hong Kong, Indonesia, Taiwan, and other locations. There will be two or three fellows each year that participate in this program. Each fellow will spend between four and nine months doing research and in an extended clinical placement model. The program was developed to work with Chinese populations regarding depression and early psychosis research and to work with undertreated and underrecognized populations. This project is a great opportunity to develop CME programs, research projects and synergies within Asian psychiatry.
During her PGY-III community psychiatry experience, Karen Liaw accompanied Drs. Park and Worth to Shanghai. She also returned to Shanghai for a one month rotation at the Mental Health Center. *Trip Report*
Ethiopia: Gregory Fricchione has been seeking resources to work with the Psychiatry Department of the University of Addis Ababa. A Psychiatry Residency Program at the University of Addis Ababa was begun in 2003 under the direction of Dr Atalay Alem. The University of Toronto has been most instrumental in helping to establish this residency program, which graduated seven psychiatrists in 2006, and six in 2007, raising the complement of Ethiopian psychiatrists from nine to twenty-two. We have been asked to help this training program teach Psychosomatic Medicine and Consultation Psychiatry.
In addition, Dr. Fricchione is an outside mental health consultant for the Ethiopian Public Health Training Initiative, which has created a model for training non-medical caregivers in Ethiopia. In the seven public health colleges, the Initiative is training undergraduate healthcare workers to go out in the community and field. The Ethiopian Council and the Carter Center have been working in tandem on a modular training structure. In the first 15 modules, there was no mental health care training, but the second 15 do include this area. Dr. Fricchione and Dr. Alem are taking part in the development of a practicum section to the training.
In 2007, PGY-IV residents, Karen Liaw and Eric Achtyes accompanied Dr. Fricchione on a return visit to Ethiopia to participate in ongoing teaching initiatives. The residents taught beginning residents fundamentals of interviewing and the psychiatric and neurological exams and took part in inpatient ward rounds at Amanuel Hospital while Dr Fricchione supervised residents in the EW, OPD, inpatient wards and general hospital floors and taught a curriculum on psychosomatic medicine to residents and faculty. *Trip Report*
Fiji: Anne Becker is researching the cultural aspects of eating disorders in Fiji. Dr. Becker received a K23 grant for a follow up study in Fiji as the social transition there has gone at an accelerated pace. Television and the internet arrived in Fiji rather suddenly putting girls with no psychiatric pathology at risk for eating disorders and the Fijian girls now have a morbidity of eating disorders similar to that of Massachusetts girls. She conducted focus groups and engaged the health and education ministries in discussions about school based programs to work with girls on the growing problem of eating disorders and found that girls felt that image and behavior are linked to economic opportunities.
Ghana: Carol Wool has developed contact with 240-bed tertiary care regional hospital in city of Ho, Volta Region, Ghana. The hospital has an inpatient psychiatric ward with 10 beds and an outpatient clinic, which has 2500 visits a year. Two psychiatric nurses who are Registered Mental Health Nurses provide most of the care along with an attending psychiatrist for the unit. There are also community clinics called Zonal Health Centre Polyclinics and a smaller District Hospital in the area. In Ho there is an NGO site, part of a larger organization called Cross Cultural Solutions. Volunteers come here for instruction in language and the culture of the region and then are placed in appropriate venues. *Trip Report*
Haiti: Nina Muriel will be working on children's mental heath issues for a Partners in Health project in Haiti.
Harvard Program in Refugee Trauma - Cambodia, Bosnia and Peru: Richard Mollica is the Executive Director for the Harvard Program in Refugee Trauma (HPRT), an organization that has spent 25 years caring for the health and mental needs of survivors of mass violence, disaster and torture through a combined practice of clinical experience and medical research. *More information*
IMPACT Program: The MGH Division of International Psychiatry is collaborating with Dalhousie University in Halifax, and McMaster University in Hamilton, Canada and Instituto Nacional De Psiquiatria Ramon De La Funete Muniz and the Instituto Nacional De Neurologia in Mexico City through the North American Public Mental Health Leadership project. This project is funded through a grant from the Department of Education's Fund for the Improvement of Post-Secondary Education North American Mobility Project. It is led by Dr. Gregory Fricchione and Dr. Felicia Smith with administrative support from Dr. John Querques and Sara Nadelman of MGH. This project has provided elective opportunities for PGY-IV residents interested in public mental health, including Janet Witte and Guiseppe Raviola in 2006 and John Palmieri and Amy Bauer in 2007. *More information*
India: Steven Safren is doing research on behavioral methods to improve HAART compliance in HIV-AIDS in Chennai, India.
Indonesia: Our Asian Initiative may work with Professor Byron Good of the Harvard Department of Social Medicine, who is seeking funding to help develop a mental health system in Aceh Province following the 2004 Tsunami. In Aceh, four psychiatrists serve a population of approximately four million people.
Guiseppe Raviola traveled to Indonesia in 2005 during his PGY-III community psychiatry experience.
Israel: During his chief residency on the MGH Consultation-Liasion service in 2006, Guy Maytal traveled to Hadassah Hospital in Jerusalem to provide advice on the development of a Consultation-Liasion service and to do consultation work.
Italy: During her PGY-IV year, Nicoletta Craven spent four weeks at Umberto Primo General Hospital at Ancona, Italy conducting research screening to determine the prevalence of major depressive disorder and other psychiatric diagnoses in patients with newly diagnosed, untreated endocrine diseases using the PDSQ and QIDS-SR questionnaires.
Jordan: Dr. Bill Pirl recently collaborated with the neuro-oncology service at the King Hussein Canter Center in Amman, Jordan, delivering lectures on the psychiatric complications of CNS tumors and caring for families of patients with CNS tumors. *Trip Report*
Mali: Dr. Ilana Braun recently visited Mali for an overview of psychiatric and traditional healing practices in various regions of the country. *Trip Report*
Mexico: See IMPACT Program, above.
Navajo Reservation, New Mexico: John Roseman spent a month during his PGY-III community rotation providing a range of psychiatric treatment services to adults and children. *Trip Report*
Nepal: Prof Dr Mahendra Nepal of the Tribuvan University Teaching Hospital in Kathmandu has visited our Division and has hosted a resident visitor in the past. He was in Boston recently because he is a collaborator with Susan Santangelo (genetic epidemiologist at MGH) who has a recently funded R-O1 to study endophenotypes associated with schizophrenia in Nepal and map the genes influencing these traits. Dr. Nepal will be training with her on the use of the DIGS and FIGS, so he can train and supervise the psychiatric residents who will administer these instruments in the course of this study. Dr. Elizabeth Hoge recently spent six weeks working with Dr. Nepal.
Pakistan: Batool Tauseef Kazim returned to her native Pakistan in 2006 to assist with relief efforts following the earthquake that struck Kashmir in October 2005 and left over 70,000 people dead. *Trip Report*
Peru: See Harvard Program in Refugee Trauma, above.
South Africa: We are working out the details with Bruce Walker, Director of the Partners AIDS Research Center, and the leadership of KwaZulu-Natal University about setting up an MGH psychiatric attending service at the Nelson Mandela University Hospital in KwaZulu-Natal in an effort to support the academic mission of its Psychiatry Department in the era of tremendous HIV/AIDS related need.
St. Lucia: Dr. David J. Borrelli has collaborated with local health providers at a community hospital in St. Lucia. Numerous areas have been identified for future training, including response to psychiatric emergencies and use of newer pharmacologic agents. *Trip Report*
Thailand: As part of his PGY-III community psychiatry experience, Ravi Hariprasad visited Bangkok and other regions of Thailand in October 2006. *Trip Report*
Zambia: We have been invited by the MGH Center for Global Health to serve as mental health consultants for an MOU with the Zambian Government to establish a Center of Excellence for Maternal and Child Health in Zambia.