The Need to Lead

January 1, 2016

Building a generation of leaders and innovators in public mental health services

Department of Psychiatry – January 2016 - View Full PDF

Patrick Runnels, MD

Director, Public and Community Psychiatry Fellowship, UH Case Medical Center; Assistant Professor, Department of Psychiatry, Case Western Reserve University School of Medicine

Farah Munir, DO

Director, Public and Community Psychiatry Fellowship, UH Case Medical Center; Assistant Professor, Department of Psychiatry, Case Western Reserve University School of Medicine

One of Ohio’s leading institutions for clinical and academic training and work in public community psychiatry, the Department of Psychiatry at University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, operates one of the nation’s longest-standing training programs in the area of community mental health services—the Public and Community Psychiatry Fellowship, which started in 2000.

In 2008, the program expanded and shifted under the current Fellowship Director Patrick Runnels, MD who also serves as Medical Director for the Center for Families and Children. Drawing on his own experiences in training and leadership in the field, Dr. Runnels refocused the fellowship towards fostering leadership and managing the complex dynamics of community health settings.

“What we know is that community mental health is mission-driven work. And when people enter into this work without a set of tools to help them understand the systems, work within a team, and lead a team of diverse care providers, predictably, they burn out,” says Dr. Runnels, who has published several articles on the topic of training psychiatrists for community health challenges, most recently in the journal Academic Psychiatry. “Our goal is to equip them with the skills they need to operate successfully across the many complex systems involved in providing public health services.”

Since that time, the program has trained and graduated 37 fellows at an average of between six and eight per year, making it the second largest fellowship of its kind in the country, and perhaps the most successful program in the country at retaining fellows in this often-frustrating, high-burnout-rate subspecialty. Of the 37 fellows to date, 50 percent hold a leadership position within a community health organization, acting as medical directors, training directors and programming directors. Nearly 88 percent of the fellows remain in public health practices at least part time. 

This fellowship offers several unique aspects, starting with the makeup of the student body. The Public and Community Psychiatry Fellowship is the only program in the country to expand the ranks of fellows beyond post-residency psychiatrists. The program also accepts qualified advance practice nurses and plans to accept qualified physician assistants in the near future. Additionally the team recently added a robust distance-learning module that allows fellows from across Ohio, including Akron, Toledo, and Columbus, to participate in the learning sessions and complete the fellowship in their home communities, expanding geographic reach.

“We are trying to adapt to and embrace the changing landscape of service providers in the field of mental health services,” says Farah Munir, DO, Associate Director of the Fellowship. “The fact is that more and more mental health -trained nurse practitioners are joining our community to serve those in need. We can train them to be leaders in the field, and engage them in the academic conversations we are having about delivering care to these challenging populations, so we are all working together toward a common goal—improving the scope and quality of care for the underserved.”

Dr. Runnels agrees and estimates that within five to 10 years at the current trajectory, there will be a shortage of nearly 30,000 psychiatrists to provide the care that is needed. “If there isn’t more collaboration across disciplines in this field, we will be faced with massive unmet needs," he says. Finding ways for people who are dedicated to the field to stay, no matter which academic credential they hold, is crucial.”

To that end, the curriculum embraces an approach that breaks the mold on the traditional lecture-based style of classroom training common in medicine. The structure and content more closely resembles that of a business school curriculum, focusing on the dynamics of working in teams, understanding systems and managing challenges. Instead of reading book chapters in preparation for a class lecture from a professor, each week the fellows are given a pre-homework assignment that involves preparing for an interactive session. One assignment asks the fellows to prepare their resumes for a job as director of a mental health organization, and the subsequent class time is spent performing mock interviews for the position. In other weeks, groups prepare team presentations or work together to complete assignments. 

Dr. Runnels attributes the program’s high retention rates to this model. “Our fellows are graduating with more knowledge of all the systems that work within the public mental health community, and are leaving the program better prepared to lead their organizations through the maze, while maintaining focus on providing high quality care to people who need it.”

To learn more about the Public and Community Psychiatry Fellowship program, please contact Dr. Runnels at Patrick.Runnels@Uhhospitals.org or Dr. Munir at Farah.Munir@Uhhospitals.org

 

 

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