Psychiatry & Behavioral Sciences Biennial Report 2021-2023

DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES

BIENNIAL REPORT 2021–23

BIENNIAL REPORT 2021–23

MAKING OUR IMPACT

MAKING OUR IMPACT

OUR PRIORITIES

• Train mental health professionals to become 21st century leaders in the fields of psychiatry and psychology.

• Provide culturally informed, evidence-based clinical care for individuals and families in our community.

• Execute cutting-edge basic and clinical research that illuminates the underlying neurobiological causes of psychiatric disorders, transforms clinical practice and identifies novel treatments.

• Promote innovation in our training methods, research and service to our community.

Welcome From the Chair

Colleagues and Friends,

It’s my pleasure to share with you the Department of Psychiatry and Behavioral Sciences at Dell Medical School at The University of Texas at Austin 2021–23 Biennial Report.

In 2022, we were delighted to welcome Claudia Lucchinetti, M.D., an accomplished clinical scientist and leader from the Mayo Clinic, as our new dean and senior vice president for medical affairs. In partnership with the school’s leadership, we continue to build a preeminent department outstanding in clinical service, teaching, research, and community engagement. We recruited several outstanding faculty members during the past two years, including Rishi Sawhney, M.D., associate chair of community psychiatry, and Young Shin Kim, M.D., Ph.D, M.S., MPH, associate chair of child and adolescent psychiatry.

It has been another very unusual two years for all of us. The COVID-19 pandemic created major changes in our lives as we witnessed terrible loss of life and disruption in our daily routines. The uncertainty of COVID-19 — coupled with working from home, social distancing, and isolation — has affected everyone. Despite this, we have perservered and endured and, in fact as documented in this report, even thrived in clinical service, training, and research. I am continually impressed by the dedication of our faculty, staff, and trainees. The predictions of a sustained mental health crisis following the COVID-19 pandemic turned out to be accurate. We continue to do your best to provide mental health care to those in need.

The future of the department is filled with promise. I look forward to seeing what new successes the coming years will bring.

DELL MEDICAL SCHOOL On a Mission to Revolutionize How People Get & Stay Healthy

Dell Medical School, as the anchor of The University of Texas Medical Center, is rethinking the role of academic medicine in improving health. Working together with our community — and powered by cutting-edge technology and digital capabilities — we set the standard for excellence in integrated, multidisciplinary patient care, pioneer research with meaningful impact, lead innovation in medical education and catalyze life sciences entrepreneurship.

UT Medical Center builds on the foundation for excellence laid by The University of Texas at Austin and our clinical partners, bringing Austin into focus as a premier destination for health care.

Our vision is defining the future of health — because we know that what starts here changes the world.

Sincerely, Charlie

Charles B. Nemeroff, M.D., Ph.D. Professor and Matthew P. Nemeroff Endowed Chair Department of Psychiatry and Behavioral Sciences Director, Institute of Early

Life Adversity Research Co-Director, Center for Psychedelic Research and Therapy Mulva Clinic for the Neurosciences

45 COURTESY

3 JOINT & EMERITUS

82 REGULAR

63 AFFILIATE

60 ADMIN

46 CLINICAL

49 RESEARCH

40 Total General Psychiatry Residents

2 Consultation-Liaison Fellows

10 Child & Adolescent Fellows

4 Psychology Postdoctoral Fellows

6 Psychology Interns

Executive Committee

Charles B. Nemeroff, M.D., Ph.D.

MATTHEW P. NEMEROFF ENDOWED CHAIR

Martinez, M.D., MHP ASSOCIATE CHAIR FACULTY DEVELOPMENT

Mark H. Townsend, M.D., MSP ASSOCIATE CHAIR, EDUCATION

New Faculty

Carol L. Alter, M.D.

EXECUTIVE ASSOCIATE CHAIR, CLINICAL INTEGRATION & OPERATIONS

D. Jeffrey Newport, M.D., M.S., M.Div. ASSOCIATE CHAIR, RESEARCH

Young Shin Kim, M.D., Ph.D., M.S., MPH ASSOCIATE CHAIR, CHILD & ADOLESCENT PSYCHIATRY

Lloyd Berg, Ph.D., ABPP DIVISION CHIEF, PSYCHOLOGY

Roger (Lowell) McRoberts, M.D. DIRECTOR, CLINICIAN WORKFORCE, ASCENSION MEDICAL GROUP

Increased Regular Faculty to 82 by recruiting 23 talented, new members to the department:

Laura Amoscato, Ph.D., Assistant Professor

Lisa Boyars, M.D., Assistant Professor

Beverly Bernal, Ph.D., Assistant Professor

Audrey Cortesi, Psy.D., Assistant Professor

Meredith Ehrhardt, Ph.D., Assistant Professor

Victoria Felki, M.D., Assistant Professor

Lief Fenno, M.D., Assistant Professor

Eric Gonzalez, M.D., Assistant Professor

Vijay Gorrepati, M.D., Assistant Professor

Young Shin Kim, M.D., Ph.D., M.S., MPH, Professor

Priya Kumar-Kaparaboyna, M.D., Assistant Professor

Erin Logue, Ph.D., Assistant Professor

Greg Muller, Ph.D., Assistant Professor

Jacqueline Posada, M.D., Assistant Professor

Christopher Powell, M.D., Assistant Professor

David Rumbaugh, M.D., Assistant Professor

Rishi Sawhney, M.D., Assistant Professor

Kathleen Stanton, Ph.D., Assistant Professor

Melvin Thomas, M.D., Assistant Professor

Mark Townsend, M.D., M.S., Professor

Celeste Valencia, M.D., Assistant Professor

Kari Whatley, M.D., Assistant Professor

Rex Wright, Ph.D., Professor

Octavio

Rishi Sawhney, M.D. ASSOCIATE CHAIR, COMMUNITY PSYCHIATRY

Puja Patel, Ph.D. DIRECTOR, PEDIATRIC PSYCHOLOGY

Michael Godwin, M.A., CRA, PMP SENIOR DIRECTOR, OPERATIONS & STRATEGY

PSYCHOLOGY

Led by Division Chief Lloyd Berg, Ph.D., ABPP, the Division of Psychology comprises over a third of our departmental faculty. Our psychologists are integral in advancing the mission of the department and Dell Med through leadership in research, clinical innovation, teaching, and community health initiatives.

The division is home to an impressive portfolio of innovative training programs, including an APAaccredited predoctoral internship in pediatric and clinical child and adolescent psychology, a postdoctoral fellowship program in pediatric psychology, and our innovative Integrated Behavioral Health Scholars Program. Our research psychology faculty are engaged in high-impact research initiatives, and our clinical psychologists provide evidence-based psychological assessment and treatment to patients and families across the lifespan.

Exemplars within our division include Suzannah Creech, Ph.D., serving as Dell Med’s assistant dean for research; Greg Fonzo, Ph.D., inaugural co-director of our department’s groundbreaking Center for Psychedelic Research and Therapy; Josh Cisler, Ph.D., co-director of the Institute for Early Life Adversity Research and co-founder of the Trauma Treatment Center; and David Heckler, Ph.D., ABPP, who is building a more inclusive field of psychology by providing individual mentorship to individuals wishing to pursue graduate-level training in psychology.

Jeffrey D. Shahidullah, Ph.D., was first author on an article advocating for child health equity in the primary care setting in the American Psychologist, the flagship journal of the American Psychological Association.

Lloyd Berg, Ph.D., ABPP, was the recipient of a 2022 Dell Med Innovation in Education Award from the Susan M. Cox, M.D. Academy of Distinguished Educators and the 2023 Ivan Mensh Award for Distinguished Achievement in Teaching from the Association of Psychologists in Academic Health Centers.

17 AFFILIATE

24 COURTESY

Total Faculty: 67 26 REGULAR

INTEGRATED BEHAVIORAL HEALTH SCHOLARS PROGRAM

According to Mental Health America’s 2023 State of Mental Health in America Report, Texas ranks last nationally in access to mental health care for youth and adults and second-to-last in mental health workforce availability. To help close this behavioral health workforce gap, the Department of Psychiatry and Behavioral Sciences partnered with UT Austin’s School of Nursing, the Department of Educational Psychology within the College of Education, and the Steve Hicks School of Social Work in 2017 to create the Integrated Behavioral Health (IBH) Scholars Program. The mission of this innovative crosscampus collaboration, funded by a portfolio of federal Health Resources and Services Administration grants, is to build an interprofessional behavioral health workforce with expertise in delivering teambased mental and behavioral health services in underserved Texas communities.

IBH scholar placements throughout our system of care have helped improve access and quality of care for individuals living with mental health conditions, substance use disorders, and intellectual and developmental disabilities. A third of them have joined our permanent workforce after graduating.

— Kathleen Casey, Ph.D. Senior Director of Clinical Innovation & Development at Integral Care

Of the 237 psychiatry, psychology, social work, and psychiatric nurse practitioner trainees who have completed the program since 2017, 36% are bilingual and 62% are from historically underrepresented or economically disadvantaged backgrounds. 90% of IBH scholars surveyed one year after completing the program reported they are working in medically underserved communities. Most recently, the 2022–23 IBH scholar cohort provided clinical services at 42 community sites throughout the Austin / Travis County area, including an expansion of 19 new training locations.

IBH Scholars Program Event

IBH Scholars Seminar / People conferring in HDB

EDUCATION

The Department of Psychiatry and Behavioral Sciences is a major contributor to Dell Med’s tenet to educate leaders who transform health and care. Our psychiatric education platform includes: psychiatry residency training, psychology relationships, psychology internships, post-docs, and psychiatry fellowships in Child, Addiction, Geriatric, Consultation-Liaison Psychiatry, and Continuing Medical Education, supporting resident innovation, research, and cross-disciplinary collaboration. Often, trainees are the ones to point out new opportunities for clinical interventions; their commitment to evidence-based clinical care is evident in every patient interaction. They are compassionate, perceptive physicians, and the department prides itself in training our future leaders in the field of psychiatry and behavioral sciences.

ADULT PSYCHIATRY

TRAINING PROGRAM

Under the direction of Roger (Lowell) McRoberts III, M.D., the Psychiatry Residency Program is home to a group of outstanding residents from across the nation, many of whom go on to further their training in psychiatric fellowship programs. Some residents participate in additional specialty training in research and psychotherapy. The program is rapidly expanding, with nearly 1,400 applicants applying for a spot as one of the twelve first-year residents. Dell Medical School residency and fellowship programs are sponsored in partnership with Ascension Seton.

Residents at Fall Retreat October 2022

Curriculum

The curriculum for the General Psychiatry Residency Program is tailored to match the clinical learning goals of each resident to achieve steady growth across the competencies and passage of the board examination following graduation.

The PGY-1 didactic curriculum has recently been refined and updated by the inpatient teaching team. Core groupings of lectures include psychiatric diagnosis across the life cycle, epidemiology and comorbidity, workup, and treatment planning inclusive of somatic treatments and multiple psychotherapy modalities (Psychodynamic, CBT, DBT, Family Therapy, Couples Therapy, Group Therapy, Motivational Interviewing, and advanced topics).

Neuroscience is highlighted in the department’s curriculum to teach residents about psychiatric genetics, neuroanatomy, and physiology. This year, the department added Brain Imaging and Psychedelics. Furthermore, a longitudinal Forensic Psychiatry curriculum that includes a partnership with the UT School of Law and the annual Mock Trial is a unique component of the departments teaching along with a longitudinal PGY-3 Quality Improvement course which has had positive impact on core clinical sites.

CURRICULUM HIGHLIGHTS

•The four-year Physician Scientist Track offers residents increasing protected time each year to complete research-focused didactics, execution of a mentored, longitudinal research project, and professional development as an academic psychiatrist.

•The three-year Psychotherapy Scholars Track offers increasing dedicated time for residents and didactic experiences to learn and develop proficiency in five forms of psychotherapy (brief treatments, behavioral therapies, motivational interviewing, psychodynamic psychotherapy, group therapy and family/couples).

•The Integrated Behavioral Health Scholars Program offers additional training for PGY-4 residents including didactic curriculum and clinical practice with emphasis on integrated behavioral health, interprofessional practice, and cultural humility.

•The Mock Trial Experience for PGY-3 residents in coordination with the UT School of Law and L2 students.

•Departmental Scholarly Day showcasing work from PGY-1 to -4 residents and medical students.

•Annual quality improvement training and project development for PGY-3 residents.

Clinical Rotations

PGY-1 residents in inpatient psychiatry at Ascension Seton Shoal Creek Hospital regularly manage complex and severely ill patients, developing core interviewing, assessing, and treatment planning skills for their primary training. PGY-2 residents gain wide experience with treating psychiatry outpatients in child and adolescent, adult, and geriatric psychiatry clinics. Teaching sites include UT Health Austin, Ascension Seton, the Austin VA Clinic, and community psychiatry clinics associated with Integral Health.

The PGY-3 year includes core rotations in Consultation-Liaison Psychiatry, Emergency Psychiatry, Forensic Psychiatry, and Addiction Psychiatry. PGY-4 residents are given ownership of their schedules and may select from an increasing array of elective opportunities.

EDUCATION

Physician Scientist Track

Launched in the summer of 2020, the Physician Scientist (Research) Track is designed with the flexibility to enable residents with research interests to engage in psychiatric research throughout the residency. Since its inception, the track has enjoyed consistent growth from its inaugural three residents to eleven in 2023–24.

for Junior Psychiatrist Investigators. The APA Research Colloquium, chaired by Charles Nemeroff, M.D., Ph.D., is an invaluable resource for early career psychiatrists to access additional mentoring and networking opportunities.

The scope of research track projects spans functional neuroimaging, psychedelic-assisted psychotherapy, perinatal mental health, machine learning, health services research, basic neuroscience, and forensic psychiatry. The Physician Scientist (Research) Track Open House, affording residency applicants a forum to meet with departmental research faculty as well as current research track residents, is attended each year by dozens of applicants, demonstrating the considerable interest generated by the research track during residency recruitment.

In addition, research track residents are garnering national attention as representatives for the department and Dell Med. For example, during the last two academic years, four research track residents— Bryan Barksdale, M.D., Ph.D.; Chris Demetriades, M.D.; Sean O’Sullivan, M.D., Ph.D.; and Brad Unroe, M.D.— were invited to participate in the American Psychiatric Association (APA) Research Colloquium

Finally, Unroe became the first graduate of the Physician Scientist Track in June 2023. Guided by his faculty mentor, Justin Benzer, Ph.D., Unroe completed his primary research project entitled “Evaluation of a Novel Integrated Care Model for Individuals Experiencing Homelessness.” This invaluable experience led him to pursue a career in governmental public health leadership.

Education Residency Track / Unroe and Benzer

Physician Scientist Track Resident Growth

PROJECTED

Psychiatry Electives Offered to Fourth-Year Residents

• Advanced Consultation-Liaison Psychiatry

• Advanced Emergency Psychiatry

• Advanced Geriatric Psychiatry

• Advanced Inpatient Child & Adolescent Psychiatry

• Advanced Inpatient Psychiatry

• Advanced Outpatient Psychiatry

• Basic Neuroscience

• Bipolar Disorder Clinic

• Brain Imaging

• Clinical Trials

• Cognitive Processing Therapy (CPT)

• Community Psychiatry at Integral Care

• Comprehensive Memory Center

• Electroconvulsive Therapy (ETC) / Transcranial Magnetic Stimulation (TMS) / Research

• Family Medicine Embedded Rotation

• HIV, Intersex, & Adult Gender Care

• Homeless Outreach Clinic

• Hospice & Palliative Medicine

• Medical Student Teaching Elective

• Neuropsychology Clinic

• Perinatal Psychiatry

• Private Practice Elective

• Psycho-Oncology

• Psychopharmacology Consults

• Reading Elective — Advanced Forensic Psychiatry

• Research

• UT Counseling & Mental Health Center

• VA Eating Disorder Rotation

Natasha Gambhir, D.O., fourth year resident, was named a 2021–22 Substance Abuse and Mental Health Services Administration minority fellow.

My interests in psychiatry include consultation-liaison psychiatry, neuromodulation, education, and interdisciplinary collaborative care. I'm excited to be in this program for the abundant opportunities to explore these interests. I appreciate how easy it is to get connected with mentors to facilitate my growth. Everyone here is approachable and eager to provide their wisdom and guidance.

Gregory Ziomek, M.D. THIRD YEAR RESIDENT

EDUCATION

Psychotherapy Scholars Track

The two-year Psychotherapy Scholars Track provides enhanced training opportunities to residents, beyond their already robust psychotherapy didactics and supervision expectations. The goals of the track are to best support trainees whose career ambitions include regular provision of psychotherapy in addition to actively engaging the community of Alice Thompson, M.D., was accepted into the American Psychiatric Association Public Psychiatry Fellowship.

psychotherapy providers as teachers and colleagues. Organized by Jessica Thompson, M.D., Valerie Rosen, M.D., and Sussann Kotara, M.D., the track provides residents protected clinic time and specialized supervisors for additional psychotherapy cases and academic pursuits. Through seminars, residents are also exposed to unique and current topics.

CONSULTATION-LIAISON PSYCHIATRY FELLOWSHIP

In the ACGME-accredited training program, consultation-liaison psychiatry fellows master the essential knowledge and skills needed to deliver comprehensive screening, assessment,

examination, and treatment of neuropsychiatric problems intersecting with management of other acute medical and surgical conditions

Residents discussing morning rounds.

R. Garrett Key, M.D., leads the efforts to expand psycho-oncology clinical services and training opportunities across UT Health Austin and Ascension clinical systems as consultation-liaison fellowship director. Under his guidance, the 2023–24 match cycle led to excellent results, matching two outstanding Dell Med general psychiatry residency program graduates to the Consultation-Liaison Psychiatry Fellowship Program: David Cho, M.D., and Greg Ziomek, M.D.

Cho has a strong interest in psychotherapy and plans to establish an outpatient clinic focused on functional neurological disorders during his fellowship year. Ziomek continues to work on the outpatient work at the Kind Clinic, providing sexual health care services in a setting that aims to eliminate stigma and access problems.

Fellows distinguish themselves both during and after their training. As upper-level trainees, they are responsible for day-to-day clinic service operations

and the teaching of other trainees. The training program’s flexibility allows fellows to explore varying interests and graduates go on to a variety of posts after training. Joseph Dragonetti, M.D., joined the fellowship in 2022–23 and developed new PGY-5 elective training experiences in neurostimulation and perinatal psychiatry.

Under the leadership of addiction medicine-board certified faculty member Blair Walker, M.D., the comprehensive treatment protocols for hospitalized patients with opioid use disorder were expanded. The team has brought forth improved patient outcomes, ultimately garnering support by Ascension for national protocol development and implementation.

Core faculty have established an integral psychiatry presence on the renal transplant team and a protocol for initiating treatment of opioid use disorder for hospitalized patients implemented on a national scale across the Ascension network.

GERIATRIC PSYCHIATRY FELLOWSHIP

The one-year clinical fellowship in geriatric psychiatry is actively recruiting its first cohort. Fellows will receive training in a variety of settings that span the typical spectrum of geriatric psychiatric care: acute

care hospitals or consultation settings, outpatient specialty clinics, long-term care settings, palliative or hospice care settings, electroconvulsive therapy service, and an inpatient geriatric psychiatry unit.

CHILD & ADOLESCENT PSYCHIATRY FELLOWSHIP

The Child and Adolescent Psychiatry Fellowship is a two-year program focused on providing the necessary training for the diagnosis and treatment of cognitive, affective and/or behavioral disorders in the child and adolescent patient population. The program’s origin dates to 1971 as a small, community-based program operating

out of Austin State Hospital. With the support of Dell Medical School and Dell Children’s Medical Center, the program continues to flourish and grow each year.

For the fellowship class of 2022, the program received 87 applications and interviewed over 50 for five positions.

The newly launched Community Psychiatry Track in the first and second years of training prepares fellows for the specialized work of being a community child

R. Garret Key, M.D.

Blair Walker, M.D.

Kari Whatley, M.D., Child & Adolescent Fellowship Program Director

and adolescent psychiatrist. In partnership with the Austin State Hospital, fellows receive training and care for children and adolescents suffering from heightened mental disturbance in a community setting. Fellows also gain experience in an outpatient setting at Integral Care. The program’s elective opportunities expanded to include experiences in

Child & Adolescent Fellows

human trafficking, crisis psychiatry, integrated clinics, and additional psychotherapy training through the consultation-liaison psychology service. The Community Psychiatry Track fellows have dedicated clinical experiences with Integral Care, Texas Child Health Access Through Telemedicine, advocacy curriculum, and more.

The Child and Adolescent Psychiatry Fellowship Program continues to accept five fellows per academic year and the program lasts two years. Fellows rotate through include outpatient clinic at Texas Child Study Center, inpatient at the Mental Health Unit within Dell Children’s as well as the children’s unit at Austin State Hospital, the consultation-liaison service, and the Partial Hospitalization Program located at Dell Children’s.

The program continues to collaborate with the Department of Pediatrics by providing training opportunities, connections, and elective experiences. The Child and Adolescent Psychiatry Fellowship Program now has regularly scheduled shared didactics with the child psychology program.

From left: Taylor Baskin, M.D.; Sovan Lek, M.D.; Kevin Hong, M.D.; Diana Nguyen, D.O.; Anand Jayanti, M.D.; Nicholas Dumlao, M.D; John Byun, M.D.; Kiran Jose, M.D.; Jessie Bangs, M.D.; Shipra Singh, M.D.; Chloe Yuan, M.D.

PEDIATRIC PSYCHOLOGY EDUCATION

The Division of Psychology offers multiple competitive training programs, including a doctoral psychology internship (six positions) and a postdoctoral fellowship (five positions). This training program is a partnership between Dell Medical School and Dell Children’s Medical Center, where trainees focus on providing mental health care within a medical system.

Predoctoral Internship

The numbers of applications and match rates continue to demonstrate the strong reputation being built within the program. In 2023, the doctoral internship program was awarded 10 additional years of accreditation, the highest number of years possible.

For the 2021–22 training year, the internship program received 92 applications and matched all six positions, who were high on the department's rank list. For 2022–23, the program received 112 applications and again matched with high ranked applicants.

The program updated its didactic curriculum to include a monthly process group aimed at providing additional professional development support to trainees. Additionally, bilingual interns can participate in a bilingual fluency exam resulting in formal certification.

At the conclusion of the internship year, all interns were prepared to start their postdoctoral fellowships. Four of the interns stayed in Austin, including two at Dell Med, while the other two joined two well-known academic medical centers in the U.S.: Children’s National Hospital and University of Oklahoma Health Sciences Center.

Postdoctoral Pediatric Psychology Fellowship

Dell Med’s postdoctoral fellows in child psychology come from strong clinical backgrounds. The fellowship welcomed three highly qualified fellows during the 2021–22 training year and four highly qualified fellows during 2022–23. The program offers personalized experiences to meet the training goals of the trainees. Additionally, postdoctoral fellows are encouraged to engage in tiered supervision during

rotations and to contribute to the teaching of interns and practicum students through didactics. These experiences are aimed at training well-rounded future psychologists who will be competitive and successful, both clinically and as educators. Over the years, trainees have received specialized experiences in specialties including primary care, inpatient medical consultation-liaison services, and trauma-informed services. The program partnered with Austin State Hospital to provide additional training in forensic assessments and Austin Health Partners for primary care specialization.

MANUSCRIPTS PUBLISHED IN:

•Accident Analysis and Prevention Epilepsia

•Pediatric Cardiology

•Training and Education in Professional Psychology

•International Journal of Environmental Research and Public Health

PRESENTATIONS AT: RESEARCH

•Annual Convention of the Association for Behavioral and Cognitive Therapies

•American Academy of Clinical Neuropsychology

International Neuropsychological Society

•American Academy of Sleep Medicine

UNDERGRADUATE MEDICAL EDUCATION

(INCLUDING CLERKSHIPS)

In 2023, a record 9% of Dell Medical School’s Class of 2023 matched into a psychiatry residency program, with two staying at Dell Med.

The department continues a joint clerkship with the Department of Neurology to provide clinical rotations to Dell Med students at Seton Shoal Creek Inpatient Unit and the Adult Emergency Behavioral Health Unit at Dell Seton Medical Center and Dell Children’s Mental Health Unit.

The fourth-year medical student psychiatry electives remained as popular and enriching as ever. Students matriculated in 49 separate elective experiences, with 20 of these reserved for visiting students interested in exploring our competitive residency program. Our trailblazing department succeeded in having nine new and unique research electives and a new clinical elective (clinical neuromodulation) approved for the upcoming academic year, increasing educational options for senior medical students entering psychiatry.

In partnership with Moi Teaching Hospital in Kenya, a collaboration established through the department’s membership in the Academic Model Providing Access to Healthcare (AMPATH), Moi medical students were welcomed to the department’s Mental Health Unit at Dell Children’s Medical Center in August 2023.

Our medical education team co-led a workshop with UT Southwestern for Association of Directors of Medical Student Education in Psychiatry in April 2023. Entitled “To Zoom or Not to Zoom? Is That the Question?”, the workshop covered lessons learned from educating during a challenging time and transitioning from in-person to virtual learning post COVID-19, such as making seminars more interactive and case-based. Members from across the country attended.

Health Learning Building, Dell Medical School

The Health Learning Building is the main site where medical students attend classes and study.

Kristin Escamilla, M.D., Psychiatry Clerkship Director

2021–23 GRAND ROUNDS

The department sponsors a series of in-person presentations covering state-of-the-art subjects in psychiatry and psychology. These lectures feature distinguished speakers from leading institutions facilitating in-depth discussions. Faculty members and trainees are given the opportunity to meet with speakers individually. This forum serves as a moment of unity for the entire department, fostering a shared dedication to education and cutting-edge advances in our field. A partial list of the presentations given in the past two years are shown below.

2021–22

• Deep Brain Stimulation

Helen Mayber, M.D. / Mt. Sinai School of Medicine

• Diversion Programs for Drug Abuse / Mental Illness

Steven Leifman, J.D. / Judge, Florida

• Alzheimer’s Disease

Trey Sunderlund, M.D. / formerly National Institute of Mental Health

• Post-Traumatic Stress Disorder

Barbara Rothbaum, Ph.D. / Emory University

• Schizophrenia

Steven Siegel, M.D., Ph.D. / University of Southern California

• Transgender Psychiatry

Neill Epperson, M.D. / University of Colorado

• Biomarkers of Alzheimer's Disease

Anand Kumar, M.D. / University of Illinois — Chicago

• Psycho-Oncology

Donald Rosenstein, M.D. / University of North Carolina

• Addiction & Brain Imaging

Clinton Kilts, Ph.D. / University of Arkansas

• Psychoimmunology of Depression

Andrew Miller, M.D. / Emory University

• Forensic Psychiatry in the Novel

John Katzenbach / Novelist

• Functional Brain Imaging

Colleen Hanlon, Ph.D. / Wake Forest School of Medicine

• Postmortem Studies in Psychiatry

Joel Kleinman, M.D., Ph.D. / Johns Hopkins University

• AMPATH & Psychiatry in Kenya

Edith Kwobah, M.D. / Moi University, Kenya

• Advances in Consultation Psychiatry in the Children's Hospital

Richard Shaw, M.D. / Stanford University

• Post-Traumatic Stress Disorder in Adolescence

Tanja Jovanovich, Ph.D. / Wayne State University

• Autism

Matthew State, M.D., Ph.D. / University of California — San Francisco

• Sleep & Psychiatry

Robert Greene, M.D. / University of Texas Southwestern Medical Center

• Postmortem Studies in Psychiatry

Joel Kleinman, M.D., Ph.D. / Johns Hopkins University

• The Development of Anxiety & Depression From Childhood to Adulthood

Martin Keller, M.D. / Brown University

• Cognition & Psychiatry Illness

Philip Harvey, Ph.D. / University of Miami

• Post Traumatic Stress Disorder & Brain Imaging

Josh Cisler, Ph.D. / University of Texas at Austin, Dell Medical School, Psychiatry & Behavioral Sciences

• Animal Models of Psychiatric Disorders

Gretchen Neigh, Ph.D. / Virginia Commonwealth University

2022–23

• Post-Traumatic Stress Disorder: Evolution of Concept

Israel Liberzon, M.D. / Texas A&M University

• Relationships Between Stress & the Epigenome: Implications for Health

Frances A. Champagne, Ph.D. / University of Texas at Austin, Psychology

• Using Telehealth Services to Connect to Mental Health Across Domains

Puja Patel, Ph.D., and Nithya Mani, M.D. / University of Texas at Austin, Dell Medical School, Psychiatry & Behavioral Sciences

• Advances in Genetics & Biology of Autism Spectrum Disorders

Matthew State, M.D., Ph.D. / University of California — San Francisco

• The Mind of the Mass Shooter

Harold I. Schwartz, M.D. / Institute of Living

• Addressing the Impact of PTSD on Family Functioning Within Organized Health Care

Suzannah Creech, Ph.D. / University of Texas at Austin, Dell Medical School, Psychiatry & Behavioral Sciences

• Future of Digital Mental Health for Adult & Pediatric Care

Niranjan S. Karnik, M.D., Ph.D. / University of Illinois — Chicago

• Cognitive Processing Therapy for PTSD

Patricia A. Resick, Ph.D., ABPP / Duke University

• The Role of Family Intervention in Pediatric-Onset Bipolar Disorder

David J. Miklowitz, Ph.D. / University of California — Los Angeles, Semel Institute

• How Science Can Transform Treatment Outcomes for People With Medical Illness

Blair Simpson, M.D., Ph.D. / Columbia University

• Arrested Development? Transitional Age Youth with Medical Illness

Maryland Pao, M.D. / National Institute of Mental Health

• Anorexia Nervosa: Some New Thoughts About an Old Disorder

B. Timothy Walsh, M.D., FAED / Columbia University Medical Center

• Social (In)Justice & Mental Health

Ruth S. Shim, M.D., MPH / University of California — Davis

• Adolescent Adaptation Following Severe Early Deprivation

Charles H. Zeanah Jr., M.D. / Tulane University School of Medicine

• Network Approaches to Understanding Mood & Anxiety Disorders

Olusola Ajilore, M.D., Ph.D. / University of Illinois, College of Medicine

• Managing Treatment Resistant Depression

William M. McDonald, M.D. / Emory University School of Medicine

• Risk & Resilience to Post-Traumatic Stress Disorder

Murray B. Stein, M.D., MPH, FRCPC / University of California — San Diego

• Women’s Mental Health

Samantha Meltzer-Brody, M.D. / University of North Carolina

• Neuromodulation Approaches to Treating Disorders of Mood & Anxiety

Paul E. Holtzheimer, M.D., M.S. / Geisel School of Medicine at Dartmouth

• Neuroscience of Psychotherapy

Robin Aupperle, Ph.D. / Laureate Institute for Brain Research

American College of Psychiatrists

Eight of our faculty were admitted into the prestigious American College of Psychiatrists.

Val Rosen, M.D.

Roger (Lowell) McRoberts, M.D.

Jane Ripperger-Suhler, M.D., FAPA

Garrett Key, M.D.

Sussann Kotara, M.D.

Ashley Trust, M.D.

Lief Fenno, M.D., Ph.D.

Jorge Almeida, M.D.

CLINICAL SERVICES

The department’s clinical activities, led by Executive Associate Chair Carol Alter, M.D., provides a diverse array of clinical care serving the needs of individuals and families within the community. Care is delivered at UT Health Austin, Ascension Seton facilities, and across the community including Integral Care, Bluebonnet Trails, the Austin State Hospital, and the Veterans Affairs Clinic. These multifaceted initiatives grant invaluable access to cutting-edge and pioneering health care, leveraging the department’s extensive research portfolio while fostering pivotal educational opportunities for trainees.

Health Transformation Building, Dell Medical School — UT Health Austin is the clinical practice of Dell Medical School. Health care professionals in the clinic deliver personalized, whole-person care of uncompromising quality.

CLINICAL SERVICES

Bipolar Disorder Center in the Mulva Clinic for Neurosciences

M.D., Ph.D. Center Director

The Bipolar Disorder Center at UT Health Austin provides comprehensive and innovative treatment for patients with bipolar disorder. It focuses on improving care while also striving to achieve the highest quality possible at the lowest cost.

The center’s care pathway is modeled on six-week cycles that provides counseling, psychiatric consultation, medication management, and prevention services to facilitate patients’ life goals and enhance well-being. The center treats people with bipolar disorder from 16 to 75 years old. The multidisciplinary team includes a psychiatrist, therapist, pharmacist, specialized physician assistant, nurse, and peer support specialist.

Adult Psychiatry Clinic

At the UT Health Austin General Psychiatry Clinic, the team of specialists see adult patients for evaluation, medication management, and individual and group therapy.

The clinic, which launched in January 2023, accepts referrals from within UT Health Austin and other community partners. After conducting a comprehensive evaluation of each patient, the clinic will use the findings to either provide ongoing services for stabilization or provide recommendations and reports to the referring physician. The clinic serves as the key site for training of adult residents who are focusing on psychiatry and is led by Mark Townsend, M.D., M.S., with participation of Julie Farrington, M.D., Christine Bartow, D.O., Audrey Addaquay-Corey, PNP, and Jacqueline Posada, M.D. Greg Muller, Ph.D., and Karl Chiang, Ph.D., deliver evidence-based time limited psychotherapy recommended by the treatment team. In addition to general psychiatry patients, Posada evaluates patients who are referred with co-occurring

medical and psychiatric issues. Consultation-liaison fellows also participate in this clinic.

Transcranial Magnetic Stimulation Service

The Transcranial Magnetic Stimulation (TMS) Service is one of the specialized, FDA-approved options offered for treatment-resistant mood disorders, including treatment resistant depression, that is a non-invasive, non-pharmacologic brain-stimulation therapy in an outpatient setting.

The service is excited to expand in the future to include the accelerated SAINT protocol developed at Stanford University, which will allow patients to complete a TMS course in one week. The plan is to incorporate TMS in upcoming research trials to further the understanding of TMS use in several additional psychiatric diagnoses in addition to depression.

Jorge Almeida,

Nick Ortiz, M.D., director of transcranial magnetic stimulation service with a machine

Women’s Reproductive Mental Health of Texas

Women’s Reproductive Mental Health of Texas (WRMH-TX) specializes in providing individualized and evidence-based care for mood, anxiety, trauma-related, and substance use disorders during reproductive life events, including pregnancy, postpartum, and perimenopause. Services offered include individual psychotherapy and medication management.

The WRMX-TX program experienced substantial growth with the addition of new faculty members, including Lisa Boyars, M.D., and Priya Kumar, M.D. — both are native Texans and UT Austin alumni. Boyars leads psychiatric services to new and expectant mothers at Dell Children’s Comprehensive Fetal Care Center and Neonatal Intensive Care Unit. She will direct the upcoming Women’s Reproductive Mental Health tracks within the General Psychiatry Residency and Consultation-Liaison Fellowship programs. Kumar leads psychiatric collaborative care services for maternal-fetal medicine.

The WRMH-TX team also continues to accrue both regional and national recognition. D. Jeffrey Newport, M.D., M.S, M.Div, the program director, served on the American Psychiatric Association’s Maternal Mental Health Advisory Panel for 2022–23, co-authoring the “Perinatal Mental and Substance Use Disorders: White Paper” report that will serve as an educational and reference resource for clinicians providing mental health care to pregnant and postpartum women. In addition, both Erin Richardson, MSN, RN, and Newport, M.D., M.S., M.Div, serve as

perinatal psychiatry consultants to providers across North America on behalf of Postpartum Support International. Finally, as the 2022–23 academic year ended, Richardson replaced Newport as medical director for the Pregnancy and Postpartum Health Alliance of Texas.

Perinatal Psychiatry Access Network in Texas

The WRMH-TX team was chosen as one of four locations to lead the pilot implementation of the Perinatal Psychiatry Access Network in Texas (PeriPAN), overseen by the Texas Child Mental Health Care Consortium. PeriPAN offers free, on-demand phone consultation services for health care providers serving pregnant and postpartum women experiencing mental health concerns.

Reproductive Mental Health Training

The Perinatal Psychiatry Training Clinic at UT Health Austin launched one year ahead of schedule in the summer of 2020. It has become a preferred training experience for residents and fellows alike. The number of reproductive psychiatry trainees has blossomed from two residents in the 2021–21 academic

Jeffrey Newport, M.D., M.S., M.Div

Erin Richardson, MSN, RN Lisa Boyars, M.D.

Delaney Herman, MSW Kathy Stanton, Ph.D. Priya Kumar, M.D.

The Pregnancy and Postpartum Health Alliance of Texas

Women's Reproductive Mental Health Team

year to five in 2022–23. To accommodate the rapidly growing demand, a second Perinatal Psychiatry Training Clinic was opened, operating out of the Maternal-Fetal Medicine service.

This success has led to a broadening of the reproductive mental health curriculum to include a women’s reproductive mental health track within the Consultation-Liaison Psychiatry Fellowship Program, which launches in July 2024, and a similar reproductive psychiatry track within the Psychiatry Residency Program, which will launch in 2025. Other educational offerings within these tracks will include consultation services within the Fetal Care Center and NICU at Dell Children’s Medical Center as well as perinatal-specific training in psychotherapy.

The WRMH-TX training program also provides opportunities for research training. During the 2023–24 academic year, one psychiatry resident and four medical students are completing WRMH-based research electives.

Comprehensive

Diagnostic & Treatment Evaluation Program

The Comprehensive Diagnostic and Treatment Evaluation Program, a unique offering for patients who seek a thorough multidisciplinary evaluation, is continuing to grow.

The program’s team completed 42 evaluations during 2021– 23 for patients from 13 states in the U.S. and three other countries. The team of five to six board-certified psychiatrists, neurologists, and psychologists provide individual evaluations, including neuropsychological testing and, if indicated, state-of-the-art brain imaging, laboratory testing, and other medical consultation to ensure the most accurate diagnoses. Patients from this program generally have multiple comorbid conditions and require intensive ongoing treatment.

ASCENSION SETON — ADULT MENTAL HEALTH

Ascension Seton Shoal Creek

Ascension Seton Shoal Creek Hospital provides inpatient mental health care services for patients in crisis and alleviates the burden placed on emergency departments throughout Central Texas. It is also the main training site for psychiatry residents and medical students, who rotate through the hospital in their second year of medical school. Melvin Thomas, M.D., serves as the medical director and leads a team of four psychiatrists as well as first- and third-year residents who may spend several months at the hospital.

Ascension Medical Group Seton Behavioral Health Outpatient Clinic

Ascension Medical Group Seton Behavioral Health Outpatient Clinic, formerly The Seton Mind Institute, serves as one of the primary outpatient training sites for Dell Med’s Psychiatry Residency Program. The clinic provides care to 1,500 patients a month. The team includes eight faculty members and 23 residents who provide general as well as specialized services in electroconvulsive therapy, geriatric psychiatry, and post-traumatic stress disorder treatment.

Consultation-Liaison Service

Consultation-liaison psychiatrists practice in medical surgical facilities across Central Texas, ranging from community hospitals to Level I trauma centers. The consultation team is made up of four subspecialty-certified consultation-liaison psychiatrists and a part time, board-certified clinical health psychologist. The team handles consultations received from numerous medical teams and provides specialized services to the “Buprenorphine Team” that facilitate the initiation of medication assisted treatment for patients with opioid use disorder, the transplant team, and the oncology service among others.

CLINICAL SERVICES

Dell Seton Medical Center Emergency Psychiatry Service — The only psychiatric emergency department in Austin providing 24/7 coverage to patients experiencing a psychiatric crisis.

Psychiatry Team in the Emergency Behavioral Health Unit of Dell Seton Medical Center

CLINICAL SERVICES

Intensive Outpatient & Partial Hospital Programs

In 2022, the Intensive Outpatient Program served 1,055 patients and provided 14,527 treatment days. The program offers both virtual and inperson services at Shoal Creek Hospital to provide individualized interventions for patients after discharge from higher levels of care. Interventions include cognitive behavioral therapy, dialectical behavioral therapy, radically open dialectical behavioral therapy, dual diagnosis, chemical dependency, and cognitive processing therapy for post-traumatic stress disorder treatment.

The Dialectical Behavioral Therapy Partial Hospitalization Program at Ascension Seton Shoal Creek in 2022–23 provided over 1,600 treatment days to more than 200 patients. The program recently began to take direct admissions from the Dell Seton Medical Center’s Emergency Behavioral Health Unit to provide a diversion opportunity for appropriate patients to maximize the inpatient bed availability at Shoal Creek.

Restore Program for PostTraumatic Stress Disorder

The Restore Program is a six-week intensive outpatient program for post-traumatic stress disorder (PTSD) serving patients over the age of 18 with any type of trauma, including military trauma, childhood sexual abuse, and complex trauma. The program is adding outings to the Blanton Museum of Art to help reduce fear of social places.

The literature outperforms in terms of results. Before the pandemic, 58% of patients met the criteria for PTSD. After the six-week program, they no longer met the criteria for PTSD or lost their diagnosis. 78% of patients lost their diagnosis in the program’s virtual cohorts and 70% no longer met criteria for PTSD in the program’s first return to in-person groups in June 2023.

M.D.

VAL ROSEN,

DEVELOPER & MEDICAL DIRECTOR OF RESTORE

DELL CHILDREN’S MEDICAL CENTER — PEDIATRIC

MENTAL HEALTH

Dell Medical School’s Department of Psychiatry and Behavioral Sciences faculty members manage the pediatric behavioral health services at Dell Children’s by offering psychiatric and psychological clinical services and training within the pediatric consultation-liaison service, inpatient mental health unit, outpatient mental health clinic, and specialty medical clinics.

Dell Children’s

Dell Children’s Medical continues its commitment to meeting the behavioral and mental health needs of all children and families in Central Texas. With the opening of the Partial Hospitalization Program in spring 2021, it became the sole children’s hospital in the state of Texas to offer a full continuum of care for pediatric mental health.

Exacerbated by the COVID-19 pandemic, the need and demand for child and adolescent mental health services remains high and continues to rise. The pediatric mental health team works tirelessly to provide patient and family-centered, evidence-

based care for children and adolescents. Their efforts focus on innovative models to meet the needs of young people with mental health crisis and foster collaboration with community and national partners through its participation with the state program, Texas Children’s Mental Health Consortium.

Grace Grego Maxwell Mental........ Health Unit

In the face of an unyielding mental health crisis both nationally and throughout Central Texas, the Grace Grego Maxwell Mental Health Unit at Dell Children’s Medical Center continues to thrive and

Exterior of Dell Children’s Medical Center (photo courtesy of Dell Children’s Medical Center)

CLINICAL SERVICES

offer unparalleled inpatient psychiatric services to children ranging from 6 to 17 years of age in the greater Austin area. With the best patient-to-staff ratios in the area, the unit is a unique place among local psychiatric facilities, allowing individualized and patient-centered care, and maintaining a high patient volume.

The unit is also the only inpatient service for many miles to prioritize and train its staff to follow trustbased relational interventions with patients who have suffered traumatic experiences, which may be the primary cause of their presentation and a driver of reactive, unsafe behaviors when feeling threatened. This approach allows staff to quickly form trustworthy connections with patients, to better understand their emotional reactions, and to avoid re-traumatization. The combined effects of these interventions have led to a precipitous drop in physical restraint usage over the past three years and has made the unit a safer and more therapeutic environment.

The unit strives to maintain access to inpatient psychiatric care for all child and adolescent patients in the community, regardless of their life situations. Increasingly, that means treating a growing patient population with more complex needs. For a modestly sized unit of 24 beds, the team manages to treat an exceptionally high number of patients each month. The unit has been able to accommodate longer hospital stays and more acuity than ever in Dell Children’s history, in large part to meet the demands of a bustling emergency room.

With a consistent reputation for quality, the unit continues to attract dedicated staff who bring a tremendous passion for universal mental health care. In September 2023, the unit expanded from two distinct, clinician-led teams to three for the first time since 2021. This helps alleviate ER wait times and make the Mental Health Unit an even more

compelling training destination for prospective residents, fellows, and medical students.

In the coming academic year, several initiatives will finally materialize after years of diligent planning. The unit will be getting its own medical facility dog, which will be a wonderful addition to the team and a breakthrough therapeutic tool to aid patients in acute crises.

Dell Children’s Medical Center, Healing Garden (photo courtesy of Dell Children's Medical Center)

Pediatric Consultation-Liaison Service

The Pediatric Consultation-Liaison Service team provides psychiatry- and psychology-related expertise for diagnosis and management of patient’s mental and behavioral disorders at the request of other health professionals within the hospital. In the 2022–23 academic year, the Pediatric ConsultationLiaison Service team welcomed new colleagues, conducted, and contributed to research and publications, participated in numerous workgroups, enhanced resident, and fellow training, and continued to deliver exceptional clinical work and specialized expertise.

Partial Hospitalization Program/ Intensive Outpatient Program

Since opening in 2021, the program has provided services to a total of 294 patients, and provides more intensive therapy than traditional outpatient or intensive outpatient programs, by providing patients 20 hours of treatment per week and incorporating nursing and psychiatry assessments, medication management, family meetings, and educational support within the program day.

Child Psychiatry Access Network

Since 2020, Dell Medical School has been one of the twelve medical schools that participate in the Child Psychiatry Access Network (CPAN) which provides free, on-demand telephone consultation services for pediatric primary care providers. Dell Med is responsible for 13 counties, spanning both urban and rural settings. Dell Med psychiatrists answer common questions providers have and offer tips when treating children with mental health care needs within their practice.

CPAN PROGRAM HIGHLIGHTS

Between Sept. 1, 2021 – May 31, 2023, CPAN has

• provided 3,601 consultations to PCPS.

• increased calls by more than 14%.

• served 372 unique PCPS.

• increased the number of unique PCPS using CPAN by 4%.

• provided 3,601 consultations.

CPAN Mental Health Consultations to Primary Care Providers by Quarter Consultations (n)

The collaborative care model that CPAN provides is a truly invaluable resource for pediatricians and nurse practicioners in Texas. Access to a network of child psychiatrists and mental health providers as well as help with mental health referrals has helped us provide continuity of care in the diagnosis and treatment of mental health disorders in a familiar setting for our children and families.

CENTRAL TEXAS PRIMARY CARE PHYSICIAN

Texas Child Health Access Through Telemedicine

Another Texas Child Mental Health Care Consortium initiative is the Texas Child Health Access Through Telemedicine (TCHATT). Beginning in September 2020, pediatric psychologists, psychiatrists and master-degree level clinicians from Dell Medical School joined 11 other medical schools in the state in providing telemedicine services to children within school districts. We are responsible for 13 Central Texas counties. Families are offered approximately five sessions for assessment, brief intervention, and stabilization based on the presenting concern.

TCHATT PROGRAM HIGHLIGHTS

Between Sept. 1, 2021 – May 31, 2023, TCHATT has

• provided 7,425 appointments.

• served 1,868 students.

• increased the number of campuses enrolled by 20%.

• increased the total number of appointments by over 200%.

TCHATT has truly been a revolutionary tool for my campus and my district. TCHATT has been a lifeline, a tool, and a change-maker for our scholars. Being able to sit in their appointments and listen to the quality of care that they are able to access brings so much joy into my job.

Texas Senate Bill 11, 2019 Session

The Texas Legislature funded a multimillion-dollar initiative that included the establishment of the Texas Child Mental Health Care Consortium, substantially expanding access to child mental health services across Texas. During 2021–23, the Department of Psychiatry and Behavioral Sciences participated in a number of these initiatives: Child Psychiatry Access Network, Texas Child Health Access Through Telemedicine, Child Trauma Research Network, Child and Adolescent Fellowship, and Youth Depression and Suicide Research Network. During the year ahead, we will participate in the Community Psychiatry Workforce Expansion program. These initiatives are explained in this report.

CENTRAL TEXAS SCHOOL COUNSELOR

American Rescue Plan Act Expansion

In Fall 2021 during the 87th Texas Legislature, the Texas Child Mental Health Care Consortium was appropriated $113 million in federal funds from the American Rescue Plan Act (ARPA). Dell Medical School was awarded ARPA funds to enhance and expand on its current consortium initiatives.

Additional TCHATT sessions are offered to youth who may need continued support for urgent mental health needs or who otherwise would not be able to access services due to lack of resources.

Adolescent Youth Substance Use Disorder Expansion: Therapeutic interventions are available to youth affected by, or at risk for, substance use, misuse, and abuse through the TCHATT partnership.

Trauma-Focused Expansion: Catered to individuals 7 to 21 years of age and their families who need longer term trauma- and grief-focused treatment, particularly in the context of COVID-19, community violence, and racial trauma. This initiative looks to foster resilience among youth in the face of future adversity.

Suicide Prevention - Youth Aware of Mental Health: A school-based program promoting increased knowledge and discussion about mental health amongst adolescents in a peer setting. The preventive program provides five interactive meetings about mental health awareness with youth from 8th to 12th grade.

Safety-A Training: A crisis intervention and safety planning training program developed to educate primary care providers on intervention strategies for child and adolescent patients who exhibit suicidal thoughts and behaviors or have had a suicide attempt. The program was adapted for the primary care setting from an evidence-based program, the Family Intervention for Suicide Prevention, which has been effective in an emergency room setting.

Child & Adolescent Psychiatric Fellowships: Aimed at increasing the number of medical professionals in Texas who specialize in the diagnosis and treatment of psychiatric and associated behavioral health issues affecting children and adolescents to:

• Increase the ratio of child and adolescent psychiatrists to the child population.

• Reduce the number of designated mental health professional shortage areas.

• Reduce wait times to see a child and adolescent psychiatrist.

Community Psychiatry Workforce Expansion

Launched in 2019, the goals of the Community Psychiatry Workforce Expansion are to:

• Collaborate with local mental health authorities to expand the availability of psychiatric appointments for children and adolescents.

• Develop training opportunities for residents and fellows within community health.

• Increase the number of Texas-trained psychiatry residents who work in the public mental health system upon completion of their residencies.

Future efforts include partnerships between Dell Med and community mental health providers, which will also provide training opportunities for residents. Dell Med is currently partnered with Integral Care and Blue Bonnet Trails Community Services to create a comprehensive and collaborative program to enhance pediatric mental health services in the community. The program added a Child Psychiatry Fellowship with expectations to expand the program.

Jeff Shahidullah, Ph.D., and Oscar Benitez, Ph.D., at Hill Country Mental Health and Developmental Disabilities Center

TCHATT & CPAN Response to Uvalde

In response to the shooting at Robb Elementary School in Uvalde County on May 24, 2022, Dell Medical School’s Department of Psychiatry and Behavioral Sciences, in collaboration with the Texas Child Health Access through Telemedicine (TCHATT) program and the Child Psychiatry Access Network (CPAN), extended their support to those affected.

Recognizing the need for additional assistance, TCHATT and CPAN clinicians made themselves available to offer grief and loss support to the Uvalde community. Dell Med faculty members volunteered with the local Hill Country Mental Health and Developmental Disabilities Center to deliver on-site crisis services. They staffed a walk-in clinic, providing immediate psychological first aid support to children, families, community members, and first responders. Additionally, they helped triage individuals to longer term care.

The TCHATT and CPAN teams distributed valuable resources to aid providers, guardians, and school staff in addressing the emotional needs of children and adolescents affected by the shooting, including guidance on how to talk to children about violence, coping with grief after tragedy and disasters, parent guidelines for helping youth after a recent shooting, and how to help children cope with frightening news.

This collaborative effort demonstrated the commitment of the department to offer support and resources to the Uvalde community during a challenging and distressing period, emphasizing the importance of mental health and emotional well-being during times of tragedy.

Texas Child Study Center

The Texas Child Study Center (TCSC) offers outpatient psychiatry and psychology services. The center offers a model of multidisciplinary care that begins with a triage process where assessments are made in collaboration with young people and families to determine the most appropriate forms of support needed, including medication management. Evidence-based assessment is used throughout the course of treatment to monitor progress and optimize the effectiveness of care. The TCSC provides several training experiences for psychiatry residents and fellows, psychology interns, and post-doctoral trainees. In 2023, clinicians at TCSC have seen 1,451 new patients and conducted 19,077 appointments.

Dell Children’s Medical Center Embedded Behavioral Health Clinics

At Dell Children’s Medical Center, pediatric behavioral health services are integrated into several medical subspecialty clinics, enhancing care for young people by providing preventive and therapeutic health promotion interventions to reduce risk for developing adverse effects related to their disease and corresponding treatments as well as addressing any maladaptive health behaviors.

Clinicians include psychologists, psychiatrists, and social workers who provide therapeutic support to youth in navigating health conditions. Some medical presentations also require pre-surgical evaluations and psychological assessments to inform medical treatment decisions, which are conducted by the department's team of clinicians. In addition to psychiatric care and cognitive behavior therapy, specialty care can also include hypnosis and biofeedback for

CLINICAL SERVICES

pain management. A strong emphasis is placed on incorporating the medical team, family, and school to systematically support the adjustment to a medical condition for the youth. As such, family-based care is utilized. In addition to clinical care, clinicians from the Department of Psychiatry and Behavioral Sciences also participate in applied research through investigation of the effectiveness of clinical interventions.

Allergy, Asthma, and Immunology: Allergy psychology services include consultation to medical providers and short-term psychotherapy for youths experiencing mental health concerns because of food allergy diagnosis.

Texas Center for Pediatric and Congenital Heart Disease: The center has specialized programs and psychology services included in every area. In heart transplant and heart failure, psychologists conduct transplant and ventricular assist device evaluations, provide pre-, post-, or both therapy and supports patients and families while on the unit.

Children’s Blood and Cancer Center: The team of psychiatrists and psychologists offer support throughout the treatment trajectory, including growing to fully support the Survivorship Multidisciplinary Clinic that is specifically designed to care for longterm survivors of childhood cancer.

Cystic Fibrosis Clinic: The cystic fibrosis psychologist provides short- and long-term therapeutic support to patients and families navigating medical treatment.

Pediatric Dermatology Clinic: The partnership between psychology and pediatric dermatology is one of a few in the nation that focuses on the psychological impacts of skin disorders.

Developmental Behavioral Pediatrics: In partnership with the Texas Child Study Center, the developmental pediatric psychologists work within a team-based and integrated model of comprehensive autism evaluation and interventions for developmental disabilities.

Family-Based Eating Disorder – Adolescent Pediatrics Clinic: The clinic provides family-based treatment using the Maudsley Approach and cognitive behavioral therapy enhanced. The department leads the assessment, diagnosis, and evidence-based treatment of children, adolescents, and college-age individuals struggling with disordered eating.

Pediatric Gastroenterology: The outpatient psychology services in the clinic have reached and treated over 300 young people and include short-term, solution-focused cognitive behavioral therapy interventions for a range of gastrointestinal-specific symptoms and chronic conditions, such as irritable bowel disease, celiac disease, short gut syndrome, and disorders of the gut-brain interaction. Additionally, a specific focus of patient care includes the Collaborative Abdominal Pain Program which is composed of a multidisciplinary team co-led by psychologists that provides psychoeducation of the gut-brain interaction and specialized treatment for management of abdominal pain.

Pediatric Headache Center: The center provides interdisciplinary evaluations with neurologists, psychologists, and physical therapists to provide comprehensive care for patients dealing with migraine headaches.

Psychogenic Non-Epileptic Events Clinic: The Psychogenic Non-Epileptic Events (PNEE) Clinic is the only multidisciplinary PNEE clinic in Texas, providing comprehensive care from neurologists, clinical psychologists, social workers, and nurse coordinators.

The Hearing Center — Ear, Nose, and Throat: Psychologists attend and contribute to monthly

Dell Children's Medical Center Specialty Pavilion where some of these embedded clinics are housed (photo courtesy of Dell Children’s Medical Center)

CLINICAL SERVICES

cochlear implant candidacy meetings, which are interdisciplinary conferences amongst ear, nose, and throat physicians, cochlear implant audiologists, speech-language pathologists, nurses, and social workers to review patient functioning in the context of impending surgery.

Rheumatology Clinic: Psychology services are routinely integrated into outpatient services for patients with chronic pain and/or lupus. Brief cognitive based treatment is leveraged to assist with disease management and associated emotional distress as well as needle phobia interfering with medically necessary infusions.

Sleep Studies Center: The behavioral health faculty develops relationships with other specialists who frequently have patients experiencing challenges with sleep and support them within the outpatient Pediatric Sleep Clinic by convening with pediatric neurologists to discuss shared patients and provide education on the types of interventions being utilized within the clinic.

School / Texas Child Study Center

(L-R): Sheri Ravenscroft, M.D., Developmental Behavioral Pediatrics Section Chief; Caitlyn Maye, M.S., psychology extern from Texas A&M Clinical Psych (5th year); Victoria Felkl, M.D., psychiatrist, Dell Medical School; Meredith Brinster, Ph.D., pediatric psychologist, Dell Medical School / Texas Child Study Center; Mitchell Todd, Ph.D., psychology postdoctoral fellow, Dell Medical School / Texas Child Study Center; Mariah Camper, MRC, psychology extern from UT/Ed Psych (3rd year); Kenia Cruz, M.A., psychology extern from UT, Ed Psych (5th year); Toni Fleming, M.A., psychometrist, Dell Medical School / Dell Children's Medical Group; Cesar Sotelo, psychometrist, Dell Children's Medical Center; Mariel Cannady, Psy.D., pediatric psychologist, Dell Medical

AUSTIN STATE HOSPITAL REDESIGN

The construction of the Austin State Hospital (ASH) has continued for the last two years and opened in summer 2024. The ASH redesign (ashredesign. org) efforts have continued, and the final set of work groups completed reports in late 2022, focused on the critical need to redesign the public mental health continuum of care along with the work done at ASH itself. These recommendations addressed the ongoing need for therapeutic housing, certified peer support throughout the continuum, and addressing the intersection of mental health and the criminal justice system. Importantly, the steering committee envisioned an ongoing leadership role for the Department of Psychiatry and Behavioral Sciences to ensure high quality, accessible mental health care is available to all members of the community.

This recommendation builds on the department’s strong commitment to expand the delivery of evidence-based, innovative public mental health services with plans to develop an ongoing institute of mental health redesign that began with the ASH project. New and existing projects include continued collaboration with invested partners at state, county, and local levels, and it is an opportunity for The University of Texas at Austin to further its public mental health support and activities. Examples include the work at the intersection of service delivery and legal systems, particularly in mental health diversion efforts; Texas Health and Human Resources state hospital initiatives; youth and young-adult early intervention; and critical mental health provider and workforce needs.

ASH Construction: Courtyard

ASH Construction: Courtyard

Members of the Austin State Hospital redesign team attended the topping out ceremony that celebrated the completion of the building frame with the placement of the final beam.

(L-R) Cory Morris, MSW, Assistant Director of Community Integration Strategy; Steve Strakowski, M.D., Associate Vice President of Regional Mental Health; Deborah Cohen, Ph.D., MSW, Assistant Professor; Sydney Harris, MHA, Director of Mental Health Redesign

Travis County Forensic Mental Health Project

In March 2023, Travis County Commissioners approved a resolution for the development of a behavioral health diversion center. This pilot program will redirect a disproportionate number of people who need mental health and substance use treatment and support from jails to the center. Learn more about the project: traviscountytx.gov/topics/forensic-mental-health-planning

As consultants, Dell Medical School led a steering committee and eight work groups to develop actionable and fundable solutions that were presented to the Travis County commissioners. With a primary guiding principle to prioritize each person’s unique situation and needs, the recommendations include: 1) Modernize the County’s technology platform and establish data use agreements to improve data sharing across relevant entities. 2) Increase the number of certified peer specialists throughout the mental health and criminal legal systems intersection. 3) Plan, develop and implement a “diversion” center. 4) Pilot at least three housing programs while establish permanent housing solutions by leveraging existing county and city efforts to fix home insecurity. 5) Reinstate the counsel at first appearance pilot with intention to make it permanent.

INTEGRAL CARE

was spotlighted by Dell Medical School’s Visionaries that highlights trailblazing faculty members who are bringing Austin into focus as a premier destination for integrated, patient health care.

The Department of Psychiatry and Behavioral Sciences is proud to partner with Integral Care, Austin’s mental health authority since the inception of Dell Medical School. Clinical innovation, research, and training are possible due to the collaboration.

Beginning in July 2023 with support from the Texas Health and Human Services Commission, resident rotations were expanded at Integral Care. Residents across all four years of the general psychiatry residency and child and adolescent fellows can work with Dell Med faculty in Integral Care programs, which include school based and emergency services, homeless health care, substance use treatment, and first episode psychosis. Child psychiatry care also expanded via the Child Psychiatry Workforce Expansion program.

Lief Fenno, M.D., Ph.D., speaks on substance use disorder treatment as a doctor and psychiatrist at Integral Care

Lief Fenno, M.D., Ph.D.,

Hal Katz, chair of the board, and David Evans, CEO, Integral Care

Mental Health Care for Individuals Experiencing Homelessness

Integral Care’s Integrated Behavioral Health Clinic at Terrace at Oak Springs specializes in serving those experiencing homelessness who struggle with severe and persistent mental illness, substance use disorders, and chronic health conditions.

The clinic has evolved to become a Health Care for the Homeless Health and Wellness Center with an expanded continuum of services from outreach and engagement to permanent housing by increasing access to specialty mental health, substance use treatment, and primary care for individuals. The health care hub also serves individuals experiencing homelessness in the downtown area, including helping them obtain and maintain employment, begin prescribed medication regimens, and access medical care for primary care, dental, and vision services. The program is entering its fourth year and open to residents for community rotations.

CENTER FOR BEHAVIORAL HEALTH COLLABORATIVE CARE

The Center for Behavioral Health Collaborative Care addresses the critical, urgent need to improve access to quality health care by working with local, regional, and national health systems and partners to advance successful adoption of the Collaborative Care Model, a team-based model of psychiatric care that supports treatment of mental health conditions by the patient’s primary care provider. Collaborative Care increases access to behavioral health care through a patient-centered, multidisciplinary model of care delivered in primary care settings. The center provides implementation expertise for primary care providers in our Central Texas community and beyond.

In 2023, three sites in the Austin area were chosen to implement collaborative care in pediatric

Integral Care's new integrated behavioral health clinic, Terrace at Oak Springs

settings: Dell Children’s Medical Center, UT Health Austin’s Amplify Center, and CommUnity Care. Dell Children’s will operate a pilot project with the guidance of the center. A program of the Center for Youth Mental Health in the Department of Psychiatry and Behavioral Sciences at Dell Med, the pilot phase of the Amplify Center launched in late January 2023 at the Austin Community College Eastview Campus. CommUnity Care will create a registry to establish measurement-based care and offer a necessary resource for implementing collaborative care.

The center and the Meadows Mental Health Policy Institute cohosted an inaugural Pediatric Collaborative Care Roundtable in January 2023 that brought together leaders from across the country. A copy of the final roundtable report can be found on MMHPI’s website ( mmhpi.org/topics/policyresearch/pediatric-and-adolescent-collaborativecare-roundtable/ ). The center will be launching a website in the coming year, which will include access to several additional collaborative care resources to assist any group interested in implementing collaborative care.

The Center for Behavioral Health Collaborative Care is a program of the Department of Psychiatry and Behavioral Sciences, established through participation in the Lone Star Depression Challenge and funded by a grant from Lyda Hill Philanthropies. Additional support is provided by the American Rescue Plan Act to implement collaborative care in three Central Texas health systems. The Michael & Susan Dell Foundation and St. David’s Foundation are to partner with the Meadows Mental Health Policy Institute to establish a Technical Assistance Center for the implementation of Collaborative Care Model.

CENTER FOR YOUTH MENTAL HEALTH

The Center for Youth Mental Health (CYMH) is dedicated to researching the experience of emerging adults and complicated barriers they face in accessing health and mental health care — barriers exacerbated by the COVID-19 pandemic. The center supports a range of initiatives, where youth buy-in is paramount and community stakeholder investment and strong partnerships are prioritized to address critical gaps in the continuum of mental health care for young people in Central Texas. These initiatives have created systemic change resulting in broadened access and early intervention.

The center’s goal is to ensure that coordinated, effective and right-sized care is easily accessible in Central Texas to truly meet the developmental needs and goals of adolescents and young adults.

Most notably, the center opened the Amplify Center in January 2023 — Texas’ first young-adult integrated behavioral health clinic on Austin Community College’s Eastview Campus. Inspired by other countries’ examples, CYMH sought to create a developmentally attuned, integrated, and multidisciplinary service and drop-in center.

Initial services at the center include therapy, care navigation, supported employment and education, and psychiatric consultation. The Amplify Center is proud of its initial early success: In the first 60 days, the center screened 63 students and enrolled 50 for services.

The center actively promotes young-adult advisory through the Emerging Voices Advocacy Council. The community advisory board currently consists of active student members from Austin Community College, Huston-Tillotson University, and The University of Texas at Austin. They also include members who have lived experiences themselves or with family in mental health services. Currently, 13 members actively guide CYMH and the Amplify Center’s programming and research.

I have been feeling a lot better mentally since I've walked through the doors at the Amplify Center. You guys are a big part of my life and I enjoy being heard and seen for the first time in my adult life.

AN AUSTIN COMMUNITY COLLEGE STUDENT

Deborah Cohen, Ph.D., MSW, Co-Director of Center for Youth Mental Health

ACADEMIC MODEL PROVIDING ACCESS TO HEALTHCARE

In 2022, the Department of Psychiatry and Behavioral Sciences grew its relationship with the global Academic Model Providing Access to Healthcare (AMPATH) community both in Mexico and Kenya.

During a grand rounds, Edith Kwobah, M.D., the head of psychiatry from Moi Teaching and Referral Hospital in Eldoret, Kenya, spoke passionately on the challenges facing psychiatry in her country as well as her research interests. The department had the first bilateral trainee exchange with her institution in Kenya in 2023. Two medical students from Moi rotated with Dell Medical School for six weeks. One of the students rotated in the child psychiatry unit for two weeks, which she said aided in solidifying her desire to pursue a career in psychiatry.

Department faculty traveled to Benemérita Universidad Autónoma de Puebla (medicina.buap. mx) (BUAP) in Mexico in August 2022 to form the Mental Health Working Group dedicated to addressing the mental health needs identified in several rural communities around Puebla. Dell Med faculty shared their expertise and experiences and learned from their counterparts at the medical school in Mexico to develop best practices.

Claire Selinger, M.D., and her counterpart in Mexico, Minou del Carmen Arevalo Ramirez, M.D., Ph.D, received the AMPATH/MAPAS Bilateral Innovation Award, a grant that help support collaborative BUAP and UT Austin faculty-led projects that address interdisciplinary health challenges across low-income populations in Mexico with the potential for reciprocal learning and application in Central Texas.

Department of Psychiatry and Behavioral Sciences faculty members will run a Project ECHO cohort focused on common mental health issues for primary care providers in Central Texas primarily serving Latina/o/x patients. Del Carmen Arevalo Ramirez will run a similar project in Puebla. In the summer

of 2024, the department will send the first group of psychiatry residents to Mexico to learn Spanish in the inaugural Spanish language and culture elective designed to equip the next generation of psychiatrists to be bilingual providers.

The Hogg Foundation for Mental Health provides additional grant funding to support Project ECHO hub administratively.

For more information on AMPATH Global, visit ampathglobal.org.

Para más información en AMPATH México, ampathmexico.org/

For more information on Project ECHO (Moving Knowledge, Not People), visit echo.unm.edu

Department of Psychiatry and Behavioral Sciences faculty members with their counterparts from the AMPATH Mexico program.

SIMS FOUNDATION

The SIMS Foundation, founded in 1995, is a local nonprofit organization that provides counseling, psychiatric and substance use recovery services to musicians, music industry professionals, and their families. Since 2011, the Ascension Mental Health group and Dell Med psychiatry residents have worked alongside SIMS, providing psychiatric and substance use recovery services in our clinics. Most recently, in 2023, over 700 members have received mental health services because of the continued collaboration.

Dell Med faculty members Lowell McRoberts, M.D., and Lloyd Berg, Ph.D., respectively serve on the SIMS board of directors and conduct research on factors impacting musician mental health and the effectiveness of mental health interventions in this psychologically at-risk population.

A diffusion weighted image shows the movement of water molecules within brain tissue

SOURCE: Mulva Clinic for the Neurosciences

RESEARCH

The Department of Psychiatry and Behavioral Sciences is an emerging center of excellence in psychiatric and neuroscientific research. Led by Associate Chair of Research D. Jeffrey Newport, M.D., M.S., M.Div., the department’s faculty utilize state-of-the-art research methodologies and technologies to develop novel treatments, explore the neurobiology of human behavior and psychiatric disorders, and evaluate the effectiveness of mental health care delivery systems.

The department’s research portfolio continues to grow at a remarkable pace. All indices of research productivity, including extramural funding, faculty recognition by peers and professional organizations, and peer reviewed publications, demonstrate this robust and sustained growth. Mentorship is a priority, as faculty train the next generation of academic psychiatrists within the department’s residency program’s Physician Scientist Track, in addition to medical students and doctoral and post-doctoral research trainees from an assortment of academic disciplines.

Another level of facilitating community access to treatments on the frontier of psychiatric research are clinical trials, including collaborative efforts with Dell Med’s departments of Neurology and Neurosurgery. The trials span medications with novel mechanisms of action, novel applications of existing drugs, and neuromodulation.

AREAS OF RESEARCH SPECIALTY WITHIN OUR DEPARTMENT:

Molecular Neuroscience

Developmental Neuroscience & Childhood Disorders

Translational Neuroscience & Neuroimaging

Psychopharmacology

Psychoimmunology

Genetics & Epigenetics

Health Services & Implementation Science

Trauma & Stress Including Post-Traumatic Stress Disorder

Addiction Disorders

Reproductive Psychiatry

Mood Disorders

Psychedelics Medicine

RESEARCH FUNDING

The trajectory of the department’s research funding is remarkable. Sustained growth in National Institutes of Health (NIH) funding, a pivotal index of the health of an academic department’s research portfolio, continues. In 2022, the department’s $4.3 million in NIH funding was 62% higher (an increase of nearly $1.7 million) than the previous year. In 2023, the department’s NIH funding grew to $4.7 million, a 77% increase (> $2 million per year) over two years earlier. This 77% increase was the 14th largest among all psychiatry departments across the U.S., and the department’s NIH funding climbed to rank at 51 among all U.S. departments of psychiatry.

AWARDS & RECOGNITION

Department faculty continue to accrue honors for their work, contributing to the growing awareness of the Department of Psychiatry and Behavioral Science’s emerging talent. During the 2021–22 and 2022–23 academic years, twelve departmental faculty collectively served on 82 journal editorial boards, eight faculty members served on 13 research grant review committees, and seven faculty members collectively held 20 leadership positions in national or international professional societies.

Jennifer Donegan, Ph.D., assistant professor, received the Alies Muskin Career Development Leadership Award from the Anxiety and Depression Association of America and a Society of Biological Psychiatry Travel Award.

Lief Fenno, M.D., Ph.D., assistant professor, received the Young Investigator Travel Award from the Molecular Psychiatry Association and was chosen to participate in the American Psychiatric Association Research Colloquium for Junior Psychiatrist Investigators. He also received three grants. One from the W.M. Keck Foundation for a total of $1,000,000 spanning across 2023–25 to study “Development of

Artificial Neurotransmitter Systems: Invention of a New Approach.” His second grant is for $4,500,000 (PI Fenno: $1,118,773) from the BD2 Foundation spanning across 2023-25 to research bipolar disorder genes in brain circuits controlling sleep/wake cycles. Lastly, he received $600,000 in 2023 from the Clayton Foundation for Research to optimize gene therapeutics.

Greg Fonzo, Ph.D., assistant professor, was elected to Associate Membership in the American College of Neuropsychopharmacology.

RESEARCH

Mbemba Jabbi, Ph.D., assistant professor, received a 2022 Special Recognition Award from the Anxiety and Depression Association of America (ADAA) and was appointed to the ADAA’s Board of Director Early Career Board.

Elizabeth Lippard, Ph.D., assistant professor, was selected as an Early Career Reviewer for the National Institutes of Health’s Addiction Risks and Mechanisms Study Section and was selected as an associate member in the American College of Neuropsychopharmacology.

Charles Nemeroff, M.D., Ph.D., professor and chair, was elected president of the Anxiety and Depression Association of America and received the Mzarek Award for Psychiatric Pharmacogenetics from the American Psychiatric Association. He was recognized as among the World’s Top 2% of Scientists on the 2022 Stanford University List of Top Scientists, received a 2023 Best Scientist Award from Research. com ranking him 331 among U.S. scientists and 491 among scientists worldwide. In 2023, he was ranked 160 among all researchers in medicine and 238 in the world. He continues to serve as chair of the APA Workgroup on Biomarkers and Novel Therapeutics, a member of the APA Council of Research, and chair of the APA Research Colloquium for Junior Investigators.

Jeffrey Newport, M.D., M.S., M.Div., professor, received recognition for a Wiley 2021-22 Top Cited Article for “Consistency of EEG Asymmetry Patterns in Infants of Depressed Mothers.” He was appointed to the board of directors of the National Network of Depression Centers and was selected to serve on the PRITE Fellowship Selection Committee of the American College of Psychiatrists, the Maternal Mental Health Advisory Panel of the American Psychiatric Association, and the executive committee of the Texas Child Mental Health Care Consortium. Finally, he was chosen to serve as the scientific program co-chair for the 2024 Annual Meeting of the Anxiety and Depression Association of America.

Jeffrey Shahidullah, Ph.D., assistant professor, served as the Dell Med op-ed fellow for Public Voices and published op-eds in U.S. News & World Report, Harvard Public Health Magazine, Psychology Today, Dallas Morning News, Next Avenue, and KevinMD. He was interviewed by PBS Newshour, Voice of America, KevinMD, and the Fort Worth Star Telegram.

Rex A Wright, Ph.D., professor, was reappointed by the American Psychological Association to a six-year term as co-editor of the journal Motivation Science and was featured for the second time in the online editor spotlight by the American Psychological Association.

Dr. Nemeroff presenting at the Anxiety and Depression Association of America

INSTITUTE FOR EARLY LIFE ADVERSITY RESEARCH

Exposure to early life adversity, including child abuse and neglect, is one of the most potent risk factors for the development of both medical and mental health illnesses. The Institute for Early Life Adversity Research, housed within the Department of Psychiatry and Behavioral Sciences and part of the Mulva Clinic for the Neurosciences, was launched to address this critical public health problem. The institute’s priorities include designing and testing new interventions and understanding biological and psychological consequences of early life adversity among a collaborative and multidisciplinary team.

In the last two years, the institute launched two main projects in service of these goals. Charles B. Nemeroff, M.D., Ph.D., received an award from the National Institute for Alcohol Abuse and Alcoholism that will provide $5 million in funding over five years. This innovative project seeks to identify biological predictors of alcohol use and post-traumatic stress disorder (PTSD) among recently traumatized adolescents. The Institute for Early Life Adversity Research also received a pilot award from the Hogg Foundation for Mental Health in collaboration with The University of Texas Medical Branch in Galveston to study differential therapeutic processes of change among adolescents with PTSD.

TEXAS CHILDHOOD TRAUMA RESEARCH NETWORK

The Institute for Early Life Adversity Research serves as the nucleus of the Texas Childhood Trauma Research Network (TX-CTRN), a statewide network funded by the Texas State Legislature that operates under the oversight of the Texas Child Mental Health Care Consortium. All twelve academic medical centers in Texas serve as nodes in the TX-CTRN.

TX-CTRN has continued to enjoy robust enrollment and retention. At the conclusion of the 2022–23 academic year, 1,920 children were enrolled in this on-going prospective, longitudinal, multi center study. Participant retention is equally remarkable with six-month follow-up visits completed by 67% of enrollees, 12-month visits by 57%, 18-month visits by 44%, and 24-month visits by 40%. These children

Percentage of children in TX-CTRN exposed to various severe traumas

Melissa Eshelman, M.D., DFABA, associate professor, was appointed by the Supreme Court of Texas and the Texas Court of Criminal Appeals to serve as a commissioner on the Judicial Commission on Mental Health, 2021–23.

have a wide array of severe traumatic experiences entailing exposure to actual or threatened death, severe injury, or sexual violence.

For the next phase of TX-CTRN, therapists at each of the network’s twelve nodes are receiving formal training and certification in trauma-focused cognitive behavioral therapy (TF-CBT), an evidence-based therapy for post-traumatic stress disorder in children and adolescents. In 2024, delivery of TF-CBT will be incorporated into the TX-CTRN research plan.

TEXAS YOUTH DEPRESSION & SUICIDE RESEARCH NETWORK

The Department of Psychiatry and Behavioral Sciences also participates in the statewide Youth Depression and Suicide Research Network, which gathers longitudinal prospective data from Texas children and adolescents who are experiencing depression to advance care and prevent suicide attempts. In 2021–22, providers saw 172 patients and increased the number of patients served to 203 in 2022–23.

CENTER FOR PSYCHEDELIC RESEARCH & THERAPY

The Center for Psychedelic Research and Therapy, directed by Greg Fonzo, Ph.D., and Charles B. Nemeroff, M.D., Ph.D., develops and tests novel psychedelic-assisted therapies to treat severe mental health disorders. It serves as an education resource for the community, region, and state on the evidence for efficacy, safety, and mechanisms of psychedelic therapies and trains the next generation of health practitioners in this potentially cutting-edge treatment modality.

Initial studies include observational studies of military veterans and veteran family members alongside the center’s first external partners, the Heroic

Hearts Project. This nonprofit organization is focused on helping veterans suffering from military trauma recover and thrive by providing them with safe, supervised access to psychedelic treatments, professional coaching, and ongoing peer support.

The Center for Psychedelic Research and Therapy also serves as a site for large, multi-site, Food and Drug Administration (FDA) approved, Phase II and III trials examining the efficacy of COMP360, a synthetic form of psilocybin, accompanied by psychological support in individuals with treatment-resistant major depression and individuals with anorexia nervosa, a severe and life-threatening eating disorder.

The center’s first investigator-initiated, philanthropically funded FDA-authorized trial is set to begin soon. This trial will examine the sequencing of psilocybin therapy followed by delivery of an accelerated intermittent theta burst repetitive transcranial magnetic stimulation (aiTBS) in individuals with treatment-resistant major depression. The expectation is that the combination of psilocybin therapy and active aiTBS will demonstrate larger magnitude and more durable benefits in eliminating symptoms of depression compared to either treatment alone. Additional studies in the early stages of development include the examination of psilocybin therapy for postpartum depression and for the amelioration of anxiety and depression in individuals with cancer.

Between 2021–23, the center raised over $3 million. The incredible support came from local and veteran foundations, including the Cain Foundation, and leaders in the community, including a $750,000 estate gift.

This [department's] work has the potential to change the paradigm in mental health and firmly stamps UT Austin at the forefront of psychiatric innovation. As a UT alumnus, I am proud to support such a forward-thinking team.

— Paul Barnhart III Psychiatry Advisory Board member, entrepreneur, UT Austin alumnus

CLINICAL TRIALS PROGRAM

The department’s Clinical Trials Program (sites. utexas.edu/mulva-clinic-for-the-neurosciences/ clinical-trials/ ) has enjoyed substantial growth. In 2021–23, the number of active clinical trials increased from three to seven with several others on the threshold of opening. Initially limited to trials of neuromodulation devices for treatment-resistant depression (TRD) and early Alzheimer’s disease, the Clinical Trials Program now investigates the use of novel pharmaceutical compounds in the treatment of major depression, TRD, and post-traumatic stress disorder. By increasing the diversity of clinical trials, in terms of both the treatments and psychiatric disorders being studied, the department is increasing the impact on the field and potentially benefitting those in Central Texas who have found no relief from conventional psychiatric interventions.

Recent and start-up clinical trials include Phase 2 to 4 studies targeting major depressive disorder, treatment resistant depression (unipolar and bipolar), postpartum depression, post-traumatic stress disorder, anorexia nervosa, and Alzheimer’s disease.

1. Vagus nerve stimulation for unipolar and bipolar TRD (LivaNova)

2. Oral mTORC1 activator for TRD (Navitor)

3. Oral TRPC4/5 inhibitor reducing neuronal excitability and normalizing emotional processing for PTSD (Boehringer Ingelheim)

4. Deep brain stimulation of the fornix for mild Alzheimer’s disease (functional neuromodulation)

5. Brexanolone for women with PTSD –inpatient (Sage)

6. Oral fatty acid amide hydrolase inhibitor leading to anandamide augmentation for PTSD (Jazz)

Launching

1. Effects of an accelerated form of rTMS therapy on explicit and implicit suicidal cognition (in-patient) (Magnus)

2. Brexanonlone for adolescents with major depressive disorder (Sage)

3. Opioid-inactive dextro-isomer of methadone and a low-affinity, low potency uncompetitive NMDA receptor antagonist for adjunctive treatment of major depressive disorder (Relmada)

4. Psilocybin for anorexia nervosa (Compass)

5. Investigational drug for bipolar manic episodes- inpatient study (Novum)

6. Psilocybin analog study for post partum depression (Reunion)

7. Valbenazine as adjunctive treatment for schizophrenia (Neurocrine)

RESEARCH PUBLICATIONS

The Department of Psychiatry and Behavioral Sciences makes substantive contributions to scientific literature, including 71 new publications listed in the National Library of Medicine’s PubMed database during the 2021–22 academic year and 80 during 2022–23. 32 (or 21%) of the department’s 151 publications in the past two years appeared in the top 2% of scientific journals, i.e., those with an impact factor of ten or greater.

Examples of articles appearing in scientific journals with high Impact Factors (IF) authored by the Department of Psychiatry and Behavioral Sciences faculty during the 2021–23 include:

Cell-type-specific population dynamics of diverse reward computations. Cell [IF:66.9] 2022; 185(19): 3568-87.

Dell Med author: Lief Fenno

IMPACT: Novel targeting strategies enabled experiments providing a causal link between genetic neuron signatures and reward prediction and outcome signatures, supporting development of a computational model describing how specific neural circuits integrate reward history.

Integrating biobehavioral information to predict mood disorder suicide risk. Brain Behav Immun Health [IF:19.2] 2022; 24:100495

Dell Med author: Mbemba Jabbi (senior author)

IMPACT: This article reviews the clinical and neurobiological characteristics that may predict suicide risk among patients with dysregulated mood.

Laboratory models of post-traumatic stress disorder: The elusive bridge to translation. Neuron [IF:18.7] 2022; (110): 1754-76

Dell Med authors: Joseph Dunsmoor (first author), Josh Cisler, Greg Fonzo, Suzannah Creech, Charles Nemeroff (senior author)

IMPACT: A summary of the inadequacy of animal models of post-traumatic stress disorder and why human studies are essential to understand this complex disorder.

Evaluation of the Strength at Home group intervention for intimate partner violence in the Veterans Affairs Health System. JAMA Netw Open [IF:13.8] 2023; 6: e232997.

Dell Med authors: Suzannah Creech (first author), Justin Benzer

IMPACT: Demonstrated that the Strength at Home program reduced the frequency of intimate partner violence, the severity of PTSD symptoms, and frequency of alcohol use.

Establishing a training and estimating inter-rater reliability across the multi-site Texas Childhood Trauma Research Network. Psychiatry Res [IF:11.2] 2023; 323: 115168.

Dell Med authors: Jeffrey Shahidullah (first author), Charles Nemeroff (senior author), Carly Hatchell, Jeffrey Newport, Wade Weber

IMPACT: This publication sets the standard for rater training and reliability monitoring in large multisite psychiatric research studies of children and adolescents.

Tag and capture: How salient experiences target and rescue nearby events in memory. Trends Cogn Sci [IF:24.5] 2022; 26(9): 782-95.

Dell Med author: Joseph Dunsmoor (first author)

IMPACT: Summarizes how neurochemical activation in the moments surrounding seemingly mundane events can rescue memory of such events, which may lead to strategies to improve recollection of information that is susceptible to being forgotten.

A schematic comparing how fear transfers to a wide variety of stimuli in a simplified laboratory-based fear learning and a real-world example aversive experience.

LOOKING AHEAD

Most of these initiatives are described in greater detail elsewhere in this report, but here we list a few of the exciting projects we have on the horizon.

CENTER FOR EXCELLENCE IN TRAUMA-RELATED TREATMENT & RESEARCH

The Department of Psychiatry and Behavioral Sciences is building upon its existing resources, initiatives, and crosscampus partnerships to establish the Center for Excellence in Trauma to serve as a national model in the provision of evidence-based psychotherapeutic and psychopharmacologic interventions to the community for traumatic stressrelated conditions. The center is training the next generation of clinical and community mental health providers and investigators in interventions, translational research, and provision of education to provide effective trauma-informed care across Central Texas and beyond. There is also a focus on trauma-informed training for interdisciplinary providers, including the creation of a new psychology fellowship program designed to attract and retain outstanding scientistpractitioner candidates who can expand the clinician-educator faculty ranks with expertise in the assessment and treatment of emotional trauma. The Center for Excellence in Trauma will also conduct cutting-edge translational and clinical research.

COMMUNITY PSYCHIATRY WORKFORCE EXPANSION

The department invests in the integrated development of future community psychiatry initiatives in its collaboration with partners such as Texas Health and Human Services, Integral Care, Bluebonnet Trails Community Services, CommUnityCare Health Centers, other federally qualified health centers, UT Austin, Meadows Mental Health Policy Institute, and a diverse range of leaders across the department’s public mental health initiatives. The department is particularly invested in addressing mental health care workforce shortages, particularly in community psychiatry, where the department contributes to residency, staffing, technical assistance, and training.

AUTISM SPECTRUM DISORDER & NEURODEVELOPMENT DISORDERS CENTER OF EXCELLENCE

As an integrated clinical research program, the Autism Spectrum Disorder and Neurodevelopmental Disorders Center of Excellence (ASD/NDD-COE) at Dell Medical School will be a national resource dedicated to enhancing understanding, treatment, and well-being for individuals and families facing challenges of ASD and other NDDs. The innovative science and compassionate, state-of-the-art facility will be staffed by a multidisciplinary group of dedicated, specialized professionals, in partnership with UT and researchers around the globe. At the center, clinicians will work side-by-side with investigators, making it possible to integrate the latest research rapidly and efficiently into clinical practice with effective assessments and interventions within the home, school, and community.

PSYCHIATRY ADVISORY BOARD

The Department of Psychiatry and Behavioral Sciences’ Advisory Board is composed of 21 influential community members who are passionate about improving mental health outcomes in Central Texas and beyond — and who recognize Dell Med’s critical role in realizing that vision. In partnership with the department and its leader, Charles B. Nemeroff, M.D., Ph.D., the Advisory Board discusses and advocates for priorities in mental health research and treatment, including outreach, initiatives, and philanthropic efforts. Each member commits to a threeyear term and provides philanthropic support to fuel the programs they help steer.

Chaired by Mark West, the Department of Psychiatry and Behavioral Sciences is grateful for this group of dedicated, innovative advisors and their investments of time and resources in aiding the department curb the country’s mental health crisis and bring Austin into focus as a premier destination for integrated, patient-centered health care.

BOARD MEMBERS

Paul Barnhart III

Paige Blake

Mary Demetree

Sidra Durst

Alfredo Frohlich

Miranda Gale

Morris Gottesman

Terry Hill

Margaret Jabour

Johnna Jones

Tim McCabe

Katie Peltier

Alex Priest

John Soloski

Samantha Stein

Karen Taylor

Holly Turner

David Vickers

Mark West

Chris Von Dohlen

Aaron Webman

Josh Cisler, Ph.D., presents to Advisory Board members on the Center for Excellence in Trauma-Related Treatment and Research.

PHILANTHROPIC IMPACT

Growing Investment, Growing Impact

Helping to transform mental health is a bold mission — and one possible only with generous support from the community. Thanks to donors, the department is exploring how childhood trauma affects mental health later in life, training the next generation of mental health care leaders, and designing novel mental health treatments that give people hope. Between September 2021 and August 2023, the department received $5,360,558 in philanthropic gifts. The department extends its gratitude for these donors’ generosity and vision.

THE CENTER FOR PSYCHEDELIC RESEARCH & THERAPY

The Center for Psychedelic Research and Therapy continues to attract significant local and national interest, with gifts totaling $239,358 in fiscal year 2023. The work to better understand how compounds like psilocybin affect post-traumatic stress disorder (PTSD), anxiety, and depression, and how they can be used most effectively, has the potential to help patients experiencing treatment-resistant disorders. This leading-edge initiative is still growing, but the pilot program for veterans suffering from treatment-resistant PTSD is producing valuable data and improving patient outcomes.

PAIGE & MARK BLAKE ENDOWED PROFESSORSHIP

Paige and Mark Blake established the Paige and Mark Blake Endowed Professorship in Psychiatry and Behavioral Health at Dell Medical School, equipping the department with the resources needed to recruit and retain top-tier talent. Their gift has allowed the recruitment of renowned child psychiatrist Young Shin Kim, M.D., M.S., MPH, Ph.D., to lead the Division of Child and Adolescent Psychiatry. Paige also serves on the Psychiatry Advisory Board. Much appreciation to the Blakes for their leadership and advocacy.

INSTITUTE FOR EARLY LIFE ADVERSITY RESEARCH

To date, the Institute for Early Life Adversity Research has received $1,361,491 in donations, expanding research efforts and providing resources and treatment to patients who endured childhood trauma. The institute trains behavioral health providers in tailored, effective care while developing novel treatments to improve patients’ lives.

BIPOLAR DISORDER CENTER

Donors continued to help the Bipolar Disorder center expand its impact. Since 2017, the center has raised $431,014 in support of training and research. During the past two years, people with bipolar disorder have received treatment with life-changing results — all while prioritizing training for clinicians.

AMPLIFY CENTER

To date, the Amplify Center, a clinical resource for adolescents and young adults experiencing mental health challenges, has received $872,726 in support from Tres Grace Family Foundation, 5th Generation Inc., and Twin Liquors. Thanks to this generous gift, the center has seen over 63 students since its inception and enrolled over 50 for services.

NEMEROFF FELLOWSHIP FUND

The Nemeroff Fellowship Fund received $276,400 to fund a fellowship for advanced diagnostics, treatment, and research training for mental illness.

B. Nemeroff, M.D., Ph.D., presenting

MATTHEW P. NEMEROFF ENDOWED CHAIR

In October 2022, the department celebrated the investiture of Charles B. Nemeroff, M.D., Ph.D., as the inaugural Matthew P. Nemeroff Endowed Chair in Psychiatry.

This prestigious position was established in memory of Matthew through the generosity of family and friends. We are grateful for their meaningful tribute and investment in the vision and leadership at Dell Medical School.

Charles

MAKE YOUR IMPACT

Support the Department of Psychiatry & Behavioral Sciences

Community support makes these patient improvements possible. Every gift and every donor expand and celebrate the work to transform mental health care.

Gifts to the Department of Psychiatry and Behavioral Sciences fuel the department to continue improving the mental health of the community and beyond. Donors play a critical role in realizing Dell Med’s mission, and the work detailed in this report is the direct result of shared passion for transforming the world through care.

We hope you consider making a gift to our department in the way most meaningful to you. If you’d like to explore opportunities to get involved, please contact the Office of Development at 512-495-5027 or dellmedgiving@austin.utexas.edu