BrainStorms Fall/Winter 2023

The publication of the University of Miami Department of Psychiatry and Behavioral Sciences

Fall/Winter 2023

Happy Holidays!

Contents

1

A Message from the Chair

2

Dr. Barbara Coffey Honored by Tourette Association of America

3

Dr. Elizabeth Crocco Gives UMiami Health Talk, Draws Largest Audience Ever

4

Center for Cognitive Neuroscience and Aging Awarded $9.7 Million for Innovative Alzheimer’s Research

6

Dr. Philip Harvey Receives Lieber Prize for Outstanding Schizophrenia Research

8

Dr. Girardin Jean-Louis Speaks on Sleep Health Equity at Congressional Briefing

11

12 Center for Translational Sleep and Circadian Sciences Shines for Its Health Equity Research at National SLEEP Conference 14 The Making of a Mentor 16 1st Annual Winter Institutes 2024 CMEs/CEs Conferences 17

10 Distinguished Researchers Receive NIH Grant to Study Epigenetic Mechanisms in Alcohol Addiction

New Online Training Helps People Navigate Digital World, Improving Cognition and Functional Skills

Using Virtual Reality to Promote Better Maternal Mental Health

18 New Mental Health Clinic for Cancer Survivors Opens 20 Events

A Message from the Chair

ear Friends: This issue of BrainStorms comes to you during our festive holiday season, a time when each of us offers thanks in our own way for all that we are given and look forward to all that we hope to do in the next calendar year.

I personally wish to offer thanks for the privilege of leading this department — an assembly of world-class scientists and clinicians who every day advance our research knowledge and the quality of our patient care; our devoted staff who work tirelessly to keep the department running smoothly; and our residents and fellows for their commitment to learning and training to be the next generation of leaders in psychiatry You will find many of their achievements described in this magazine.

discussed sleep health equity at a congressional briefing, the first ever held on the subject by the National Sleep Foundation. Dr. Jean-Louis also wrote about the sleep gap faced by minority and low-income communities in an article published in The Lancet Neurology. And he and a stellar group of our faculty and students gave 15 poster presentations and five oral presentations at SLEEP 2023, the world’s premier clinical and scientific meeting in the field. l In other groundbreaking research efforts, Dr. Claes

l One highlight of 2023 was Dr. Elizabeth Crocco’s

presentation about cognitive disorders, brain health and the challenges of dementias as part of the UMiami Health Talks series. Dr. Crocco’s talk, moderated by award-winning newscaster Ileana Bravo, drew a record audience of more than 700 who tuned in to hear what she had to say. l Dr. Philip Harvey, Dr. David Loewenstein, Dr. Crocco,

and Dr. Rosie Curiel Cid attracted attention — and significant funding — for their work with our Center for Cognitive Neuroscience and Aging, which was recently awarded a total of $9.7 million in federal and state grants.

All four will use the funding to continue their varying approaches to including more minority groups — especially African American adults — in Alzheimer’s disease studies. l Dr. Harvey also received the Lieber Prize for outstanding

schizophrenia research, the highest honor in the field.

He has studied schizophrenia for more than 30 years, focusing on cognition and everyday functioning in severe mental illness. One of our important clinical advances is Dr. Harvey’s new Brain Health and Fitness Program, which helps adults with mild cognitive and mental health issues learn new skills to perform routine tasks.

Wahlestedt has been awarded $2.1 million by the NIH to study epigenetic mechanisms in the brain related to alcohol addiction, and Drs. Azizi Seixas and Judite Blanc are using virtual reality to promote better maternal mental health.

Looking forward to 2024, we are especially proud to present our 1st Annual Winter Institutes. Held in Boston and Miami, they will give practitioners an opportunity to earn CMEs/CEs while hearing world-renowned faculty present the latest findings about psychopharmacology and brain aging. Early bird registration has been extended to January 24.

And on a personal note, I am grateful to have been the honoree at this year’s Supporting Abilities Gala hosted by the Tourette Association of America for my work with people with Tourette Syndrome and tic disorders.

Our program received recognition as a Center of Excellence by the association in 2019. Its encouragement inspires me to continue to find new ways of helping people with the whole range of neuropsychiatric disorders present with the syndrome.

All of these achievements and more are profiled in this issue of BrainStorms. I encourage you to read their stories, and I offer you best wishes for the holiday season and for 2024.

l Our Center for Translational Sleep and Circadian

Sciences kept observers — including those in our nation’s capital — alert in a variety of ways. Center Director and Distinguished Professor Girardin Jean-Louis, Ph.D.,

Barbara

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Dr. Barbara Coffey Honored by Tourette Association of America

he advocacy and fundraising organization cited her years of work on behalf of patients with Tourette Syndrome and tic disorders.

Barbara Coffey, M.D., M.S., Professor and Chair of the Department of Psychiatry and Behavioral Sciences at the University of Miami Miller School of Medicine, division chief for Child and Adolescent Psychiatry, was honored by the Tourette Association of America (TAA) for her work on behalf of people with Tourette Syndrome and tic disorders.

The honor was bestowed at the association’s annual gala at the Tribeca Rooftop in Manhattan on Nov. 1.

“I’ve worked with the TAA for years, so I know firsthand the importance of their commitment to individuals with Tourette Syndrome and their families,” Dr. Coffey said.

“I am incredibly appreciative of this honor and look forward to continuing with our mutual mission to find viable solutions for people with Tourette Syndrome.”

International Expertise in Tourette Syndrome An internationally recognized specialist in Tourette Syndrome and related disorders, Dr. Coffey established and has led the UHealth Tics, OCD and Related Problems Program since 2017. The program received TAA designation as a Center of Excellence in 2019 in recognition of the program: l Offering the highest level of care for Tourette Syndrome and other tic disorders l Conducting groundbreaking research in the field l Training the next generation of clinicians and specialists l Providing outstanding advocacy and outreach

Barbara Coffey, M.D., M.S., speaking at the Tourette Association of America gala.

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In bestowing the organization’s highest honor, TAA pointed to Dr. Coffey’s long history of clinical and research excellence, which includes considerable work with two TAA boards.

“We recognize and celebrate Barbara’s years of volunteerism, including but not limited to, co-chairing our Medical Advisory Board, serving as a member of our Scientific Advisory Board, leading the TAA Center of Excellence at the University of Miami Miller School of Medicine and previously at the TAA Center of Excellence at the Icahn School of Medicine at Mount Sinai in New York, and her advocacy efforts on Capitol Hill,” TAA said in a statement.

Early Encounter with Tourette Syndrome Patient Dr. Coffey began her work with Tourette’s patients in the 1980s and traces her interest in the field to a child who exhibited typical symptoms of the disorder but whose obscenity-laden outbursts only happened at church.

“To me, this was really fascinating,” said Dr. Coffey.

“I knew that Tourette’s was a genetic disorder, yet there were major psychological aspects to it.”

Dr. Coffey discovered the child’s parents had extensive histories in the Catholic church earlier in their lives.

His father had spent time in a seminary, his mother in a convent. But both had left and later married and had children. And the father had severe obsessive-compulsive disorder, putting his son at high risk for Tourette Syndrome.

“I wasn’t quite sure what to do with the child,” Dr. Coffey said, but suggested a straightforward solution.

“I told the parents, ‘Maybe we should just keep him out of church.’ And the outbursts went away.”

It was the causal blend of nature and nurture that fueled Dr. Coffey’s passion and set a course for her career.

“There’s an interaction between the genetic vulnerability and environmental precipitants,” she said. “We know that Tourette disorder has a genetic origin. But there is also a whole range of neuropsychiatric disorders that are present with this syndrome, including ADHD, OCD, and anxiety and mood disorders.”

The TAA is the only national organization dedicated to improving the quality of life for those affected by Tourette Syndrome, tic disorders, and co-occurring conditions.

All proceeds fund raising awareness, advancing research, and fostering support.

Dr. Elizabeth Crocco Gives UMiami Health Talk, Draws Largest Audience Ever

ore than 700 people tuned in for a presentation by Elizabeth Crocco, M.D., Professor and Medical Director of the UM Memory Disorders Clinic. Her talk, The Mind and Memory: Answering Your Questions About Cognitive Aging, Brain Health, and the Challenges of Alzheimer’s Disease and Related Dementias, drew 700 viewers eager to learn more about one of the world’s fastest growing diseases for which there is no cure.

Dr. Crocco addressed the classifications of normal cognitive aging, mild cognitive impairment, and clinical dementia; the role of evidence-based brain biomarkers and cognitive tests that aid in the early diagnosis of cognitive disorders and their underlying brain disorders; the emerging agents currently used in the treatment and management of early Alzheimer’s disease; and the

best practices in providing optimal care for those with Alzheimer’s disease and related dementias in later life.

In case you missed this important, informational talk, you can scan the QR code below to watch on YouTube.

UMiami Health talks are public, free informational health webinars presented by world-renowned UHealth physicians and scientists.

Dr. Crocco’s UMiami Health Talk was moderated by award-winning newscaster Ileana Bravo. (above right)

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Center for Cognitive Neuroscience and Aging Awarded $9.7 Million for Innovative Alzheimer’s Research espite many advances in Alzheimer’s disease (AD), older minority groups remain underrepresented in research and clinical trials compared to their white counterparts.

The Center for Cognitive Neuroscience and Aging (CNSA), is poised to help address these disparities thanks to a series of recently awarded federal and state grants totaling $9.7 million.

“The center has a distinguished track record in studying Alzheimer’s disease in diverse older adult populations,” said David Loewenstein, Ph.D., Professor of Psychiatry and Behavioral Sciences and Director of the CNSA. “This new funding will support groundbreaking research on traditionally underserved ethnic and cultural groups, training the next generation of scientists and continuing our work in prevention and clinical care.”

Benefits of Alzheimer’s Research in African American Communities Dr. Loewenstein and Rosie Curiel Cid, Psy.D., Associate Professor of Clinical Psychiatry and Chief of Cross-Cultural Neuropsychology and Cognitive Neuroscience at the CNSA, will serve as co-principal investigators on a five-year, $7.6 million grant awarded by the National Institutes of Health (NIH) for the study “Innovative Deep Phenotyping of African Americans at Risk for Alzheimer's Disease.”

At present, African Americans have twice the prevalence of AD compared to other groups, while their older demographic has an increased risk of diabetes, stroke, and reduced renal function. Although there is growing evidence of modifiable risk factors that can prevent or delay cognitive decline in a person’s lifetime, the scarcity of data in the African American community complicates efforts to determine whether these factors apply to this population.

“This study will directly address well-documented barriers to participation in research with innovative approaches to recruiting and engaging older African American adults,” Dr. Curiel Cid said. “As a new model for conducting AD research, our methods promise to be informative for the field and to make clinical research more accessible.”

Simple yet robust blood-based tests will scan for biomarkers of AD and other neurocognitive disorders in African Americans. Cognitive testing will complement

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David Loewenstein, Ph.D.

Rosie Curiel Cid, Psy.D.

“The long-term goal is to discover the mechanisms that will help in the prevention, treatment and eventual cure of Alzheimer’s disease and related dementias, including the development of risk profiles to deliver more individualized interventions.”

—Dr. David Loewenstein

“We are currently following more than 1,000 research participants in addition to those to be enrolled through this new federal grant,” Dr. Loewenstein said. “The long-term goal is to discover those mechanisms that will help in the prevention, treatment and eventual cure of Alzheimer’s disease and related dementia, including the development of risk profiles to deliver more individualized interventions.”

Elizabeth Crocco, M.D.

Philip D. Harvey, Ph.D.

amyloid PET and MRI scans to compose a complete clinical and medical evaluation of these essential genetics.

“These tests can easily be deployed in community settings as an alternative to costly, more-invasive testing,” Dr. Loewenstein noted.

Fostering Long-Term Trust in Academic Medicine Through their preliminary studies, both investigators found many barriers to research in African American communities, the result of years of racially associated medical traumas and economic disadvantages. To achieve the projected study cohort of 300 participants, they will begin by going into African American communities in Miami-Dade and Broward Counties to highlight the many health benefits that can be gained by minimizing barriers to participation.

“A person’s culture plays a crucial role in health behaviors, perception of illness and even the etiology of dementia, all of which can delay diagnosis and treatment as well as influence the risk of and resilience to AD,” Dr. Curiel Cid said. “As we deeply phenotype African Americans, we will also measure how cultural factors and other determinants such as literacy, stressful life events and social isolation may contribute to the increased risk of AD.” The investigators anticipate that older African American adults who learn about these factors in their communities, rather than within intimidating clinical spaces, will be more inclined to enroll in the study.

When enrollment is completed, testing can begin in the participants’ own homes, without the need for transportation or other barriers to participation.

After the data is collected, including state-of-thescience blood-based biomarkers of AD and neuroimaging, genetics and novel brain neuroimaging modalities, the study will move into a longitudinal and collaborative phase featuring beneficial partnerships with health education and community outreach resources. The long-term collaboration will also extend to the study’s research partners, including other departments at the Miller School and experts at the Mayo Clinic and the University of Florida.

Supplemental Research Projects In addition to the NIH grant, the Florida Department of Health’s Ed and Ethel Moore Disease Research Program awarded four research grants totaling $2.1 million to Drs. Loewenstein and Curiel Cid; Elizabeth Crocco, M.D., Professor of Psychiatry and Chief of the Division of Geriatric Psychiatry; and Philip D. Harvey, Ph.D., Professor, Vice Chair for Research and Chief of the Division of Psychology.

Dr. Crocco will focus on expanding an extensive African American community registry and conducting additional bloodwork to study the contributory effects on AD of renal disease, cardiovascular disease and diabetes.

The grant awarded to Dr. Harvey will fund a postdoctoral fellow at the CNSA to be mentored on cognitive neuroscience and brain research.

Dr. Curiel Cid’s grant will support the infrastructure, community connections and pilot work to set up the in-home assessments for the federal grant with African American elders. Dr. Loewenstein will use his portion of the grant for new and improved cognitive challenge tests to detect very early-stage AD and biomarkers in Hispanic and non-Hispanic older adults.

“Though we are all working in different areas of research, our efforts and studies are all interconnected toward a larger purpose: to have all minority groups become better represented and receive the benefits of cutting-edge AD research,” Dr. Curiel Cid said.

This year, the CNSA turned 5!

Since launching in 2018, the Center has established itself as a leader in cognitive neuroscience and the identification and diagnosis of Alzheimer’s and related dementias.

One of the Center’s original goals was to expand the role of the Florida Alzheimer’s Disease Research Center, a statewide consortium funded by the National Institutes of Health that includes UM, the University of Florida, Mount Sinai Medical Center and other universities in Florida. They successfully achieved this goal in 2021 when they were awarded a $15M grant for the 1FL ADRC—making UM the site of its clinical core.

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Dr. Philip Harvey Receives Lieber Prize for Outstanding Schizophrenia Research he Brain and Behavior Research Foundation has awarded Philip Harvey, Ph.D., Professor of Psychiatry and Behavioral Sciences, the Lieber Prize for his outstanding achievements in schizophrenia research—the highest honor awarded in the field.

“This achievement underscores Dr. Harvey’s lifelong commitment to advancing our understanding of this complex disease,” said Henri R. Ford, M.D., M.H.A., Dean and Chief Academic Officer of the Miller School.

“His remarkable catalog of discoveries has profoundly influenced the field and ultimately provides a pathway to improved therapies for mental disorders.”

Previous winners of the award, which is named in recognition of Stephen and Constance Lieber, constitute a roster of luminary researchers including several Nobel Prize winners. As a recipient of the Lieber Prize, Dr. Harvey received $50,000 and attended a reception in New York City. He also presented his work at the International Mental Health Research Symposium in October, along with winners of awards in mood disorders, neuroscience and child psychiatry.

“Receiving this award as a psychologist is a huge honor, and being acknowledged by the greater community is a testimony to the value of the research and discoveries made by our large group of collaborators at the Miller School, the VA and those around the country,” Dr. Harvey said. “I appreciate joining this cohort of elite winners and sharing my work.”

Advancing Schizophrenia Research Dr. Harvey has studied schizophrenia for over 30 years, focusing on cognition and everyday functioning in severe mental illness. Other aspects of his research include treatment in cognitive remediation and pharmacological domains, and multiple recent genomic studies of cognition, disability and suicide in the VA populations. He conducted the first study of working memory in schizophrenia and the first study of

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the genomics of disability in serious mental illness.

His work has led to more than 1,100 published papers and abstracts, 70 authored book chapters and close to $60 million in total funding, including being awarded the largest mental health research grant by the U.S. Department of Veterans Affairs.

The Lieber Prize is the latest addition to Dr. Harvey’s extensive list of awards, which include the Schizophrenia International Research Society’s inaugural Outstanding Clinical and Community Research Award; the John B. Barnwell Award, the VA’s highest honor for outstanding achievement in clinical research that advances the diagnosis, prevention and treatment of diseases and disorders in the veteran population; and the American College of Psychiatrists’ Stanley Dean Research Award.

In 2010, Dr. Harvey joined the Miller School to continue his research efforts while collaborating with young researchers. Since then, he has published over 400 peer-reviewed papers with over 59,000 citations, and received 22 research grants.

“Dr. Harvey is a national treasure not only in the department but in the medical campus and University,” said Barbara J. Coffey, M.D., Professor and Chair of the Department of Psychiatry and Behavioral Sciences. “The field of cognitive and social neuroscience in schizophrenia will be forever beholden to him for his seminal work.”

BAC of tower of London

BAC Symbol Coding

Some examples of the brief cognition assessment tests implemented

by Dr. Harvey and his Miller School team.

Some of the technological simulations Dr. Harvey’s patients use include learning how to use an ATM and refill prescriptions.

“This achievement underscores Dr. Harvey’s lifelong commitment to advancing our understanding of this complex disease. His remarkable catalog of discoveries has profoundly influenced the field and ultimately provides a pathway to improved therapies for mental disorders.”

— Dr. Henri R. Ford, Dean and Chief Academic Officer, Miller School

Technological Implementations in Schizophrenia Treatment Dr. Harvey has implemented various technologies in the assessment of schizophrenia. Patients in his studies receive a personal touch to begin their mobile ecological momentary assessments, where they are asked pertinent questions about their location, comfort level, mood and health. Dr. Harvey and his team receive the data built into the assessment app and have already noticed an increase in more accurate readings due to these changes.

“We are now doing a broad-spectrum approach to schizophrenia as the evolution of our interest started with cognition, then its relation to disabilities and its many variants,” Dr. Harvey said. “Since people with schizophrenia have difficulties reporting their functioning states, we have developed technologies that move away from the patient in the lab to them using smart devices to understand what is going on in their natural environments.”

Further use of technology involves computerized neuropsychological tests consisting of challenging mental puzzles. More robust implementations feature Dr. Harvey’s Brain Health and Fitness Program, (more on p. 11). which uses software he co-designed for patients to learn technology and improve their cognition though virtual reality simulations of daily tasks.

“We have noticed that these interventions have a considerably greater potential for disability reduction,” Dr. Harvey said. “Our studies are noted nationally because we are targeting critical challenges in mental disorders with our approaches and striving to give patients a greater sense of independence.”

While the Lieber Prize is the highest honor in the field, it doesn’t mark the end of Dr. Harvey’s research efforts.

He has already started looking at how technology can be used for assessments and training interventions in people with conditions besides schizophrenia, such as depression and bipolar disorder.

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Dr. Girardin Jean-Louis Speaks on Sleep Health Equity at Congressional Briefing hen it comes to sleep health in the U.S., minorities and low-income communities have a sleep deficit compared to their white counterparts. Because of the importance of this imbalance, the National Sleep Foundation (NSF) hosted its first congressional briefing on the subject, with Girardin Jean-Louis, Ph.D., Distinguished Professor and Director of the Center for Translational Sleep and Circadian Sciences (TSCS) at the Miller School of Medicine invited as a speaker.

Sleep issues go beyond feeling tired: Poor sleep can be associated with health impairments and reduced quality of life. The congressional hearing served as a platform for members of Congress, staff and interested stakeholders to learn from an expert panel of sleep and circadian investigators about sleep health disparities, the various avenues to promote sleep health equity and recommended steps to reduce sleep inequity.

“The Miller School’s TSCS has an excellent track record in conducting stakeholder-engaged interventions to improve sleep and circadian health in minoritized groups,” Dr. Jean-Louis said. “It was fitting for the NSF

Girardin Jean-Louis, Ph.D.

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to invite us to discuss the solution-focused approaches we have used to achieve sleep health equity. Our framework for studying disparities in sleep and circadian health, which received national recognition in 2022 [Science Magazine and NPR], has set the stage for implementation of sleep interventions at the community and future national level.”

Actionable Steps for Sleep Health Equity Dr. Jean-Louis has focused on sleep equity for more than 20 years. His time at the Miller School leading the TSCS has brought effective campaigns to increase awareness of sleep disorders and circadian health. The center has stood out by emphasizing the importance of incorporating patient voices in the deployment of tailored sleep health literature in minority communities through health fairs and screenings in local areas such as barbershops, beauty salons and places of worship.

Dr. Jean-Louis emphasized these same approaches to Congress with his presentation, which began with examining the ubiquity of sleep health disparities and how they can be observed in all sectors of health systems and community centers. Establishing equitable partnerships with stakeholders is also essential in formulating strategies to develop and implement interventions. A public health campaign aimed at minority communities can educate on the importance of sleep and circadian health. Dr. Jean-Louis concluded by speaking on the importance of training the next generation of sleep researchers.

“The congressional briefing provided an excellent opportunity to discuss social determinants of sleep health while advocating for the implementation of solutionfocused interventions,” Dr. Jean-Louis said. “Led by Rep. Zoe Lofgren [CA-18], we believe that Congress is in an excellent position to focus on our recommendations to

Dr. Jean-Louis (second from left) and other speakers invited by the National Sleep Foundation.

develop mechanisms to support community-academic partnerships to achieve the goal of sleep health equity at the national level.”

Tailored Interventions in Sleep Disparities Though the sleep field has made great strides, “more work needs to be done in addressing sleep health in communities beyond Black and Hispanic populations,” Dr. Jean-Louis said.

TSCS has built a solid infrastructure at the Miller School to support programs geared toward eradicating sleep and circadian health disparities in South Florida.

Its Miami Sleep Festival brings together experts in sleep and circadian health and digital health equity, as well as other stakeholders. Additional programs, such as the Tailored Approach to Sleep Health Education, develop educational tools for sleep and sleep apnea in the Black community.

Alzheimer’s disease and related dementias in older minority communities are also crucial for the TSCS. All these programs lead to the “ACT Now!” clinical trials to educate people of color on the importance of participating in trials to gather data that can be implemented in the local and national stages.

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Distinguished Researchers Receive NIH Grant to Study Epigenetic Mechanisms in Alcohol Addiction laes Wahlestedt, M.D., Ph.D., Professor of Psychiatry and Behavioral Sciences, has been awarded a $2.1 million grant from the National Institutes of Health (NIH) to study the epigenetic mechanisms in the brain related to alcohol addiction.

“Our goal is to find the underlying drivers for alcohol use disorder in the hope of eventually developing some type of treatment,” said Dr. Wahlestedt, who is also Director of the Center for Therapeutic Innovation and Associate Dean for Therapeutic Innovation at the Miller School.

Dr. Wahlestedt is the principal investigator for the five-year collaborative grant, “Epigenetic Modulation of Amygdalar Circuits That Control Alcohol Compulsivity.”

The laboratory study will be conducted in collaboration with Estelle Barbier, Ph.D., Associate Professor, and Markus Heilig, M.D., Ph.D., Professor at Linkoping University in Sweden; and Zane Zeier, Ph.D., Associate Professor, and Luis Tuesta, Ph.D., Assistant Professor in the Miller School’s Department of Psychiatry and Behavioral Sciences.

Dr. Wahlestedt noted that this will be among the first alcohol use disorder studies to focus on epigenetic drivers—modifications of gene expression due to stress or environmental factors rather than direct alterations of the genetic code. “We have long hypothesized that compulsive drinking and addiction relate to epigenetic changes in the brain, almost like if a switch has been turned on or off,” he said. “This study will help test that hypothesis and examine where in the brain this happens, and which specific molecular pathways play key roles.”

Previous research by Dr. Wahlestedt and his collaborators has shown that behavioral changes associated with alcohol addiction are evident in signaling networks in specific brain regions, such as the amygdala, which is activated in response to threatening or dangerous stimuli. For instance, the Barbier/Heilig laboratory has investigated why some laboratory animals self-administer alcohol in a compulsive manner.

Other laboratory studies have pointed to the importance of an epigenetic modification called histone methylation in regulating gene expression.

“A key feature of alcohol use disorder is compulsive drinking despite negative consequences or at

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the expense of other rewards,” added Dr. Wahlestedt.

“These clinically significant compulsive behaviors occur in a minority of individuals that consume alcohol—a strong indication that epigenetic vulnerabilities are at the core of the disease. Hopefully, this new study will point to new therapeutic targets within the brain’s signaling system.”

Zane Zeier, Ph.D.; Claes Wahlestedt, M.D., Ph.D.; and Luis Tuesta, Ph.D.

New Online Training Helps People Navigate Digital World, Improving Cognition and Functional Skills he Brain Health and Fitness Program gives adults with mild cognitive and mental health issues new skills to perform “routine” tasks.

For people facing aging, cognitive decline, mental health issues or other concerns, living in a digital world can be an ongoing challenge. Tasks many people take for granted, like shopping online, ordering a food delivery, getting money from an ATM or buying a mass transit card, can stretch their technical skills.

To help people better manage technology, and to improve their cognitive function, the Miller School of Medicine Department of Psychiatry and Behavioral Sciences recently established the Brain Health and Fitness Program, which augments patient care with computerized cognitive and functional skills training.

“There are many people who have trouble learning new technologies, and we want to help them get a better handle on that,” said Philip Harvey, Ph.D., Leonard M. Miller Professor of Psychiatry and Behavioral Sciences, Vice Chair for Research, Chief of the Division of Psychology and director of the program. “That includes adults with serious mental illness, as well as older people who may have mild cognitive impairments, or even healthy adults who simply want to acquire new skills. Increasing cognitive performance makes it a lot easier to learn new skills, regardless of a person’s current situation.”

important tasks, such as online shopping, operating ticketing kiosks and withdrawing money from an ATM. They can also learn medication organization and adherence, a crucial task for patients receiving integrated pharmacological augmentation and brain fitness training.

FUNSAT is simple to complete at home. Patients train for around two hours a week, for at least 15 minutes per session. The program staff monitors their progress online and sends encouraging messages, if necessary.

Through the software, participants learn by doing.

“In our most recent studies, we’ve shown that when people improve in the training, they actually start doing these things in the real world,” said Dr. Harvey. “FUNSAT improves their ability to perform certain tasks, as well as boosting cognition particularly in concert with cognitive training. Not to mention, the practice training gives them confidence to go out and actually do these activities.”

Customized Functional Skills Assessment and Training Designed to last three to six months, this fee-for-service program begins with a one-on-one consultation with Dr. Harvey. He assesses each patient’s condition, the psychiatric services they are receiving and the drugs they have been prescribed. In some cases, he may suggest a consult for a different medication or offer a new referral for psychiatric care and/or support services.

From there, a customized program is developed for the patient. The team helps patients access the program’s evidence-based software modules, which run on PCs, Macs, iPads—most large devices that run Google Chrome. Patients then self-administer the training at home, community centers or other preferred venues.

The cloud-based software, called Functional Skills Assessment and Training (FUNSAT), was designed by Dr. Harvey and Sara Czaja, Ph.D., Professor of Gerontology at Weill Cornell College of Medicine and Professor Emeritus at the Miller School. It teaches people how to perform

Enhancing Skills in Everyday Technology Though the Brain Health and Fitness Program is currently based in South Florida, the software’s cloud configuration could make it available to virtually anyone with a good connection. Still, Dr. Harvey and colleagues have worked with a number of facilities to implement FUNSAT, including the Los Angeles County Department of Mental Health, the New York State Office of Mental Health, the Manhattan Psychiatric Center and aging centers throughout the country. The online training helps patients tune their skills before going back into the world.

Though not covered by insurance, the program is rapidly gaining popularity, as it provides a unique opportunity to improve people’s quality of life.

“We have found that two-thirds of the people doing the training make tremendous progress,” said Dr. Harvey.

“It helps them improve their skill levels and learn to use everyday technologies that had been giving them trouble.

It’s a great way to enhance their well-being.”

The Brain Health and Fitness Program

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Center for Translational Sleep and Circadian Sciences Shines for Its Health Equity Research at National SLEEP Conference aculty and students presented 15 poster sessions and five oral presentations at SLEEP 2023, the world’s premier clinical and scientific meeting for sleep medicine, sleep and circadian research and sleep health.

Ana G. Sánchez Alfonso, Research Coordinator with Dr. Girardin Jean-Louis, Distinguished Professor at the SLEEP 2023 Meeting poster session.

This was the 37th annual meeting of the Associated Professional Sleep Societies (APSS), a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society, held in early June in Indianapolis.

“I presented my first abstract at the APSS meeting in 1993,” said Girardin Jean-Louis, Ph.D., Professor of Psychiatry and Neurology, and Director of the Center for Translational Sleep and Circadian Sciences (TSCS) at the Miller School. “Now, we have multiple presenters depicting different aspects of our research, whether that be community-engagement research, laboratory-based research, or research based on models using national datasets, such as the National Health and Nutrition Examination Survey (NHAINES), National Health Interview Survey (NHIS) and others.”

TSCS focuses on research and community engagement, according to Dr. Jean-Louis, who was recently appointed

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Distinguished Professor at the University of Miami, which formally recognizes the originality and consequence of his scholarly research and the way it has advanced specific areas of study and student education.

The work presented at SLEEP 2023 illustrated TSCS’s focus, looking at and engaging minoritized communities, as well as developing solution-focused interventions to help solve inequities. TSCS also develops models to better acquire sleep and circadian research data.

“We look at different types of health disparities in South Florida in a way that will bring about solutions to reach the national mandate of health equity across all American communities,” he said.

This year, TSCS shared research on cardiovascular disease and brain injury as it relates to sleep.

Among the TSCS faculty presenting, Azizi Seixas, Ph.D., Interim Chair of the Department of Informatics and Health Data Science, presented on different types of machine learning models aimed at achieving equity in sleep and circadian science. TSCS Research Assistant Professor Judite Blanc, Ph.D., talked about different models of community engagement among multiethnic Americans.

Dr. Jean-Louis participated in a panel discussion on community-engaged models to reduce cardiovascular disease risk via sleep apnea treatment, as well as screening in barber shops, beauty salons and churches to ensure that all people have access to screening and treatment.

“We led conversations about sleep-disordered breathing in South Florida, which is new data from a National Institutes of Health (NIH) Research Project Grant R01 that we brought from NYU,” Dr. Jean-Louis said.

“We are beginning to look at some of the baseline data to try and answer questions such as: What are some of the environmental toxicants that may predispose some folks to sleep disordered breathing and short sleep, which may lead to cardiovascular diseases, such as high blood pressure?”

Low Delta Causes High Blood Pressure Dr. Jean-Louis and TSCS colleagues are learning, for example, that many in the Black community develop high blood pressure because of reduced exposure to delta sleep.

“Those who don’t get enough deep delta sleep, don’t experience lower blood pressure during sleep, therefore their pressure is always high. As a consequence, a lot of Black folks try different treatments, but no single medication works. Our preliminary data suggests that the problem really is that they’re not sleeping enough to get into that delta deep sleep state,” he said.

SLEEP 2023 was an ideal venue to showcase TSCS’s work on the world stage, according to Dr. Jean-Louis.“Since we left NYU a couple of years ago, we have been looking at diverse communities in South Florida to better understand some of the

environmental as well as the psycho-social factors that predispose folks to having circadian dysregulations and short sleep,” he said.

“Since then, TSCS has committed not only to community engagement but also to build a new lab, a circadian lab — the only lab that would focus primarily on understanding circadian abnormalities among Black and Latinx. There are circadian labs that look at the general population, but when fully operational, this lab is going to focus on what’s happening in minoritized communities to better understand the causes of circadian abnormalities and the downstream effects in terms of brain injury and cardiovascular disease.”

The data that emerges from those studies in the lab will translate to solution-focused interventions in the communities surrounding the Miller School, he said.

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The Making of a Mentor

oluntary Professor Dr. Fred Seligman dedicated 52 years to the UM Department of Psychiatry and Behavioral Sciences. Initially pursuing a career in pediatrics, Dr. Seligman accepted a faculty appointment in the UM Department of Pediatrics in 1968.

Within a decade, he had completed his residency and fellowship in child and adolescent psychiatry, eventually rising to become director of the division. There, he discovered his passion for mentorship. To date, Dr. Seligman has mentored more than 100 child and adolescent psychiatry trainees.

Recently, he attended the American Academy of Child and Adolescent Psychiatry Annual Meeting in New York City, the largest conference for child and adolescent psychiatrists, for which he has been the official photographer for many years. While in the city, Dr. Seligman and his trainee Abdulrahman Althukair, M.D. visited the Roosevelt Hotel, the city’s designated locale for immigrants entering the U.S. today. The visit had an unexpected impact on Dr. Althukair, one he felt compelled to write about and share with us on the following page.

Each year in an issue of AACAP News, the publication of the American Academy of Child and Adolescent Psychiatry, the organization honors mentors who have made a significant difference in our professional and personal lives. The following was submitted by Dr. Warren Ng, the current president of AACAP, about Dr. Fred Seligman, Voluntary Professor in the Department.

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Fred Seligman is someone whom I have the greatest love and respect for. This unsung hero is the incredible individual who CAPtured AACAP through the lens of his humanity and camera for decades. His photos are a testament of his generosity and selflessness.

He would run around our annual meeting every year to all of the right moments and reappear everywhere. Behind that flash was Fred. His love for AACAP and child and adolescent psychiatry is captured in the beautiful images that he took of us when we gathered as a family and community.

He CAPtured our spirit, our passion, and our beloved community. I loved turning the camera on him and making sure that he was in pictures too!

When I first met Fred, I was so moved by his humility, warmth, and joy. Maybe it was our shared Canadian roots or our love of taking photos. Fred may have been behind the scenes, but he will always be center stage in the limelight when I think about my mentors. “Nothing dims the light that shines from within” as Maya Angelou says, and Fred is a true North Star.

A casual meeting with my supervisor Dr. Fred Seligman in the lobby of the New York Hilton Hotel at the 2023 AACAP meeting led to a field trip that became a powerful and unforgettable experience. Dr. Seligman told me about his plan to visit the Roosevelt Hotel, which was a few blocks away from the AACAP meeting. I immediately expressed my interest in joining him. All we knew was that the hotel had been contracted by the city of New York to house refugees that had fled their home countries.

We surmised that many had experienced unimaginable trauma. Although we were not allowed to enter the hotel, we were able to interact with some of the refugees outside.

We communicated with several people about their stories, hopes, and dreams for the future, mostly using non-verbal gestures and occasionally Google translate.

Their initial hesitation to talk to us quickly melted away after friendly gestures and smiles. They were then willing to share some information with us, perhaps because they saw in our faces a genuine welcome. A man selling coffee on the sidewalk wanted to open his own coffee shop.

A father showed us his artwork, which he sells online to support his family. We spoke with mothers about their journeys, and it was clear that they were determined to build new lives for themselves, despite the trauma

they had experienced. Several children were proud of their schoolbags. Older siblings kept an eye out for their younger siblings. Their resilience and determination were truly inspiring. We were confident that they would overcome their challenges and shape their own destiny.

We saw how people from diverse backgrounds were able to come together and form a cohesive community.

The group of people around that building seemed like a small town in the middle of a big city. Ironically, on our way back to the Hilton, we identified one of the refugee families several blocks from where they temporarily lived.

Dr. Seligman taught me the beauty and power of observation. He showed me how to gather a lot of information just by watching people and interacting with them in a simple way. For example, we identified different attachment styles among the children we met, as well as other vital observations. He reminded me that while we can’t solve all of the problems people face, we can still make a positive impact on people’s lives with small acts of kindness. And that we have the potential to make a significant difference in peoples’ lives interacting with them outside the traditional clinical setting.

Read more about Dr. Seligman in “It’s All About the Children” published in BrainStorms in 2021 at https://tinyurl.com/DRFREDS.

We’re looking for participants for clinical trials. See if you’re eligible and help advance our research into the most innovative treatments and therapies.

Contact: Maria Loreta Lopez Clinical Research Coordinator Mll161@miami.edu 305-243-6127

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Save these Datesto for our 2024 CMEs/CEs Using Virtual Reality Promote Better Conferences!

Maternal Mental Health We are thrilled to present our 1st Annual Winter Institutes!

Grand Beach Hotel Miami Beach, Miami, Florida Learn from World-Renowed Faculty and get your CMEs/CEs at a spectacular oceanfront resort!

WEEK 1

WEEK 2

February 19 –23, 2024

February 26–March 1, 2024

Psychopharmacology: A Master Class Charles B. Nemeroff, M.D., Ph.D. or Mindfulness and Compassion in Clinical Practice: Enhancing Treatment Effectiveness and Personal Wellbeing Susan M. Pollak, M.T.S., Ed.D.

Aging and the Brain Elizabeth Crocco, M.D., Rosie Curiel Cid, Psy.D., and David Loewenstein, Ph.D. or Essential Psychopharmacology, 2024, Practice and Update Barbara Coffey, M.D., M.S., Philip Harvey, Ph.D., David Martinez Garza, M.D., Luca Pani, M.D., and Dhruti Patel, M.D.

Early-bird registration deadline extended to January 24, 2024!

Visit umiami-cme.org for more details and to reserve your spot!

For more information contact Kim Miele at kpm99@miami.edu or 941-932-2671.

Join us for the first-ever conference on Psychopharmacology for the Primary Care Practitioner and Other Health Care Professionals April 5–6, 2024 Fairmont Copley Plaza, Boston, MA Psychopharmacology for the Primary Care Practitioner and Other Health Care Professionals The first course of its kind, this seminar will focus on evidence-based pharmacological interventions and the most advancement in the field of Psychopharmacology.

The curriculum will equip primary care practitioners to confidently diagnose and manage the prevalent mental health conditions and associated comorbidities like cardiovascular disease, arthritis and diabetes.

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Early-bird registration deadline extended to January 24, 2024!

Visit umiami-cme.org for more details and to reserve your spot!

For more information contact Kim Miele at kpm99@miami.edu or 941-932-2671.

Using Virtual Reality to Promote Better Maternal Mental Health

t’s a “technology to the rescue” story. After years of trying different strategies to turn around some dismal maternal mortality rates — especially among minority, underserved communities — researchers at the University of Miami Miller School of Medicine are studying the potential of virtual reality (VR) to help reduce one of the main drivers.

“Maternal mental health, particularly among racial ethnic minorities, is abysmal as compared to their white counterparts,” said Azizi Seixas, Ph.D., Interim Chair of the Department of Informatics and Health Data Science and Associate Director of the Center for Translational Sleep and Circadian Sciences. “And when we peel away the layers and try to understand why there are so many significant maternal health disparities, we see that mental health is a key component.”

The Nurturing Moms study will provide headsets preloaded with VR videos to women currently pregnant and others who have given birth in the previous 12 months. Effectiveness will be measured after each VR session and following completion of the yearlong study to gauge the technology’s short- and long-term impact on maternal mental health.

Using VR to Access Mental Health Care The VR videos are designed as an immersive experience that is part education, part mindfulness. The technology is available through on an existing partnership between the Media and Innovation Lab and BehaVR, a VR company based in Nashville. “The Miller School of Medicine is one of the leaders in this space,” Dr. Seixas said.

Azizi Seixas, Ph.D.

Judite Blanc, Ph.D.

“Many people relegate virtual reality or immersive technologies to just the world of gaming,” he said.

However, evidence now supports VR for helping people mitigate mental health and psychophysical factors including pain and addiction. VR also is a potential solution where women can access standardized mental health care at any time or place, without barriers, Dr. Seixas said. The headsets will be provided free of charge to study participants.

“Pregnancy is a stressful and sometimes even traumatic experience for us,” said study principal co-author Judite Blanc, Ph.D., Research Assistant Professor of Psychiatry and Behavioral Sciences at the Miller School.

“By wearing the headset, you completely remove the outside world and its stress. You go to another world where everything is beautiful. You’ll see nature while you’re listening to a beautiful voice.”

The VR immersive experience provides education and supports mindfulness better than a smartphone app, Dr. Blanc said, based on her experience using the technology.

While the goal of the Nurturing Moms project is to support women during and after pregnancy, “you’re not just doing it for them,” Dr. Blanc said. “You’re also doing it for healthier families, and so we have a better world with healthier human beings in the future.”

Moving forward, the researchers would like to leverage this pilot data to develop a bigger study, Dr. Blanc said.

“We have to address the public health emergency. What’s happening at the public health level is not sustainable.

We have Black women and women of color dying.”

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New Mental Health Clinic for Cancer Survivors Opens

he Fields Galley Cancer Survivorship Emotional Wellness Clinic helps people who are vulnerable to anxiety, depression and suicide.

When cancer patients complete radiation or chemotherapy treatments, they are often hailed as heroes. This milestone is sometimes marked with a celebratory bell ring, or with nurses and doctors who provide rounds of applause as patients leave the clinic.

But the end of these treatments rarely means the end of the emotional distress. Survivors must still cope with multiple life changes: physical changes, financial difficulties, work or school interruptions, or changes in social roles or relationships.

“People think you’re done with cancer treatment and you’re going to pick things up right where you left off,” said Ingrid Barrera, Psy.D., Director of Clinical Operations for Cancer Supportive Services at Sylvester Comprehensive Cancer Center, part of UHealth – the University of Miami Health System. “But you’re not the same person you used to be.”

Newly diagnosed cancer patients are seven times more likely to commit suicide within the first six months of their diagnosis than the general population, according to an American Cancer Society study published in The Cancer Letter. Those who suffer from cancers that carry long-term quality-of-life impairments also face increased risks of suicide.

Frank J. Penedo, Ph.D., Associate Director for Cancer Survivorship and Translational Behavioral Sciences at Sylvester, said that suicide risk data has shown the medical community that cancer patients must be closely monitored and helped even after they’re done with their treatment or go into remission. In the past, patients received significant assistance to deal with their emotions throughout their diagnosis and treatment phases, but as they transitioned into survivorship after their primary treatments, resources to cope with their emotions and survivorship challenges, such as symptom burden, financial concerns and reintegration into social and work roles, were limited at best. “They didn’t get a lot of attention in terms of managing the challenges they face right after the completion of primary treatment,” Dr. Penedo said.

“Several influential reports have coined this challenging experience for survivors as ‘lost in transition.’”

That’s why Sylvester opened the Fields Galley Cancer Survivorship Emotional Wellness Clinic.

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As director, Dr. Barrera, who is also the director of UHealth’s Therapeutic Suicide Prevention Program and an Assistant Professor of Clinical Psychiatry and Behavioral Sciences at the University of Miami Miller School of Medicine, assembled an interdisciplinary team including a psychologist, psychiatrist, licensed social worker, music therapist and an art therapist who form the core of the clinic’s innovative programming.

Donor Support The Fields Galley Private Foundation, a charitable organization founded by the family of Nat Galley Fields, a St. Petersburg, Florida, philanthropist, is supporting the clinic. Fields’ father committed suicide in 1984, leaving him and his family to deal with the “huge collateral damage” of that agonizing event. “I believe that for my father, the fear of life became stronger for him than his fear of death,” Fields said. “I would like to spare others from the same.”

That prompted Fields to work with Sharon Hartman, now the co-trustee of his foundation, to learn about dialectical behavior therapy (DBT), an evidence-based program of psychotherapy that teaches skills to manage emotional distress. The foundation first donated money to start a DBT-based suicide prevention program for adolescents at Jackson Memorial Hospital. Then it donated nearly $400,000 to the Miller School’s Department of Psychiatry and Behavioral Sciences to implement a suicide prevention program for adults. Dr. Barrera ran that program, and her work impressed Fields and Hartman.

Ingrid Barrera, Psy.D.

Frank J. Penedo, Ph.D.

“We have been working with Dr. Barrera for years and have come to trust that when she speaks, there is a real need, and we listen,” Fields said. “We see these funds as giving Dr. Barrera and UM an opportunity to create something fantastic.”

— Frank J. Penedo, Ph.D.

However, Dr. Barrera felt more needed to be done and proposed the idea to expand therapy to all cancer survivors.

She explained the critical need, and the foundation agreed to donate an additional $428,000 to start the program.

“Like most people, we did not realize that often people in remission can have more cancer-related mental health issues than they experienced while actually fighting the cancer,” Fields said. “Their life focus changes from ‘fighting and survival mode’ to ‘What do I do now?’”

A New Approach Fields and Hartman believe that traditional foundations are often hesitant to fund new approaches like those offered through UM. “Our foundation prefers to fund new, somewhat experimental mental health programs that approach an old problem in new ways,” Fields said. “We believe that Dr. Barrera’s program design is doing this.

It makes it easier to tweak details to accommodate

needed changes very quickly when process is not dictated by the past, making success more likely.”

The Fields Galley Cancer Survivorship Emotional Wellness Clinic operates through Dr. Barrera’s office at Sylvester and several of Sylvester’s satellite facilities, in addition to offering remote services.

The team uses DBT and other psychotherapy programs, and is part of a broader initiative at Sylvester, and across the country, to holistically address all issues cancer patients face.

Needed Service National organizations including the National Cancer Institute and the American Cancer Society have advocated for the term “cancer survivor” to extend from diagnosis throughout the life of any cancer patient. This way, Dr. Penedo said, care teams can address the challenges of the survivorship experience early on, coordinate access to available resources, and monitor how patients are coping and adjusting.

Dr. Barrera has beeninstrumental in developing emotional wellness programs for cancer survivors and has big plans to grow the clinic. For now, she is thrilled that Fields and Hartman have entrusted her and Sylvester with the resources to implement this critically needed service.

“We’re so grateful,” Dr. Barrera said. “This program can save lives, and none of this work would be possible without the Fields Galley Private Foundation.”

Fields and Hartman believe Dr. Barrera and her team deserve all the credit. “We have been working with Dr. Barrera for years and have come to trust that when she speaks, there is a real need, and we listen,” Fields said. “We see these funds as giving Dr. Barrera and UM an opportunity to create something fantastic.”

Our 2021-2022 Annual Report is out!

Read about our activities and events, largely made possible by you. Thank you for supporting our Department! To request a print copy please email psychiatry@med.miami.edu.

To read the full version online, visit https://tinyurl.com/UMAR2223

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Events

Alpha Omega Alpha Induction Ceremony Alpha Omega Alpha is a national medical honor society founded in 1902 and is dedicated to improving care for all by recognizing high educational achievement, honoring gifted teaching, encouraging the development of leaders in academia and the community, supporting the ideals of humanism, and promoting service to all. Induction into this prestigious society is one of the highest honors that can be bestowed upon a medical professional and indicates a lifelong commitment to scholarship, leadership, professionalism, and service.

This year, psychiatry resident Dr. Manasi Parrish was inducted into the society.

AOA inductees

Medical Students Host DOCS Health Fair in Fort Lauderdale The University of Miami’s medical students have been organizing health fairs throughout South Florida for over 40 years. Since, the Department of Community Service (DOCS) has expanded to include fairs from Key West to Fort Lauderdale. The Fort Lauderdale Health Fair is the busiest of all. Thanks to our wonderful volunteer medical students, we were able to provide much-needed services to very grateful patients.

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Dr. Mousa Botros, Assistant Professor, UM Psychiatry Clerkship Director

What to Do & Where to Go

Common Purpose Transforming lives through teaching, research and service.

For a Mental Health Emergency, CALL 911 if you believe someone is in danger of hurting themselves or others.

Jackson Behavioral Health Hospital Triage 305.355.7332 Silver Alert If your loved one has gone missing, please CALL 911 immediately.

Silver Alert is a statewide initiative to involve the public in locating a cognitively impaired person who has gotten lost driving or while on foot. For more information visit floridasilveralert. com.

University of Miami Hospital (West Building) We offer telehealth appointments for psychiatric and psychological services, please call 305.243.0214

Office Numbers

Child & Adolescent 305.355.7148

Main Psychiatry Appointment Scheduling 305.243.0214

Soffer Clinical Research Center 305.243.2301

Chairman’s Office 305.243.6400

Courtelis Center 305.243.4129

Deerfield Beach 954.571.0117 Center for Cognitive Neuroscience and Aging (CNSA) 305.355.9080 Brain Fitness Pavilion 305.355.9080 *English, Option 3 Memory Disorders Clinic 305.355.9065

COVID-19 Resources

Mental Health Resources

For updates on UM actions and policy changes related to coronavirus please visit umiamihealth.org

In addition to UM, these organizations are offering mental health support and information during the pandemic.

Our Center for Cognitive Neuroscience and Aging’s statement on COVID-19 cnsa.med.miami.edu World Health Organization Follow the WHO’s global response to the coronavirus pandemic www.who.int Centers for Disease Control and Prevention The latest guidance and recommendations for fighting coronavirus in the U.S. www.cdc.gov National Institute of Allergy and Infectious Diseases Emerging research on the novel coronavirus www.niaid.nih.gov

The University of Miami Leonard M. Miller School of Medicine Department of Psychiatry and Behavioral Sciences is committed to: Conducting research that deepens our understanding of the development, pathophysiology, and prevention of psychiatric illness and the nature of human behavior, and apply this knowledge to the development and delivery of more effective, evidencebased treatments.

Offering comprehensive treatment and consultation to our patients, their families, and the community.

Providing outstanding mental health education and multidisciplinary training to the next generation of health care providers and investigators.

DIRECCT Core values l Diversity l Integrity l Responsibility l Excellence l Compassion l Creativity l Teamwork

American Foundation for Suicide Prevention www.afsp.org National Suicide Prevention Lifeline 1.800.273.8255 suicidepreventionlifeline.org National Alliance on Mental Illness www.nami.org/Home Mental Health America www.mhanational.org/covid19 The publication of the University of Miami Department of Psychiatry and Behavioral Sciences Executive Editors Samantha Richter Robert S. Benchley Soffer Clinical Research Center 1120 NW 14th Street, Miami, FL 33136

The Department of Psychiatry and Behavioral Sciences wishes you a happy and healthy holiday season and joyous new year!