2023 Psychiatric Service Awardees Honored for Innovative Service Programs

The Extension for Community Healthcare Outcomes (ECHO) is a virtual education intervention model developed by Sanjeev Arora, M.D. ECHO sessions have been shown to strengthen health care infrastructure, improve communication and coordination among specialists, provide access to expert guidance, improve scope of practice, and promote implementation of evidence-based practices.

The program has evolved into a learning framework focused on case-based learning, wherein participants attend meetings hosted by a central entity to present anonymous cases, consult with a multidisciplinary team of specialists, and learn from the cases presented by other colleagues. Case presentations are highly interactive, capitalizing on the insights of an interdisciplinary team and ECHO participants.

In 2019, the Division of Substance Abuse and Mental Health of Delaware’s Department of Health and Social Services used a state opioid response grant from the Substance Abuse and Mental Health Services Administration to partner with the Community Health Center Inc. and its Weitzman Institute on a Project ECHO model for peer support providers.

As of July 22, 2022, the division has facilitated 63 Peer ECHO sessions since launching in 2019, with 127 participants from 67 organizations and seven states. Curriculum included “Team-Based Care,” “Using Your Story to Advocate/Overcome Stigma,” “Suicide Prevention and Intervention,” “Engaging Peers in Collaborative and Caring Relationships,” and “Harm Reduction and the Recovery-Oriented Approach.”

The Psychiatry High-Risk Program (PHRP) is an innovative, recovery-based suicide prevention program established in 2017 to address rising suicide rates of youth and young adults in central New York.

PHRP treats individuals aged 14 through 40 years who are struggling with thoughts of suicide or recent attempts. The treatment program involves weekly manual-based individual psychotherapy sessions with medication management and, when indicated, family and group therapies. The staff include a general psychiatrist (director), two child psychiatrists, a child psychologist, a nurse practitioner, five clinical social workers, and an administrative assistant for intake coordination. Referrals come from inpatient psychiatry units, emergency departments and consult services, other mental health clinics, primary care, and self-referrals.

When possible, therapists attempt to contact potential participants while they are still hospitalized to facilitate transitions in care. The most common primary diagnosis in the PHRP is major depressive disorder beginning in the early teens. Other common conditions seen in the PHRP include posttraumatic stress disorder, borderline personality disorder, anxiety disorders, bipolar disorder, substance use disorders, and eating disorders. Most patients have an extensive history of suicide attempts, psychiatric hospitalizations, and previous unsuccessful treatments.

The Train New Trainers Primary Care Psychiatry Fellowship at the University of California, Irvine School of Medicine, is a year-long clinical education program for primary care–oriented trainees and health care professionals who wish to receive advanced training in primary care psychiatry. This training targets the most frequently encountered mental health–related disorders and treatments found in the primary care setting and trains primary care providers to recognize symptoms of common mild-to-moderate psychiatric conditions, complete a quick and targeted assessment, and provide evidence-based treatment using cognitive-behavioral therapy techniques, motivational interviewing, and appropriate medications.

The curriculum includes over 50 hours of training with two in-person conferences on weekends, two case-based tele-education learning modules a month, and at least one hour a month of small-group mentoring sessions with a program faculty member. More than 750 participants have been trained across the United States. ■