Psychiatrists Cross Borders for Collaborative Learning

Some people want to build walls along the border between the United States and Mexico, while other people want to build bridges and roads to link them closer together.

A few weeks after APA’s 2017 Annual Meeting in San Diego, members of the San Diego Psychiatric Society met with their counterparts from Mexico. Sessions were held in both San Diego and Tijuana, just a short drive away. The theme was “Psychiatry Without Borders” and featured presenters from both Mexico and the United States, said Bernardo Ng, M.D., chair of APA’s Council on International Psychiatry and vice president of La Asociación Psiquiátrica Mexicana (APM). Former APA President Michelle Riba, M.D., of the University of Michigan, offered the opening remarks in Tijuana, while Enrique Chavez, M.D., the president of the APM, closed the event with a talk in San Diego.

The collaborative meeting was conceived by Ng, who practices at Sun Valley Behavioral Health in Imperial, Calif., about 100 miles east of San Diego, near the Mexican border, and Steve Koh, M.D., M.P.H., M.B.A., a professor at the University of California, San Diego, and former president of the San Diego Psychiatric Society. One benefit of the program: all attendees could receive CME credits from their respective societies.

“For the first time, we had a meeting that was held concurrently in English and Spanish, where psychiatrists and researchers from both countries attended and presented lectures and symposia,” said Ng.

For instance, a symposium on neuromodulation was presented by two experts on ECT, Maria Lapid, M.D., of the Mayo Clinic and Sergio Galvan, M.D., of Mexico’s Hospital Angeles. The segment on transcranial magnetic stimulation was delivered by Simon Kung, M.D., of Mayo and two psychiatrists from the Clinic STIM in Guadalajara, Mexico, Thelma Sanchez, M.D., and Marisela Duran, M.D. A symposium on eating disorders matched Walter Kaye, M.D., of the University of California, San Diego, with Eva Trujillo, M.D., of Volver a Empezar in Mexico.

“We are also trying to coordinate training opportunities between U.S. and Mexican institutions to permit rotations in both directions,” said Ng.

Drugs—legal and illegal—present questions for both psychiatric societies. Americans often head south to buy drugs, including antipsychotics, which are available in Mexico without prescription. That raises questions about monitoring patients once they return home, said Riba. Meanwhile, the passage of medical marijuana laws in California has resulted in increased smuggling of the weed into Mexico, a reversal of the historical norm, said Ng.

The border region extends about 25 miles on either side of the formal boundary and has a very mixed culture, said Ng. The area is so used to free exchange of visitors that it has more in common within the region than with the rest of each country.

“If people move elsewhere, it’s like they’re going to another country,” said Ng. “I get one new patient a month who is a college student returning home with psychosis or depression because of culture shock.”

Even in a moment of political distancing, he said, commerce, collaboration, and scientific exchange will continue, he said. “We were able to do real-time comparisons in both countries, and we found that there were more similarities than differences. This connection is not going to stop.” ■