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Residency program focuses on overlooked mental health needs

EAST LANSING, Mich. -- Despite the fact mental health problems are more common than high blood pressure and diabetes combined, about two-thirds of mental health patients are cared for entirely by primary care providers without proper training.

Additionally, even larger numbers of other patients regularly have their psychosocial and emotional needs overlooked.

A new five-year, $1 million grant allows Michigan State University to develop an intensive three-year residency curriculum focused on primary care mental health, the result of which means better-trained physicians meeting patients' needs.

Led by Robert Smith of the College of Human Medicine's Division of General Internal Medicine, the program will use a "train the trainer" model to produce skilled faculty to train residents in mental health care.

"Most mental health patients are cared for entirely by primary care providers, since there no longer is sufficient numbers of mental health professionals," Smith said. "But, through no fault of their own, most primary care providers have not been trained for this. The result is that most patients with mental health problems receive very marginal care."

Compounding the problem is that patients with organic diseases such as diabetes and heart failure do worse in the presence of unchecked mental illness. Also, mental health problems are more common in underserved/high risk groups such as minorities, the poor, homeless, and those battling substance abuse and suffering from domestic violence.

The new MSU program, funded by the U.S. Health Resources and Services Administration, will develop and test a curriculum for primary care residents with increased amounts of mental health training, Smith said. About 40 residents will be trained each year for five years.

"Our goal is that graduating residents be as skilled with treating major depression or stress, for example, as they are with diabetes or hypertension," he said. "Given the dearth of available mental health professionals, the limiting factor in achieving and sustaining such a new curriculum is faculty development of general internal medicine teachers and other primary care teachers."

Smith said the program addresses that by using a "train the trainer" model to produce skilled faculty to train residents. Each resident will undergo 100 hours of training each year. The goal is once started, the residencies will become self-sufficient and training will be offered throughout other sites in the MSU health care education system. Also, there will be high rate of placement of resident graduates in medically underserved communities, he added.

The College of Human Medicine's community-based linkages will be vital in expanding the program statewide, Smith said.

"With campuses across Michigan, the college's standing in local communities provides the foundation to develop and expand a new residency," he said.

Contact: Jason Cody
Michigan State University

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