Rural Western North Carolinians should have better access to mental health support over the next few years thanks to a new, state-funded Psychiatry Residency at MAHEC that started on July 1, 2017.
“The majority of counties in our region don’t have any psychiatrists,” says Dr. Stephen Buie, MAHEC Psychiatry Residency Program Director. “Primary care physicians try to fill the gap, but we have a shortage of these physicians in WNC too.”
MAHEC’s new residency program is an innovative approach to meeting the needs of high-risk, medically underserved populations like ours. All 16 WNC counties have been designated as Health Professional Shortage Areas. More than half are listed in the “most distressed” category with higher-than-average rates of substance use disorders and suicide.
Unlike traditional residency programs, MAHEC residents will spend much of their clinical time consulting with physicians and patients in primary care settings. The program includes instruction in primary care medicine to ensure residents understand the day-to-day challenges and constraints these physicians face.
Many residency programs provide residents with only one 6-week rotation in a primary care setting over the course of their 4-year residency. MAHEC’s program uses a longitudinal approach in which residents spend 2-3 years in primary care settings where they can develop meaningful relationships with primary care providers and their patients.
MAHEC’s residency program is designed to train psychiatrists who can collaborate and consult with primary care physicians who are often the only doctors available to provide mental health care in underserved rural areas. The follow up rate for psychiatric care is better when it can be provided in a primary care setting, notes Buie.
“The only way we are going to solve our bigger, system-wide challenges is to work collaboratively with primary care physicians to expand mental health resources,” says Thomas Campbell, MD, first-year psychiatry resident at MAHEC.
“I love rural communities and want to practice in one,” shares Campbell, who grew up in a small town in the eastern part of Washington State. “It made sense to choose a residency where I could get rural experience.”
MAHEC’s partnership with hospitals, treatment centers and medical practices throughout the region will provide residents with a wide variety of experiences working with adults, adolescents, and children in inpatient and outpatient settings, treatment centers, and rural primary care practices across WNC, where mental health support is needed most.
“I didn’t realize there was such a shortage of psychiatrists in this area,” explains first-year resident Sheritta Carmichael, MD, who recently relocated from Georgia. “The primary care physicians I’ve been working with are ecstatic to have someone to consult with on their more challenging cases.”
Carmichael likes that MAHEC’s residency emphasizes talk therapy not just medications and provides training in a variety of therapeutic approaches including cognitive behavioral therapy, interpersonal therapy, dialectical behavior therapy, and psychodynamic psychotherapy. She also loves MAHEC’s community-based emphasis.
“Many of the programs I looked at seemed to be more concerned with making a big name for their medical school or hospital,” shares Carmichael. “Here the emphasis is on helping our patients and letting our reputation grow from that.”
Historically, at least 50% of physicians stay and practice within a 100-mile radius after completing their residency, which should benefit WNC communities for many years to come.
MAHEC was established in 1974 and is a leader in healthcare, education and innovation. Located in Asheville, MAHEC serves a 16-county region in Western North Carolina. It is the largest Area Health Education Center in North Carolina, which evolved to address national and state concerns with the supply, retention and quality of health professionals. MAHEC’s mission is to train the next generation of healthcare professionals for Western North Carolina through quality healthcare, innovative education, and best practice models that can be replicated nationally. For more information on MAHEC, visit www.mahec.net.