New addiction training collaboration benefits patients, psych residents

Over the past three years as a University of Mississippi Medical Center psychiatry resident, Dr. Chaz Richardson has seen a plethora of patients who cope with prescription or “street” drug addictions.

“Addiction is one of those things in Mississippi that is prevalent, but nobody wants to talk about it or treat it,” Richardson said. 

In a state that's short on psychiatrists and addiction specialists, Richardson and other fourth-year psychiatry residents hope to give better care to patients through additional training at the nationally acclaimed Pine Grove Behavioral Health and Addiction Services in Hattiesburg. A new affiliation between UMMC and Pine Grove is allowing residents to gain hands-on experience in addiction treatment not currently included in the Medical Center's psychiatry programs, said Dr. Scott Rodgers, professor and chair of the Department of Psychiatry and Human Behavior.

Working hand in hand with Rodgers' department to bring the partnership to fruition was UMMC's Office of Mississippi Physician Workforce. Dr. John Mitchell, associate professor of family medicine and the office's director, said he recognized “a desperate need for more psychiatrists in the state, but also the need for additional opportunities in training, especially in addiction medicine. Addictions are so prevalent, both nationally and in our state.”

“Pine Grove is one of the strongest behavioral health treatment programs in the nation, with an excellent reputation,” Rodgers said. “One of their areas of great strength is in addictions. We have a department with wide-ranging programs, but there are some gaps in what we offer.”

Inpatient addiction programs offered by Pine Grove include 12-week intensive residential programs for adults struggling with different areas of chemical dependency, treatment for women with eating disorders and treatment of sexual addictions. Pine Grove also offers adult alcohol and drug detox.

“We're working now to fill our gaps, but until we do, we want to give our trainees and residents opportunities to learn from the clinicians at Pine Grove,” Rodgers said.  “We wanted to affiliate with them formally so that our residents can go there in their fourth year and spend a month rotating in their various units.”

UMMC's gap areas include not just addiction programs, but psychiatric inpatient services for adolescents ages 13-17. “We treat people with eating disorders, but we don't have an organized program for it,” Rodgers said. “This rounds out our residents' educational training experience. Until this point, that was not really possible.”

The experience is voluntary, but most residents are eager to take part, Rodgers said. “Pine Grove has been very gracious and kind in welcoming us,” he said.

The training will focus primarily on drug addictions, said Dr. Joy Houston, associate professor of psychiatry and program director of the psychiatry residency. Residents will take an active part in treatment of men and women in Pine Grove's residential programs, along with those in outpatient and less lengthy inpatient care.

Richardson will do a rotation at Pine Grove in September. About six residents annually will go to Pine Grove, each working a different month. “I want to get as much out of this month as I can in order to treat my patients in the future,” Richardson said.

The need for psychiatric care in Mississippi was made even greater in recent weeks, Richardson said. The state Department of Mental Health said in May that it will close its 29-bed acute medical psychiatric service unit at the State Hospital at Whitfield in the wake of an anticipated $8.3 million in budget cuts in the new fiscal year.

“Psychiatrists are in short supply in Mississippi,” Rodgers said. “We have such a dire need for better mental health treatment, and this university serves a vitally important role in training psychiatrists and psychologists.”

The way the collaboration will work: Residents will work side by side with Pine Grove staff and live in an apartment in Hattiesburg rented by Pine Grove. They will take part in treatment of a variety of patients with addictions, including those in Next Step, a men's 12-week, intensive alcohol and drug addiction program.

They will rotate through the Women's Center, a similar 12-week program; the Legacy program for those ages 55 and up in need of substance abuse treatment; and the Professional Enhancement Program, or PEP, for professionals with addiction disorders, interpersonal difficulties and vocational issues. They will not treat patients in Pine Grove's Gratitude Program for those coping with sexual addictions.

They'll also consult on patients at Forrest General Hospital in Hattiesburg, the umbrella organization over Pine Grove, said Dr. Teresa Mulvihill, a psychiatrist and addictionologist who is serving as the liaison between Pine Grove and UMMC. Residents will also observe at the county's Drug Court, she said.

“They'll get a big-picture overview of everything,” said Mulvihill, who is on staff at Forrest General and works several days a week at Pine Grove's outreach office in Madison. “We want to expose them to many types of addictions. We are 12-step based, and they're going to get a solid core of medical ways to treat addictions. And it takes a family to treat addictions, so they'll get to go to our family program that meets every other week.”

UMMC's psychiatry residents currently do a short rotation through the Veterans Affairs Medical Center, “but it's only a single population and a partial program,” Houston said. The Pine Grove affiliation “gives them the chance to see multiple programs designed for multiple populations. This will increase their familiarity and comfort in dealing with those patient populations.”

If one of the residents wants to do a second rotation at Pine Grove, “they can write their own program,” said Dr. Diane Walker, a psychiatrist and Pine Grove's medical director. “We've got extensive programming at Pine Grove.”

An added goal of the collaboration is for Pine Grove and UMMC not just to enhance training, but to recruit residents to practice at UMMC, or to stay in Mississippi - perhaps as a Pine Grove psychiatrist -- once they've finished their residencies.

“We recognize the shortage of psychiatrists in our state,” Walker said. “We hope this is a way of maintaining more psychiatrists. Several of our doctors at Pine Grove are approaching retirement. We're actively recruiting.”

“I feel collaborations such as this will go a long way in opening doors for other potential medical training opportunities,” Mitchell said. “It's my hope that this and possibly other collaborations will one day stimulate more interest in psychiatry and allow us to increase our production of psychiatrists for our state.” 

The partnership “is our starting point,” Houston said. “There are a lot of ways we can expand this over time. This could cause some of our residents to be interested in a fellowship in addiction treatment. We look forward to being able to build this program with Pine Grove.”

Richardson said he's planning to practice in Mississippi because the need is so great.

“Methamphetamines, street drugs, opiates … that's probably where the most training is needed. I will try to get the most out of it because of what I've seen in the last three years,” he said. “The most interesting thing I've seen so far is treatment of folks in the medical field or other professionals who may have just stumbled down the wrong path. They can come (to Pine Grove) and get very private care.”

“Our goal is to train people to go throughout Mississippi to take care of Mississippians,” Rodgers said. “We are eager to do that."