A CASE FOR SUPPORT
Psychiatry and Behavioral Health
Dear friend,
As a recognized center of excellence, we compassionately care for people with some of the most complicated psychiatric and behavioral health disorders, including substance use disorders.
The University of Cincinnati Department of Psychiatry and Behavioral Neuroscience encompasses one of the top research departments in the nation, with multiple ongoing studies in bipolar disorder, schizophrenia, as well as depression, anxiety and substance use. Ongoing research efforts allow our team to pursue new clinical therapies that can improve how we deliver care.
Our strengths:
• A founding member of the National Network of Depression Centers, a clinical and research consortium organized to advance mental health care.
• Precision medicine: Determining the right combination of medication and treatment for anxiety and depression is key. Ongoing research efforts are identifying how individuals respond to medications and psychotherapy based upon their own unique biology. This helps to eliminate trial-and-error approaches, avoid unwanted side effects and help our patients get better faster.
• Leading a large national study of bipolar disorder in youth, evaluating the effectiveness of medication and lifestyle interventions to mitigate weight gain.
• The UC Mood Disorders Center is the region’s only premier care provider for treatment-resistant depression, with a focus on personalized interventions.
Our vision is to continue to lead the way in innovative models to meet the growing demand for mental health care, to connect patients to the right treatment at the right time, to leverage data to improve outcomes for patients worldwide and to train the next generation of leaders in the field.
We are so grateful for your thoughtful consideration to partner with our team in support of this important work that we are confident will improve lives here in Greater Cincinnati and around the world.
Melissa DelBello, MD, MS
Dr. Stanley and Mickey Kaplan Endowed Chair and Professor Department of Psychiatry and Behavioral Neuroscience
RESEARCH
Growing and retaining top talent
At the UC Gardner Neuroscience Institute, our faculty leaders bring an evidence-based focus to everything we do. To attract rising-star researchers and expand our quests for discovery, we must evolve our resources to maintain the fast pace required for continual health care innovation.
Endowed chairs for clinical leadership and research faculty
Historically, endowed chairs were a want-to-have, today it is a need-to-have in order for UC to be competitive with other nationally ranked academic medical centers. Endowed chairs are essential to our ability to recruit and retain top talent among a competitive field of other neuroscience institutes. Establishing new chairs builds permanency and sustainability in our areas of excellence:
Clinical leadership to advance the subspecialty care areas of:
• Mood disorders
• Psychotic disorders
• Anxiety
• Women's mental health
• Geriatric psychiatry
• Mental health outcomes
Neuroscience research chairs expand clinical trials and basic neuroscience research, to enable the discovery of new medications and treatments, and protect time for physicianscientists to balance patient care with research and teaching. An endowed research chair allows us to recruit new thought leaders or retain vital faculty and ensures continuity of important research efforts at the university.
Paired with our advanced facilities and research operations, endowed chairs will attract nationally and globally recognized faculty to the UC Gardner Neuroscience Institute. This accelerates the research and development of new treatments, all to directly benefit more patients.
Expanding research for improved outcomes
MRI research technology
MRI scans are now a key component of clinical research trials at the neuroscience institute—including in Parkinson’s disease, stroke, epilepsy, memory and mood disorders. Neuroimaging research allows a physician or researcher to evaluate a patient’s baseline or see how they respond to new medications or therapies. To support our robust research efforts, the institute is in need of a dedicated research scanner.
An MRI focused entirely on research, with staff trained in neuroinformatics and the latest imaging techniques, will broaden our discovery efforts across all specialty areas. The outpatient facility (that opened in 2019) was built to accommodate an additional MRI with researcher staffing space.
For example: By harnessing functional MRI in patients with mood or anxiety disorders, brain scans prior to and early in treatment are able to predict which treatments will be most effective. This breakthrough allows us to tailor our treatment with precision, ensuring that patients receive optimal treatment from the outset rather than the traditional ‘trial and error’ approach.
Research endowment fund
Neuroscience is the most prolific research area throughout the academic health center and the entire university. Creating a substantial research endowment will encourage further cross-disciplinary projects across departments and centers and can spark “high-risk/highreward” ideas that are less likely to find support through conventional grant funding.
Pilot grants are the mustard seeds of research. Their results lead to much larger grants from the National Institutes of Health and other external foundations.
For example, $925,000 in pilot grant funding from 2014 to 2020 resulted in $16,236,369 in monies from the government and external foundations—a 16 to 1 return on investment.
A research endowment fund is critical to progress and will allow investigators to pursue more novel, long-term and untested research projects, giving them the security to take the risks that will yield breakthrough discoveries right here in Cincinnati.
“Current treatment approaches for anxiety and depression often involve trying multiple treatments before finding the right one.
But what if we could begin with a treatment tailored to an individual’s unique characteristics and genes, increasing the chances of success from the start? Our research at UC is moving us closer to this goal and toward personalized medicine.”
JEFFREY R. STRAWN, MD
Professor and Director of the Anxiety Disorders Research Center at the University of Cincinnati
Research focused on precision medicine and lifelong brain health
Personalized medicine
Our research is uncovering how treatments can be tailored to identify the right treatment for the right patient at the right dose based on a variety of individual factors. This work is a critical step to allowing physicians and other clinicians to predict which treatments will work for anxiety, depression, bipolar and other mental health disorders. These preliminary findings have led to a clinical trial of antidepressants that will guide dosage based on a patient’s metabolism. Future studies will continue to examine genetic predictors of treatment response.
Risk and resiliency: Children of parents with bipolar disorder
If a parent has bipolar disorder, there is a 50% chance their child will develop it as well, making it one of the most familial psychiatric disorders. Our internationally renowned team of experts have spent decades conducting longitudinal studies on youth at-risk for developing bipolar disorder to identify leading risk factors. Critically, these studies also focus on identifying the protective factors, or resiliency factors, that can help an at-risk child minimize the risk for the development or severity of bipolar disorder.
Many children with bipolar disorder present with ADHD symptoms, and the stimulants used to treat ADHD can often make their symptoms worse. We are studying the long-term effects of stimulant medication, as well as whether there are certain age ranges when treatment is most ideal.
Prevention and early intervention care for mood and anxiety disorders
Care services that introduce prevention strategies and early interventions for adolescents and young adults will improve long-term mental health outcomes. Currently, two in three youth diagnosed with depression and/or anxiety are unable to access the care they need.
Types of care may include nutritional assessments, like checking levels of Omega-3s and prescribing natural supplements, or introducing mindfulness meditation practice, both of which are evidence-based approaches.
The addition of early career researchers in subspecialty areas of mood and anxiety disorders will allow us to explore untested yet promising approaches that will continue to advance personalized care, maximizing treatment effectiveness and reducing illness severity.
Understanding when and how psychosis and schizophrenia may develop
Psychosis, a mental health condition characterized by a disconnection from reality, may manifest as hallucinations, delusions, or impaired insight, and can be a signal or a first sign of a chronic mental health disorder such as schizophrenia. As with other mental health disorders, early identification and intervention is crucial.
Our research clinicians are studying when and how to screen for and identify the signs of psychosis to prevent more serious complications or advancement of disease.
• Early intervention programs for psychosis decrease hospitalizations and relapses, improve symptoms and increase quality of life compared with treatment as usual.
• Our first episode program reduces hospitalizations, reduces suicidal behavior, improves quality of life and improves subjective distress.
• Early clozapine treatment or long-acting injectable treatment are feasible options in early intervention programs.
Additionally, research to find new definitive treatments for schizophrenia is vital, but public and philanthropic financial support to expand and intensify research remains vastly insufficient. Funding can advance our diagnosis and treatment approaches for these conditions, to improve patient outcomes.
“One important area of my research is the development of new antipsychotic medications with broader efficacy and fewer
side effects.
This
new treatment approach to schizophrenia
is completely different from all the antipsychotic drugs that have been used over the last 70 years."
HENRY NASRALLAH, MD Professor Emeritus of Psychiatry
Women’s mental health research
According to research from Jyoti Sachdeva, MD, director of women's mental health at UC Health’s West Chester Hospital, one in five mothers and one in 10 fathers experience a perinatal mood disorder.
Women experience one-and-half to three times higher rates of depression and are specifically at-risk during times of hormonal changes such as puberty, menopause, pregnancy and postpartum. Up to 75% of women go untreated and only 5% reach remission.
Sachdeva, who is an associate professor in the Department of Psychiatry and Behavioral Neuroscience at the UC College of Medicine primarily studies perinatal mental health. Through a series of surveys of medical providers and mothers on their experiences with perinatal mood disorders, she seeks to better understand how additional education would help care teams with screening and support for their patients.
Additionally, she is studying how interventions and improved access to mental health resources for women may improve the perinatal care experience. These include automated health screenings, more effective education resources and trainings for clinicians and parents. Future projects will develop a tool kit for frontline providers, and guides designed specifically for mothers around the prevalence and risks of anxiety and perinatal mood disorders.
Research to reverse the opioid addiction crisis in Ohio
Through the UC Center for Addiction Research, our faculty have helped lead some of the largest studies in the nation aimed at implementing interventions to reduce opioid related deaths, as well as better understanding the biological, social and psychological patterns tied to mental health and addiction disorders.
Like other areas of the country, Ohio has seen a rise in mental illness, suicide and deaths related to drug overdose over the past decade, and the COVID-19 pandemic exacerbated these problems. These clinical studies are engaging communities across Ohio to implement evidence-based practices as well as to collect data with the goal to ultimately reverse the trajectory of deaths related to mental health conditions and addiction. Dedicated funds will allow researchers to study other addictions such as alcohol and cannabis as well as train providers to rapidly implement results from our research.
CLINICAL CARE
Grow our patient data infrastructure, strengthen services for our centers of excellence, creating a national destination for care
The power of big data: Improving patient outcomes
To offer truly world-class care for our patients, we need to rely on not just the expertise of one doctor, but leverage the expertise of every single doctor in our institute and beyond. We must continue to scale our approaches to personalized treatment for our patients, understanding that care is unique to each individual.
With the vast amount of health data now available, a physician has millions of data points at their fingertips. The flow of new information never stops as biomedical knowledge from new research doubles every 73 days. However, the time lag from putting new knowledge into practice currently takes more than a decade.
The UC Gardner Neuroscience Institute is building an integrated network of research, clinical data and quality improvement processes that will rapidly deliver new learnings to the bedside, vastly improving patient care and quality and longevity of life.
Adopting a big data approach to care
Before
• Average 17 years from evidence to practice.
• Lacks patient input and learned experience.
• Disparities in practice, decision-making.
• Measures process with outcomes.
After
• Less than 3 years to apply new evidence to patient care.
• Patient-driven research and resources.
• Aligned use of best practices, efficient and accessible evidence.
• Measures real-time patient outcomes, to continuously modify care.
Leveraging big data
As a member of the Bipolar Disorder Learning Health Network, UC is collaborating with 18 other institutions, including Massachusetts General Hospital, to rapidly bring new learning directly to patient care, driving change not only in treatment but also in the quality of life for those with this illness. Patient involvement will foster collaboration, co-production and problem-solving among patients, clinicians and researchers to identify and address challenges and advocate for better systems of care. This, in part, will be made possible by the unrestricted sharing of outcomes data between member institutions. This approach will measure real-world outcomes from patients that will drive immediate and continuous improvements for patients with bipolar illness and truly optimize clinical care for our patients and their families.
“I am most interested in knowing if the treatments we provide in clinical care are effective, and if not, then developing new ways of delivering care to improve outcomes for individuals and populations. This is especially the case with mood disorders such as bipolar disorder where there is often uncertainty in diagnosis and treatment. If we could learn from our current practices and collaborating institutions’ practices, then we potentially could identify which next steps are needed to improve patient outcomes.”
JOSEPH CERIMELE, MD, MPH Professor of Psychiatry Director, Psychiatry Health Outcomes Research
Tackling the mental health care crisis
The COVID-19 pandemic revealed a new pandemic of its own: the overwhelming need to better support mental health care. Over half of adults with a mental illness do not receive proper treatment. More than 28 million individuals in the United States don’t have access to care with Ohio as one of the most challenging states for patients to access care.
Rapid access services
A current gap in our psychiatric services is a walk-in clinic that can provide short-term psychiatric services to immediately connect patients to the level of care they need. UC Health receives nearly 500 referrals a week of new patients urgently seeking mental health care treatment—however, with our care teams working at full capacity, we can only reach about 6% of these patients in need.
A Rapid Access Care model would staff an expanded team comprised of psychiatrists, nurse practitioners, social workers and care coordinators to assess, stabilize and guide patients to necessary and appropriate treatment. A triage model of care would match patients to the right services and resources they need, to prevent more urgent and possibly lifethreatening situations.
Adding this level of care would increase access by 50% for those patients seeking psychiatric services.
“We are establishing innovative care models to keep up with the growing
demand for
mental
health care. Rapid access services would help us reach populations who desperately need to be seen, to prevent progression of illness.”
MELISSA DELBELLO, MD, MS
Dr. Stanley and Mickey Kaplan Endowed Chair and Professor Department of Psychiatry and Behavioral Neuroscience
Creating sustainable models for mental health care in rural areas
For the past five years, a small team from UC Psychiatry has worked in partnership with Adams County Health Department to provide mental health care services. In 2020, the county recognized the lack of health professionals for their community, in particular for youth and adults identified with needs for mental health care support due to their involvement in the judicial system.
Through grant support, UC was able to establish telehealth and other psychiatric services for adults in the court system as well as expand services to help their children who have been affected by the trauma of having a family member incarcerated. Philanthropic support could add clinical student rotations in providing rural mental health care to ensure that vital mental health services are available in these underserved communities.
Seamless transitions from pediatric to adult care
For patients with a mood disorder diagnosed in childhood, the transition of care to adulthood means a new treatment team, a new setting and new responsibilities for managing their illness. Hiring a care coordinator will greatly aid in the transition for adolescents and young adults into adult care. This process will help foster independence for patients and reduce barriers that can affect adherence to care or interruption of a treatment plan.
Establishing a transition clinic will include hiring care coordinators, as well as building infrastructure to collect and track data in order to ensure the best patient outcomes.
Personalized interventional psychiatry
There is a growing demand for innovative therapies for patients with mood disorders and treatment-resistant depression. The UC Mood Disorders Center provides evidencebased treatments tailored to an individual patient’s needs. These include: transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT) and ketamine nasal spray. These treatments result in the most dramatic positive changes to the lives of patients with treatment-resistant depression that are seen in this field including symptom remission rates of approximately 60-80%.
As one of only a few sites in the U.S. providing ketamine treatment, we are also leading the way in research to understand its effectiveness in treating depression and suicidality. Our research psychiatrists are also currently involved in studies on novel psychedelic treatments that offer promise for the treatment of depression. Additional support would allow us to accelerate and expand our research efforts on these therapies.
Philanthropy has the potential to greatly impact our department’s ability to expand our clinical services in these areas, providing access to an increasing number of patients that we are currently unable to treat. For example, due to space and staffing constraints, we are currently at capacity for the ketamine clinic, while our current patient demand doubles the amount of treatments that we can deliver today.
EDUCATION
Building excellence in care, specialty training and research
From nurse practitioners and physician assistants to psychiatry fellows, as an academic medical center we offer specialty, hands-on training and mentoring from our department of nationally recognized faculty-clinicians.
Medical Student Scholars Program
UC College of Medicine Psychiatry Medical Student Scholars Program (MSSP) is focused on incorporating a psychiatric research experience and mentorship within medical school studies.
The MSSP is a longitudinal program that spans four years of medical education, with an intensive research component taking place in the summer between the first and second year of medical school. This program gives students early exposure to the field of psychiatry in general, and psychiatric research, specifically. Students apply to the Psychiatry and Behavioral Neuroscience MSSP after their first semester of medical school. The program provides a stipend for the summer period of research, made possible by philanthropic support.
Residency programs
Following medical school, students pursuing psychiatry have several options for residency. While most graduates go into a categorical psychiatry program that is four years, UC also offers two programs that combine multiple specialties in a five-year residency. These include Family Medicine and Psychiatry; and Pediatrics, Child/Adolescent and Adult Psychiatry.
These rigorous training programs prepare residents to sit for the board exams of both specialties, while gaining skills and experience in integrated care. Opportunities to further grow and sustain our residency programs include:
• Creation of an endowed residency program director, to protect faculty time and balance of duties across clinical care, education and research.
• Scholarly support to current residents for travel and research, to enrich their experiences and to help recruit and retain top candidates.
Fellowships
One-year post-graduate training programs provide the opportunity to advance in a subspecialty area of psychiatry/ mental health care such as addiction, forensic, geriatric, child/adolescent/ young adult and research. Fellowship positions include MDs and PhDs but also extend to opportunities for physician assistants and nurse practitioners who wish to pursue specialized training in mental health. Additionally, allied health professionals (such as social workers, therapists and psychologists) also seek out clinical hours to enhance their training and experience working in the mental health care field.
Education and training programs
The UC Gardner Neuroscience Institute is a magnet of talent, attracting out-of-state high school graduates and potential graduate students to Ohio with the promise of a world-class education, mentors in research and industry, and access to leading laboratory and clinical facilities. We plan expansion and support of the following areas:
• Simulation lab space and training support
Several of the top programs in the country use simulation-based training: realistic clinical environments that blend learning with virtual and hands-on experiences through a model of team-based patient care. At UC, leadership from across the academic health center and UC Health have articulated a high-level vision and operational model for a simulation center that will teach not only basic procedures but also complex neurological care skills.
• Student recruitment and programming
The UC College of Medicine is committed to building a physician workforce that accurately reflects the community we treat. Our mission is to recruit and retain the most talented students, residents and faculty to our academic medical center and support them in pursuing neuroscience specialties.
• Continuing medical education
Training programs will provide continuing medical education in our areas of excellence. New programming will offer primary care physicians opportunities to enhance learning in often requested specialties like depression and anxiety.
MEASURES
OF SUCCESS
Philanthropic support will speed our time to impact in the areas of research, patient care and training the next generation. We will track and measure our success in these areas through improved scores and metrics in:
Research
Our research portfolio will grow and be measured by: the number of publications in top level journals, faculty presentations at conferences, and scores/rankings from the National Institutes of Health and Blue Ridge Rankings. Additionally, we will track membership growth in premier research networks such as StrokeNET, Mood Disorders and the Alzheimer’s Disease Research Centers (ADRCs).
Clinical
Investments into personalized medicine and clinical advancements will be measured by: improving patient outcomes (relevant to a patient’s quality of life including symptoms, functionality, and physical, mental and social health), impacting key hospital metrics like decreasing mortality and re-admissions rates, and improving patient safety and satisfaction. These will additionally support our reputation rankings in mass media outlets like U.S. News and World Report.
Education
Being a destination for complex neurological care also means being a destination for the best and brightest talent—from students pursuing our residency and specialty fellowship programs to new clinicians and researchers. As demand increases for limited spots (for example, hundreds of fellowship applicants for 10 openings), so will competitiveness and the strength of applicants, along with the quality of care and research across the institute. Professional physician networks like Doximity and professional organizations like Association of American Medical Colleges will help us measure this.
THANK YOU
We’re grateful for your thoughtful consideration of a leadership gift in support of our 10-year vision for psychiatry and behavioral neuroscience.
CONTACT
Emma Laverty
Associate Vice President for Development University of Cincinnati Foundation
Emma.Laverty@foundation.uc.edu
610-331-9046
Jonathan Agree
Vice President for Development, Academic Medicine Enterprise University of Cincinnati Foundation
President, UC Health Foundation
Jonathan.Agree@foundation.uc.edu
610-533-3014
To learn more about how philanthropy can make a meaningful impact, scan the QR code or visit foundation.uc.edu/ucgni/psychiatry