BrainStorms 2021 Spring Edition

Spring 2021 The publication of the University of Miami Department of Psychiatry and Behavioral Sciences

In This Issue

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How to Talk to Your Loved Ones About Mental Health Tips from Felicia Gould, Ph.D., assistant professor and clinical neuropsychologist

Rosie Curiel Cid, Psy.D., Co-Chairs the 2021 Alzheimer’s Public Educational Forum

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Coping With Isolation and Other Stressors

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You Need More Than Sleep to Feel Rested

Barbara J. Coffey, M.D., M.S., on helping our elderly loved ones navigate these trying times

Residents, Medical Students Accepted to American Association for Geriatric Psychiatry (AAGP) Scholars Program

Professor Firdaus Dhabhar, Ph.D., discusses the important differences between sleep and rest

Maintaining Optimal Brain Health in Challenging Times Marcela Kitaigorodsky, Psy.D., assistant professor and neuropsychologist, Center for Cognitive Neuroscience and Aging Katherine Gorman, Psy.D., postdoctoral fellow, Center for Cognitive Neuroscience and Aging

Letter from the Chair Dear Friends, It’s hard to believe a year has gone by since COVID-19 upended our lives. Many of us have tried to emerge from 2020 hopeful about this new year and eager to return to activities pre-pandemic life afforded us. We’ve already seen approval for Emergency Use Authorization of several vaccines. Some institutions have also begun pediatric clinical trials—an encouraging sign that our youth may soon be eligible to receive protection against COVID-19. Hope appears to be on the horizon.

The emphasis on the importance of mental health remains especially strong. We in the department are hopeful that this is a positive step toward more regular conversations about maintaining one’s mental health not only during crises or in the face of hardships, but all the time.

Though we are still facing challenges and working through uncertainties, there are some exciting things happening in the Department.

On June 11, we will hold a virtual graduation ceremony to celebrate our Resident Class of 2021 and wish them well on their next endeavor. This summer we will welcome a new class of 14 promising residents, four of whom recently earned their MDs at the Miller School.

I am thrilled to welcome back Dr. Suchitra Joshi as assistant professor in the Division of Child and Adolescent Psychiatry. Dr. Joshi completed her fellowship at UM in 2018 and has rejoined the Department. I am ecstatic that Dr. Joshi has chosen to launch her career with us.

I am also pleased to share that Associate Professor Dr. Dante Durand has been promoted to Vice Chair of Clinical Services. As we continue to grow the Department, Dr. Durand will be instrumental in helping to implement and promote clinical programs designed to deliver patient care that is personal, coordinated, evidence-based and of the highest value to benefit the mental health of our patients. Dr. Durand will continue in his role as Medical Director of the Adult Outpatient Clinic at Jackson Behavioral Health Hospital.

Lastly, I’m excited to announce that we will be updating the mission, goals and priorities of the department. Through strategic planning sessions and group discussion, we are taking a deep and detailed look at opportunities to propel the Department into the future of psychiatry. We will keep you updated and look forward to sharing an innovative and updated vision.

Most Sincerely,

Barbara 1 BRAINSTORMS | SPRING 2021

How to Talk to Your Loved Ones About Mental Health When Felicia Gould, Ph.D., a clinical neuropsychologist with the University of Miami Health System, thinks about mental health, she likes to quote her former department chair: “There is no health without mental health.”

Maybe you’ve seen a friend or family member’s emotional state suffer during the pandemic. Perhaps mental illness runs in your family, and you worry about certain behaviors in your child, spouse, or sibling. How do you voice your concerns kindly and clearly?

“I encourage people to do their best to have those potentially uncomfortable conversations on any aspect of mental or physical health,” Dr. Gould says. Her techniques, developed over years of working with patients, can guide you to discuss sensitive topics with those you love.

Be prepared

Conversations about mental health should be an ongoing process. An intense, one-time intervention is unlikely to resolve an issue. Before any discussion, check yourself first.

Make sure you’re calm and collected before speaking.

“More than 80% of communication is non-verbal.

If you’re upset, nervous, or angry, the other person will pick up on your body language,” Dr. Gould says.

Talking points

Have a plan—jot down your concerns, suggestions, and any positives so everything is clear in your mind.

Pick a time when you’re less likely to be interrupted.

Dr. Gould recommends starting with education, especially when speaking to a young person or teen.

If you think someone is depressed, for example, know the symptoms and causes.

Delivering your message

Some basic rules can help steer your conversation in a positive direction: l l l l l l l

Be a good listener Practice empathy Avoid giving advice Don’t label or judge Don’t pressure the person to take medication Steer clear of blame Offer perspective

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The sandwich technique

Try easing into difficult conversations using Dr. Gould’s “sandwich” technique. “You sandwich the negative topic between two positives. You might start by saying, ‘You’re so valuable to me and this family. You’re a great provider. On the other hand, I see you isolating, angry and pulling away.

Am I wrong? I want you to fully enjoy life, and I appreciate you listening to me,’” Dr. Gould says.

This technique may open the door to future discussions and potential solutions.

Finding answers

Make sure you rule out any underlying health problems. “Suggest that the person see their primary care doctor,” Dr. Gould says. Self-care is next.

“Are they eating three healthy meals a day, getting enough sleep, activity, and socialization?”

Dr. Gould asks, adding, “Self-care starts young; even children can learn self-care. If your child or teen doesn’t understand how to practice self-care, teach them.”

Remember, however, as children mature, they are increasingly responsible for their self-care.

Maybe you’ve seen a friend or family member’s emotional Talk therapy helps many people regain emotional health. Consider starting with family therapy; counseling may feel more approachable when the spotlight isn’t focused on one person.

Eventually, people can “work their way up” to oneon-one sessions with a therapist. What if your loved one doesn’t take action or accept help?

“Whether it’s addiction, depression, anxiety, or another issue, it’s ultimately their journey. Plenty of people seek supportive counseling because their significant other refuses to seek help.”

Hereditary issues

Mental health concerns like bipolar disorder and depression often run in families.

“When you discuss this concern, mention someone who successfully dealt with their problem.

For example, ‘Your uncle struggled with depression, and he’s doing better now.’ You could also talk about a famous person who successfully dealt with their mental health issue. Sometimes, you may need to bring up people who’ve succumbed to their illness: ‘I’ve seen this happen in others, and I don’t want to lose you.’”

Here’s a recap of Dr. Gould’s step-by-step approach for having tough talks: l

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Start with a compliment or positive comment Express your concerns Present possible options and solutions End on a positive note: “I care about you and want you to enjoy life. I’m here for you if you need to talk.”

Follow-up: “We discussed this a while back, but I haven’t seen any changes.”

Or, “I’m checking in. How are you doing?”

Helping vs. enabling

It’s harder to practice tough love during a pandemic when many families are together 24/7, regardless of behavior.

Dr. Gould says there is a significant difference between financially enabling someone using drugs and asking them to leave the family. Again, it comes back to self-care.

From setting boundaries to making time and space for yourself and seeking counseling support, safeguarding your mental health is paramount.

While you’re at it, check in with yourself, too.

“If anything, our mental health is more important now than ever,” says Dr. Gould.

If you or someone close to you has suicidal thoughts, call 9-1-1 or the 24-hour National Suicide Prevention Hotline at 800-273-8255. The hotline is available in English and Spanish.

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Rosie Curiel Cid, Psy.D., Co-Chairs the 2021 Alzheimer’s Public Educational Forum This year, for the first time, the Mild Cognitive Impairment (MCI) Symposium, Workshop, and Public Educational Forum was held virtually. A restructure of the usually in-person program consisted of live presentations, Q&A sessions, and panel discussions.

Presented by The Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center and 1Florida Alzheimer’s Disease Research Center, the event offers a space where new information is provided and in-depth discussions take place about the earliest stages of Alzheimer’s disease and related disorders. Speakers included experts in the fields of neurology, neuropsychology, psychiatry, geriatrics, epidemiology, genetics, imaging and neuropathology.

In 2013, the MCI Symposium introduced the first Alzheimer’s Public Educational Forum for patients, at-risk family members and caregivers. This segment originated in response to the need for increased information from the general public about risk factors, early detection, prevention and treatment of Alzheimer’s disease and related conditions.

This year’s Public Educational Forum was sponsored by Mount Sinai Medical Center, Miami Beach, the University of Florida and the 1Florida ADRC. Rosie Curiel Cid, Psy.D., associate professor and chief of cross-cultural neuropsychology and cognitive neuroscience, co-chaired the virtual forum and David Loewenstein, Ph.D., director of the Center for Cognitive Neuroscience on Aging and associate director of the full ADRC, served as a presenter, answering the many thoughtful questions submitted by the public.

More than 800 people registered.

“The astonishing increase of those receiving a diagnosis of Alzheimer’s dementia or other related disorders continues to significantly impact our population,” Dr. Curiel Cid said. “From patients to families to caregivers, there are few people left unaffected by this disease. During the covid pandemic alone, deaths in the U.S. due to Alzheimer’s or dementia increased 16%. This is monumental growth just in the last year and it was reflected in the vast forum audience.

Everybody wants answers and treatments and cures and we are working determinedly to find them.”

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One unique aspect of the 1Florida ADRC as it relates to both professional and lay education is the Annual MCI Symposium and the accompanying Public Education Forum. Our academic-community partnerships thus far have facilitated broad dissemination of this forum that serve as a bridge to support the goals of the CNSA. This forum allows Alzheimer’s disease and related disorders stakeholders across the state and country to “meet the scientists” to foster some of the activities that the center very much cares about: education, recruitment of new participants, retention of existing participants and collaboration with other Alzheimer’s Disease Centers (ADC).

This is one innovative example for the Center’s Outreach, Recruitment and Engagement Core, given

the transference to a virtual event for the first time. This is a special educational event, a unique contribution from our 1Florida ADRC to the overall ADC network.

In 2020, Dr. David Loewenstein, Director of the CNSA, and his team of expert investigators together with other Florida institutions, were awarded a $15 million grant to collaborate on Alzheimer’s disease research. The five-year National Institutes of Health/National Institute on Aging grant brings together top Florida researchers to focus on better understanding how to diagnose, treat, prevent, and potentially cure Alzheimer’s in diverse populations. The consortium of these institutions is the 1Florida Alzheimer’s Disease Research Center.

More than 6 million Americans are living with Alzheimer’s.

By 2050, this number is projected to rise to nearly 13 million.

In 2021, Alzheimer’s and other dementias will cost the nation $355 billion. By 2050, these costs could rise as high as $1.1 trillion.

One in nine people age 65 and older (11.3%) has Alzheimer's dementia.

One in three seniors dies with Alzheimer’s or another dementia. It kills more people than breast cancer and prostate cancer combined.

Source: 2021 Alzheimer’s Association Facts and Figures Report.

Age, education areas and sex may have significant effects on cognitive test performance in many areas We are fortunate in many cases that there are significant amounts of large normative data on the expected performance on different cognitive tasks which account for age, sex and level of educational attainment. Like blood tests where there are acceptable ranges. For example if a test of memory falls so far out of normal range where the individual’s performance falls at the lower 8th, 5th or 1st percentile relatively to cognitively unimpaired individuals of similar age, sex, ethnic and educational background, that test is considered abnormal.

Factors such as anxiety and depression can have an effect on test results but only to a certain extent on specific tests. Experienced neuropsychologists can look for patterns in test results that indicate whether scores are indicative of these conditions or are more consistent with patterns such as Alzheimer’s Disease This can further be verified though neuroimaging of the brain through MRI or amyloid PET by our physician colleagues.

Our 2019–2020 Annual Report is out!

We consolidated this report to reflect our work over the last two years. Despite the coronavirus pandemic, the members of our Department worked tirelessly to keep our patients healthy, our programs afloat, and even initiate new programs. We hope you enjoy reading about our activities.

To view the digital version of our Annual Report, please visit issuu.com/umpsych. To request a print copy, please email psychiatry@med.miami.edu.

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Coping With Isolation and Other Stressors

By Barbara J. Coffey, M.D., M.S.

The coronavirus crisis put everyone on high alert. We don’t just worry about getting sick or seeing friends or family members fall ill, we’re having to deal with new safety protocols, restricted freedoms and a heightened sense of isolation. These concerns are especially acute for the elderly, who are at much greater risk from the virus.

I am hearing people ask how they can support their elderly relatives and friends during this time. One caregiver described how she’s caring for her 90-year-old mother at home. Her mother is healthy, but recently has become very emotional over minor things such as when the daughter helps her with meals or bathing.

These are tasks the daughter did before the pandemic.

The daughter is struggling with a big question: How can I help my mother so she can get back to being a strong, happy woman, the way she was before the coronavirus pandemic?

I am a child psychiatrist by training, but I can tell you that there are many similarities between geriatric psychiatry and child psychiatry. For this caregiver, the first order of business is to make sure her mother has not been exposed to COVID-19 and does not have the virus. In the elderly, the virus can present in different ways, apart from the classic shortness of breath, fever and cough.

[Seniors] also have the benefit of wisdom, or what some people call the long view.

They have lived through other trying times, and may have the perspective to say, “This too shall pass.”

Secondly, as I would advise parents of children, it’s important to provide a basic understanding of what is going on right now, but don’t overburden vulnerable people with too much information. Set aside time to discuss the topic in a straightforward and thoughtful manner. Answer questions, but don’t overwhelm them with excess information they haven’t asked for.

This is important whether you’re dealing with an elderly person or a child. It may also be that her mother is feeling isolated from the rest of her family and friends, and being excluded from visits to minimize her risk of exposure. In this situation, I encourage caregivers to help the elderly person stay in touch with others.

That’s very important, for the elderly and for children.

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And it’s especially important if your elderly relative is in a senior care facility and can't visit him or her. If that’s the case, keep the lines of communication open and consistent. Schedule a FaceTime or Zoom call or phone call on a regular basis. The elderly love to receive mail. A simple card or short note makes them feel connected to the outside world.

If you have a child at home, have him or her draw a picture to include with your note. If the facility allows you to speak to your relative through a window, take advantage of it.

Check on your relative’s emotional and physical state of health by speaking to the facility staff at regular intervals.

Do men and women cope differently with isolation?

It depends on the individual. Women often tend to have very strong social networks of friends. Some men, on the other hand, have their spouses and may not have as large a network. It’s important to recognize that there are differences in the way people respond to isolation and to accept people where they are.

From a health standpoint, we do know that COVID-19 affects men more than women. It’s not known if that’s because of an immune system response or something else, but it may have an impact on how people deal with the emotional aspects of COVID-19. Men may think, “Should I worry about getting this virus a lot more than my wife has to?”

The elderly must be especially careful about being exposed to the virus. This requires more self-isolation and a disruption to their routine. However, they also have the benefit of wisdom or what some people call the long view.

They have lived through other trying times, and may have the perspective to say, “This too shall pass.” In the meantime, realize that, like the rest of us or perhaps even more so, they require extra support and understanding.

Barbara J. Coffey, M.D., M.S. Professor and Chair, Department of Psychiatry and Behavioral Sciences University of Miami Health System

Awards and Recognition Residents and Medical Students Accepted to 2021 American Association for Geriatric Psychiatry (AAGP) Scholars Program Four psychiatry residents have been accepted to the prestigious 2021 American Association for Geriatric Psychiatry (AAGP) Scholars Program. Congratulations to Dr. Sung Min Ma, Dr. David Martinez Garza, Dr. Julia Salinas and Dr. Ahmed Valdes, Jacob Rosewater and Neil Mehta!

The AAGP Annual Meeting is the premier educational event in geriatric mental health care, providing the latest information on clinical care, research on aging and mental health, and models of care. The AAGP membership provides scholarship funding for eligible medical students and psychiatry residents to attend the AAGP Annual Meeting and supports a special educational program for trainees during the meeting. The aim of the Scholars Program is to encourage trainees to pursue specialized training in geriatric psychiatry to meet the mental health needs of the expanding population of older Americans.

Ahmed Valdes, M.D. is a current

PGY-2 interested in the intersection of medicine, neurology and psychiatry with particular interests in helping patients with delirium, dementia, psychosis and catatonia as well as collaborate care with the teams taking care of them.

Sung Min Ma, M.D.

is a current PGY-2 resident interested in mood disorders, dementia, public and cultural psychiatry, psychodynamics, and systems / delivery of care.

Neil Mehta

is a current 4th year medical student interested in dementia, phobias, mood disorders, and personality disorders.

David Martinez Garza, M.D.

is a current PGY-3 and rising Chief Resident whose interests lie in neuropsychiatry, psychotic-spectrum disorders, Alzheimer’s disease, neuroimaging (structural and functional) and addiction psychiatry.

Jacob Rosewater

is a third-year medical student and Co-President of the Psychiatry Student Interest Group who is planning to apply for psychiatry residency soon.

Julia Salinas, M.D. is a current

PGY-3 planning to pursue a fellowship in Geriatric Psychiatry with a particular interest in clinical research. Some of her research interests include neurocognitive disorders and serious mental illness in the elderly.

MindGames, the American Psychiatric Association’s national residency team competition, is intended to stimulate and challenge residents on their medical knowledge and care of patients with mental illness and substance abuse disorders. Typically held in person, this year’s MindGames took place virtually and 102 teams competed. The UM/JMH Psychiatry residents earned sixth place out of 102 teams!

Congratulations to Drs. Natalie Martinez-Sosa, Dr. Matthew Bojanowski, and Dr. Jordan Levy on demonstrating tremendous knowledge of psychiatric disorders and proudly representing UM and Jackson!

left to right: Dr. Natalie Martinez-Sosa, Dr. Matthew Bojanowski, and Dr. Jordan Levy

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You Need More Than Sleep to Feel Rested You’re healthy, you’re getting enough Zzz’s, but somehow you feel unusually tired. Morning wake-ups are a struggle, afternoons a slog. You even drag through dinner, eager to crawl back into bed, figuring a good night’s sleep will magically restore your pep. If this describes your behavior, more sleep may not be the only medicine you need. The prescription may also call for rest and relaxation—a concerted effort to step back and do nothing.

What’s the difference between rest and sleep?

Rest and sleep are related but not synonymous, says Firdaus Dhabhar, Ph.D., expert in psychiatry, microbiology, and immunology at Sylvester Comprehensive Cancer Center and a professor at the University of Miami Miller School of Medicine.

“Rest is different from sleep because you can be at rest, and get rest, without being asleep,” Dr. Dhabhar adds.

It’s easy to confuse the two, of course, because when we don’t get enough of either. The end result is the same: exhaustion.

In fact, restless sleep is often the culprit of our lethargy. “It is possible that you might sleep for a long or reasonable amount of time, but if your sleep is disturbed and if you don’t have sufficient periods of deep sleep and REM sleep, then you might not feel rested even though the quantity of sleep seems like it should have been enough,’” he says.

Let’s assume, however, that good, deep slumber hasn’t fixed your fatigue.

You’re chronically tired, maybe even burned out.

Job pressures, family demands, and financial worries weigh heavily, disturbing your every waking moment. Throw in the societal expectations of being plugged in 24/7 and it turns into the perfect recipe for bone-deep weariness.

Dr. Dhabhar recommends tuning out and shutting off. In short, trying for “a state where one is largely free of stress and strenuous mental or physical activity.”

This, however, may be easier said than done.

Also, COVID-19 has made true rest and good sleep that much more difficult. As Dr. Dhabhar acknowledges, “Unfortunately, the pandemic has increased the levels of “bad” stress for many, if not most of us.”

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The weary and the exhausted shouldn’t despair, however.

Dr. Dhabhar has several suggestions: l

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Start by thinking of rest as essential.

“A good amount of rest is critical for health and healing,” he says.

Don’t worry about not having a particular hour or a set number of minutes to unwind and tune out.

You can always start slow and build up. “How much time depends on what you nee and what the demands on your life will allow. However, even if you don’t have the “ideal" amount of time, it is likely to be helpful if you can take some time off to just let yourself BE in a stress-free state.”

Give your mind and body time off from strenuous activity. “Physical activity and exercise have many benefits, but these active states are different from being at rest,” he adds. In other words, your morning mile may release wonderful endorphins, but it won’t necessarily offset your rest deficit.

Relax while reading a pleasant book or article.

Watch a nature documentary. Complicated and/or controversial are out of bounds during rest time.

Tune into your environment. “Sitting by the ocean and watching the waves, feeling the breeze, taking in the mountains, or the birds, bees, and trees, and even admiring the people-made beauty of an urban setting in a stress-free state is another way to get rest,” Dr. Dhabhar says.

Hang out with a close friend or family member, but make sure that it’s in “a non-judgmental, non-critical, non-competitive, loving, caring, stress-free manner.”

Slow down, listen to music you like, take regular breaks from your desk, and turn off the electronics at the end of the workday.

Take a nap.

Sleep is always restorative.

Maintaining Optimal Brain Health in Challenging Times

By Marcela Kitaigorodsky, Psy.D., and Katherine Gorman, Psy.D.

Brain health is important for an active, happy, fulfilling life. During times of stress, we can easily let our physical and mental health slide. COVID-19 has been challenging and has greatly impacted our typical routines.

However, here are six ways in which we can still promote brain health during challenging times.

1. Use it or lose it Staying cognitively active can help stave off signs of aging, including symptoms of dementia. Consider taking up a new hobby, such as cooking, gardening, card games, or coding. Learning new skills, such as a new language or musical instrument, improves overall cognitive function and memory abilities.

2. Working out What is good for the heart is good for the brain. Regular exercise improves cognitive functioning while reducing cerebrovascular risk factors. Going for a brief walk between zoom meetings, using a fitness tracker to track steps, practicing yoga by watching guided YouTube exercises, or using an exercise application that provides exercise classes are all excellent ways to remain active.

3. Limit alcohol Twenty-nine percent of Americans increased their alcohol intake during the pandemic, likely due to increased stress, loneliness, anxiety, depression, and boredom. While Zoom cocktail hours offer a convenient way of socializing, limiting alcohol intake is important for brain health. The Centers for Disease Control and Prevention currently recommend up to one drink daily for women and two drinks daily for men. If you notice you have been drinking more lately, consider trying out some new “mocktail”recipes instead.

4. Distant Socializing Finding safe ways to socialize has been one of the greatest challenges of the pandemic. Socialization is crucial because it keeps our brains active while also providing emotional support. Fortunately, we are in the age of technology and can engage in many of our usual social activities over Zoom, FaceTime, or other applications. Great ideas for socializing include organizing virtual book clubs, trivia nights, religious services, and even drive-thru movie nights or virtual birthday parties.

Socializing outdoors with appropriate distance and mask wearing can also be considered. Some ideas include going with a friend for a hike, a bike ride, fishing, or a walk.

5. Sleep hygiene Adequate sleep is critical to brain health. This might be challenging lately due to increased stress and disrupted routines. To improve sleep, wake up at the same time every day, even if you have nothing planned.

Two hours before bedtime, turn off electronics, take a warm bath, listen to music, read a book, or engage in a relaxing activity. Wait until you feel sleepy to get into bed so that you fall asleep quickly and your brain learns to associate the bed with sleep. Worrying is keeping you up? Make a to-do list or write down your worries earlier in the evening so you can get these thoughts off your mind.

6. Emotional well-being is pivotal for brain health.

If you are struggling with anxiety, depression, or grief, consider making an appointment with a psychologist or psychiatrist. Most services are available online, including a broad range of support groups. Find a provider at https://doctors.umiamihealth.org/ Marcela Kitaigorodsky, Psy.D. Assistant Professor Center for Cognitive Neuroscience & Aging Katherine Gorman, Psy.D. Postdoctoral Fellow Center for Cognitive Neuroscience & Aging

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What to Do & Where to Go

Common Purpose Transforming lives through teaching, research and service.

For a Mental Health Emergency, CALL 911 if you believe someone is in danger of hurting themselves or others.

Jackson Behavioral Health Hospital Triage 305.355.7332 Silver Alert If your loved one has gone missing, please CALL 911 immediately.

Silver Alert is a statewide initiative to involve the public in locating a cognitively impaired person who has gotten lost driving or while on foot.

For more information visit florida silveralert.com.

Office Numbers Main Psychiatry Appointment Scheduling 305.243.0214

Chairman’s Office 305.243.6400

Courtelis Center 305.243.4129

University of Miami Hospital (West Building) We offer telehealth appointments for psychiatric and psychological services, please call 305.243.0214

Deerfield Beach 954.571.0117 Center for Cognitive Neuroscience and Aging (CNSA) 305.355.9080

Child & Adolescent 305.355.7148

Brain Fitness Pavilion 305.355.9080 *English, Option 3

Soffer Clinical Research Center 305.243.2301

Memory Disorders Clinic 305.355.9065

COVID-19 Resources

Mental Health Resources

For updates on UM actions and policy changes related to coronavirus please visit umiamihealth.org

In addition to UM, these organizations are offering mental health support and information during the pandemic.

Our Center for Cognitive Neuroscience and Aging’s statement on COVID-19 cnsa.med.miami.edu World Health Organization Follow the WHO’s global response to the coronavirus pandemic www.who.int Centers for Disease Control and Prevention The latest guidance and recommendations for fighting coronavirus in the U.S. www.cdc.gov National Institute of Allergy and Infectious Diseases Emerging research on the novel coronavirus www.niaid.nih.gov

The University of Miami Leonard M. Miller School of Medicine Department of Psychiatry and Behavioral Sciences is committed to: Conduct research that deepens our understanding of the development, pathophysiology, and prevention of psychiatric illness and the nature of human behavior, and apply this knowledge to the development and delivery of more effective, evidence-based treatments.

Offer comprehensive treatment and consultation to our patients, their families, and the community.

Provide outstanding mental health education and multidisciplinary training to the next generation of healthcare providers and investigators.

DIRECCT Core values l Diversity l Integrity l Responsibility l Excellence l Compassion l Creativity l Teamwork

American Foundation for Suicide Prevention www.afsp.org National Suicide Prevention Lifeline 1.800.273.8255 suicidepreventionlifeline.org National Alliance on Mental Illness www.nami.org/Home Mental Health America www.mhanational.org/covid19

The publication of the University of Miami Department of Psychiatry and Behavioral Sciences Executive Editor Samantha Richter Soffer Clinical Research Center 1120 NW 14th Street | Suite 1457 Miami, FL 33136