Psychiatry

Little Free Library offers books for young patients

The Little Free Library is a new highlight to the Child and Adolescent Clinic on the third floor of Poynter Hall.

Starting in October, when patients arrived on the third floor of Poynter Hall, they noticed something new. Right in the middle of the Child and Adolescent Clinic waiting room sits a Little Free Library. The wood box with a glass front door holds books for young  patients to read, take home, or donate new books.

“The goal was to get some children’s books that reflected neurodiversity and developmental diversity. Children will be able to read books about transitioning to school, dealing with disabilities, going through a divorce, but also just to create something for children to look forward to when they arrive for an appointment,” said UNMC Child Psychologist Dr. Jonathon Sikorski, who wrote the proposal for the Free Little Library.

It operates under the premise of a “take a book, leave a book” free book exchange. There are currently more than 50,000 Little Free Libraries around the world.

“The goal of the project would be to provide our families, who are often low-income and from underserved populations, an opportunity to read books that positively impact and reflect the situations and struggles they are going through at the time. It is a great way to provide a simple outreach service for all divisions that can support itself well into the future,” Dr. Sikorski said. “It’s also a lot of fun.”

The Nebraska Guild donated $1,000 to build and install the library as well as fill it with books. Dr. Sikorski said book donations are welcomed, especially older books, which may no longer be in print. Donations can be dropped off on the third floor of Poynter Hall or mailed to the UNMC Department of Psychiatry, 985575 Nebraska Medical Center, Omaha, NE 68198-5575.

Dr. Hwang presents findings on Oxytocin research

UNMC Research Director Dr. Soonjo Hwang

UNMC Department of Psychiatry Research Director Dr. Soonjo Hwang presented his latest research findings on Oct. 10-11 at the Great Plains IDeA-CTR Second Annual Scientific Meeting at the Truhlsen Campus Events Center at UNMC.

The research project enrolled 24 adolescents with disruptive mood and behavior disorders. Dr. Hwang says irritability is a significant mental health issue in the pediatric population and occurs in children and adolescents with various psychiatric diagnoses. Dr. Hwang and his research team have been looking at the impact of Oxytocin on children and adolescents with severe levels of irritability/emotional dysregulation/and aggressive behavior.

Dr. Hwang said one of the established neurobiological mechanisms of irritability is increased activation in the amygdala and other neural areas responsible for the acute threat response system. Oxytocin is a hormone with a commonly suggested mechanism being a reduction of activation in this system, and therefore may be potentially a mechanism-based treatment option for irritability.

The study hypothesized that administration of intranasal oxytocin would be associated with improvement in levels of irritability as well as a decrease in the heightened response of the acute threat response system to emotional stimuli on functional MRI (fMRI ). Dr. Hwang also anticipated a positive correlation between the level of reduction in response of the acute threat response system observed on f MRI with improvement on irritability symptom profiles (rating scales measuring specific aspects of irritability, including reactive and proactive aggression and callous emotional trait).

The 24 adolescents were assigned to either placebo or Oxytocin for three weeks. Pre- and post-treatment irritability rating scales, f MRI and MEG scans were completed.
“Oxytocin intranasal administration can be a potentially clinically innovative and effective treatment modality for youths with significant levels of irritability; as a mechanism-based treatment modality,” Dr. Hwang said.

Dr. Hwang’s current study has lead him to submit an NIH U Grant proposal to study single-dose pharmacokinetics of intranasal Oxytocin and fMRI in 14-18 year olds with clinically significant irritability.

Department of Psychiatry Research Lead Brigette Vaughan and Research Assistant Arica Lerdahl as well as Boys Town National Research Hospital researchers Herma Meffert, Stuart White, Tony Wilson and James Blair are working with Dr. Hwang on the project.

Spotlight: Liz Wiese

Office Assistant II
Department of Psychiatry

Liz has worked at UNMC since 2005. Her duties have included clinical reception, billing, administration, and student education. She has served in many key roles on the GME steering committee, including taking minutes, organizing meetings, and award presentations. Liz helped in the creation of the Program Information Form as well as Program Letter of Agreement.

Could you start by listing when you started with the Department of Psychiatry and some of the roles you have had?

Liz Wiese

I started in the Department of Psychiatry at UNMC November 30, 2009 in the billing department. I worked in the billing department for a few years then started helping
with the student education. My job description evolved again and I was no longer doing billing but helping at the clinic front desk along with the student education. I am currently working in administration and no longer work at the clinic front desk. I have also helped with Grand Rounds since 2013.

Could you discuss the work you have the done with the GME team?

I have gotten our Program Letters of Agreements sent out and kept track of, set up numerous meetings, taken minutes for all our meeting, went to a few site visits, kept track of CV’s, put PIF books together, and gotten awards printed and put together as well.

Why did you go into the area of Psychiatry?

I had been working in the medical field for a few years but was ready for a change and had been trying to get on at UNMC for quite some time. My sister worked in this department so she was my in. I have been here ever since.

What are some of your hobbies?

Right now my hobbies include planning for our baby we have coming in March. Besides baby planning, my husband and I have our own Harley Davidson motorcycles that we enjoy taking out when the weather permits. We also help out with a bulldog rescue that keeps us busy with fostering dogs and getting them rehomed.

Flores tackles “Color of Medicine”

Dr. Sheritta Strong and Graduate Student Laura Flores

On Oct. 10, Laura Flores discussed challenges specific to under-represented populations in medical school as part of a presentation titled, “The Color of Medicine.”

Flores, a first-year graduate student in the Medical Degree/ Ph.D. Scholars Program, was honored in the Walls Do Talk Challenge sponsored by She Leads Healthcare and Harvard University. She was one of two winners. Flores won the public vote for her presentation “Walls.”

The contest focused on creating an anti-bias learning environment in medical schools. Submissions are the student’s vision of what a typical medical school or hospital-affiliated portrait wall would look like in that context.

Flores said she wanted to participate in the challenge for a few reasons. A native of New Mexico, which has a large Hispanic population, Flores said she never really felt different until she moved to Nebraska after being accepted in the M.D./Ph.D. program. It was during her first year at UNMC, Flores said she began to hear unflattering statements that alluded to the only reason she was admitted to medical school was due to her race and not her ability.

Laura Flores says about being a Hispanic woman in medical school: “I desperately want this wall to come down and reveal a strong Hispanic woman – a woman I am proud of. But for now, it reflects loneliness; a feeling minority students experience too often.”

Flores has begun speaking about issues specific to the under-represented population in small groups and large groups.

“Being asked to speak to large groups helps me feel like I belong. It helps me feel empowered,” Flores said. “I think it’s a huge deal to get this out into the open, especially in a place like Nebraska. Without doing these large group meetings, no one would hear about it. When it’s just us four students, it’s easy to talk about it because we all feel the same. It’s intimidating to talk to people who don’t feel the same way that you do.”

Flores’ presentation also discussed the importance of mentors. Flores said of the importance of children having a mentor: 55 percent are likely enroll in college, 78 percent volunteer, 130 percent are likely to hold leadership positions and 90 percent also become mentors.

“Mentorship leads to a sense of belonging,” Flores said. “They are there to tell you that you belong, that you’re in medical school for a reason. It’s good to hear that from someone who has some power because I could tell myself that all day long and never believe it.”

 

Psychiatry plans for new Residency Program

The Department of Psychiatry GME Steering Committee

The UNMC Department of Psychiatry is building its own residency program, which will blend academic excellence and front-line clinical experience.

UNMC Department of Psychiatry Interim Chair, Dr. Howard Liu, said the goal is to design a new residency program, which will begin in July 2020 and serve Nebraska’s needs for
decades to come.

“The goal is to not design the best residency program in Nebraska, but to develop one of the best residency programs in the country. We will know we’ve begun our journey when our best M4s choose to stay in our program. We will recognize that we’re halfway there when we open new fellowships in full range of psychiatric specialties. And we will know that we’ve truly arrived when our graduates are nationally known for their expertise while increasing access in our most underserved Nebraska communities.”

Residents will work with UNMC and its clinical partner, Nebraska Medicine, a well-established academic health system in the region with 809 licensed beds at its two hospitals, more than 1,000 physicians, and more than 40 specialty and primary care clinics in Omaha and surrounding areas.

Future Program Director Dr. Daniel Gih said within the new program, there will be four pillars (Wellness, Interprofessional, Specialty Clinical Experiences, and Experiential Learning in Psychotherapy) that will distinguish UNMC’s training.

“These pillars characterize our educational philosophy which we refer to as WISE. Our WISE residents will not only have excellent clinical and didactic training, but will also be able to work effectively in diverse healthcare delivery systems while managing personal well-being,” Gih said.

On Nov. 1, 2018, ACGME (Accreditation Council for Graduate Medical Education) will visit the Psychiatry Department. In February 2019, the Department is expected to hear if it can begin recruiting residents for 2020.

Currently, UNMC is affiliated with Creighton University’s residency program for psychiatrists.