Long-envisioned psychiatric emergency center now open at Nebraska Medical Center

By Julie Anderson
Omaha World-Herald

After opening quietly in early October, the new adult psychiatric emergency services unit at the Nebraska Medical Center saw nearly 400 patients during its first three months of operation.

The long-envisioned center was intended to address a significant increase in recent years in the number of people coming to the hospital’s emergency room with problems related to mental health and substance abuse.

And the pandemic has only added to the need.

Dr. Howard Liu, chair of psychiatry at the University of Nebraska Medical Center, said 40% of Americans responding to a June survey reported that they were struggling with mental health or substance abuse problems.

In November, Nebraska data indicated that about one in four households had a loved one taking medications for mental health problems or receiving therapy, and about one in 10 said they needed therapy but didn’t get it.

“So certainly there is a gap out there, and we need to build a strong safety net for mental health in every community,” Liu said in a recent video interview.

While the medical center and other mental health providers offer telehealth consultations, such care isn’t always comprehensive, he said. In addition, crises continue to occur, and people need a safe place to bring loved ones for help.

David Cates, Nebraska Medicine’s director of behavioral health, said the need for such a unit in the community was identified in a 2015 needs assessment.

The hospital sought input from many sources — from first responders to Region 6 Behavioral Healthcare — in developing the center, which is based on a University of Michigan model. Liu has credited Region 6 Behavioral Healthcare for carrying the torch for the project.

Dr. James Linder, Nebraska Medicine’s CEO, said the $4.8 million in renovations needed to create the center on the ground floor of Clarkson Tower was covered by a combination of philanthropic support and the health system’s capital budget. Clarkson Tower is near 42nd Street and Dewey Avenue.

By Jan. 3, the new center had recorded 381 visits since it opened on Oct. 5.

Patients still arrive in the emergency room as they have in the past. They are cleared for medical concerns first, Liu said, a step requested by other mental health providers in the community so they don’t have to repeat it if patients later are transferred. Nebraska Medicine does not have its own inpatient psychiatric beds.

Once cleared medically, patients can go to the new center and begin treatment right away. Unlike most traditional emergency rooms, the center is staffed 24 hours a day with a psychiatrist, advanced practice professionals, psychiatrically trained nurses and licensed mental health practitioners.

Linder said one of the medical center’s next priorities will be to develop a medical and psychiatric unit where people can be treated for both mental health and physical conditions at the same time.

The space where that unit would be situated now is being used to provide beds during the COVID-19 surge, he said. The project can move forward once that space becomes available and the health system has secured a portion of the estimated $8 million cost from donors.

With the addition of the psychiatric emergency center, Liu said, the hospital already has been able to decrease the amount of time mental health patients spend in the ER and get them more quickly to a place where they feel safe and supported.

Currently, one in eight visits to an emergency room in the United States involves a patient with a psychiatric or substance abuse problem. Nebraska Medicine alone saw a nearly 80% increase in people with a psychiatric crisis in its ER from 2015 to 2019, with more than 3,000 such visits just last year.

Liu said the unit is designed to operate like a train station, with patients stopping briefly and then moving on to the next phase of their care, whether that is an admission to an inpatient mental health unit or a referral to a community-based behavioral health organization.

Ideally, patients stay less than 24 hours. But those who need an inpatient bed may stay a couple of days until the right space becomes available. In the meantime, they can begin treatment.

The unit’s staff has been forging alliances with organizations in the community that work with people with behavioral health problems in order to help patients who are discharged make those connections.

Cates said the staff hopes providers from those community programs eventually will come to the unit to meet with patients.

The unit also is staffed seven days a week by trained and certified peer-support specialists, who also had input into the unit’s design.

Link to original story:

Diversity, Equality and Inclusion Committee celebrates leaders in psychiatry

The Department of Psychiatry DEI Committee will be marking this month by highlighting different people and statistics relevant to people of color in mental health.

Mamie Phipps Clark, PhD (1917 -1983) 

Mamie Phipps Clark was the first African-American woman to earn a doctorate degree in psychology from Columbia University. She previously earned both her bachelor’s and master’s degrees from Howard University. Her experience in college and specifically graduate level courses helped Clark realize the shortage of psychological services available to the African American community and other minorities.  Her groundbreaking research on the impact of race on child development helped end segregation and was influential in desegregation efforts including the Brown vs. Board of Education in 19554. Her dedication and passion for adequate mental health services for all prompted Dr. Clark to open her own agency to provide comprehensive psychological services to the poor, blacks, and other minority children and families.  In February 1946, Dr. Clark and her husband opened the doors of “The Northside Center for Child Development” for those in the Harlem area.  She worked in the center counseling and providing other psychological services from 1946 until 1979, when she retired.  Although retired, Clark served on different advisory boards and was still very active within her community.  Dr. Mamie Phipps Clark died on August 11, 1983. 

James P. Comer, M.D., M.P.H . 

Dr. Comer is the Maurice Falk Professor of Child Psychiatry at the Yale University School of Medicine’s Child Study Center in New Haven, Connecticut. He is known nationally and internationally for his creation of the Comer School Development Program in 1968 within Yale University’s School of Medicine. Dr. Comer’s has focused his career on improving school restructuring and has been featured in numerous newspaper, magazine and television reports, while also having several articles published in academic journals. He is a co-founder and past president of the Black Psychiatrists of America.  Dr. Comer is the recipient of countless recognitions and holds over forty eight honorary degrees. In 2014, Dr. Comer received a prestigious nomination by President Barrack Obama to serve on the President’s Commission on Educational Excellence for African Americans. 

Jacki McKinney, M.S.W. 

Ms. McKinney is a survivor of trauma, addiction, homelessness and the psychiatric and criminal justice systems. She is a family advocate specializing in issues affecting African-American women and their children and is a founding member of the National People of Color Consumer/Survivor Network. Ms. McKinney has been a consultant and advisor to the Center for Mental Health Services and is well known for her moving presentations to national audiences on issues such as seclusion/restraint, intergenerational family support and minority issues in public mental health. Additionally, Ms. McKinney is a proud recipient of Mental Health America’s highest honor, the Clifford W. Beers award, presented to a consumer of mental health and/or substance abuse services who best reflects the example set by Beers in his efforts to improve conditions for, and attitudes toward, people with mental illnesses. She is also the recipient of a Lifetime Achievement Award from the Substance Abuse & Mental Health Services Administration’s Voice Awards program which was presented to her for her distinguished leadership and advocacy on behalf of trauma survivors.

Maxie Clarence Maultsby, Jr, M.D. (1932-2016) 

Dr.  Maultsby was the founder of the psychotherapeutic method, rational behavioral therapy. Through his work and therapeutic method, Dr. Maultsby explored emotional and behavioral self-management. Dr. Maultsby’s unique contributions include making emotional self-help a legitimate focus of scientific research and clinical use. Through rational behavior therapy he formulated a comprehensive system of cognitive-behavioral psychotherapy and counseling that incorporated, in a clinically useful way, the most recent neuropsychological facts about how the brain works in relation to emotional and behavioral self-control. The technique of cognitive-behavioral therapy and counseling that Dr. Maultsby created is the first comprehensive, yet short-term, culture and drug-free technique of psychotherapy that produces long-term therapeutic results. In addition to authoring books for health professional therapists and counselors, Dr. Maultsby has written four pioneering books that describe his method of emotional self-help, called rational self-counseling. 

Freda C. Lewis-Hall, M.D., DFAPA 

Freda C. Lewis Hall earned her B.S. degree from Johns Hopkins University and her medical doctorate from Howard University in Washington, DC. Dr. Lewis-Hall is currently Pfizer’s Senior Vice President & Chief Medical Officer. Trained as a psychiatrist, Dr. Lewis-Hall has held an array of leadership roles across the healthcare and pharmaceutical sectors, as well as in academia, medical research, and direct service provision. In 2010, Dr. Lewis-Hall was appointed by the Obama Administration to the inaugural Board of Governors for the Patient-Centered Outcomes Research Institute (PCORI), and in 2012 she was appointed chair of the Cures Acceleration Network Review Board and a member of the National Center for Advancing Translational Sciences (NCATS) Advisory Council of the National Institutes of Health. She also serves on the Executive Committee of the Clinical Trials Transformation Initiative and on numerous other boards, including those of Harvard Medical School, The Institute of Medicine’s Forum on Drug Discovery, Development, and Translation, and Save the Children. Dr. Lewis-Hall has received several recognitions including being named as one of Savoy’s Top Influential Women in Corporate America in 2012, named “Woman of the Year” by Healthcare Businesswomen’s Association’s in 2011, as well as being recognized in 2010 as one of the nation’s 75 Most Powerful Women in Business by Black Enterprise Magazine and among the 25 Most Influential African-Americans in health care by Black Health Magazine. 

Linda James Myers, PhD 

Dr. Myers Linda specializes in psychology and culture; moral and spiritual identity development; healing practices and psychotherapeutic processes; and intersections of race, gender and class.  Internationally known for her work in the development of a theory of Optimal Psychology; Dr. Myers has conducted trainings England, South Africa, Ghana and Jamaica. She is the author of numerous articles, book chapters, and five books, including: Understanding an Afrocentric World View: Introduction to a Optimal Psychology; and, most recently, co-editor of Re-centering Culture and Knowledge in Conflict Resolution Practice. Dr. James Myers’ Oneness model of human functioning offers a trans-disciplinary focus that builds on insights from the wisdom tradition of African deep thought, and converges with modern physics and Eastern philosophies. Her current research interests comprise the application of that model to a broad range of issues from health and education to business ethics. Dr. James Myers has received numerous honors and awards for excellence in research and scholarship, including being named Distinguished Psychologist by the Association of Black Psychologists; the Bethune/Woodson Award for Outstanding Contributions in the Development of Promotion of Black Studies from the National Council of Black Studies; Oni Award by the International Black Women’s Congress; and, the Building to Eternity Award from the Association for the Study of Classical African Civilization, among others. Professor James Myers is a recipient of the O.S.U. College of Arts and Sciences Outstanding Teaching Award, a member of the national honor societies of Phi Kappa Phi and Psi Chi, a past president of the Association of Black Psychologists, and Chairman of the Board of Directors for the National Association for the Education of African American Children with Learning Disabilities. 

Residency Team prepares for its second match day

The work has been done and the list has been delivered. Now, the UNMC Department of Psychiatry Residency team waits to see who will match with their program.

Match Day 2021 takes place on Friday, March 19th. The results will be released at 11AM Central. On that day, the residency program will more than double, going from four residents to ten. After a successful first year, the residency program received additional financial support from the VA and approval from the UNMC GME office to go from four residents a year to five. They will add a second-year transfer resident who will start later this summer.

“We successfully acquired more funding support from the VA to increase our residency size,” said Daniel Gih, MD, Department of Psychiatry Education Director. “It was important to the people that helped lay the groundwork of our new residency program to expand the number of residents we train. As the flagship and state-supported medical school, we have a duty to help train more psychiatrists who will hopefully stay in Nebraska or the region following their graduation from us. We are an underserved state for behavioral health, and we need to replace a retiring workforce. This upcoming summer, Dr. Zachary Rupp, who is currently in a family medicine residency program will join our inaugural intern class, and we plan to match five new interns on Match Day in March.” 

In July 2020, UNMC welcomed new residents Dr. Michaelyn Everhart, Dr. Matthew Kelly, Dr. Andi Ngo and Dr. Emily Royer. Dr. Ngo, who is also a trained pharmacist, attended the University of Hawaii John A. Burns School of Medicine while Dr. Everhart attended the University of Kansas School of Medicine. Both Dr. Kelly and Dr. Royer are graduates of UNMC. Dr. Claudia Moore started a one-year addiction medicine fellowship after working as an emergency medicine physician for the last 14 years at Nebraska Medicine.

Dr. Gih said the foursome has done an amazing job as the inaugural class.

“Last year, we were very fortunate as a new program to match a class that came from the top half of our list,” he said. “However, we have a shared understanding that we cannot simply rely on last year’s outcome and become complacent. We have implemented a more applicant-friendly interview schedule with breaks immediately before interviews, updated our welcome orientation presentation to focus on the near and intermediate goals for the residency, and responded more accurately about the day-to-day activities in the residency since we have officially opened this past July. The evaluation and ranking process has been refined, and many colleagues representing different disciplines within the department participate in interviews.”

The 2020 class was recruited with in-person interviews and tours of the UNMC campus and the city of Omaha. They were taken out to dinner and sat face to face with several leaders in the department. Recruitment of the incoming group was entirely different, due to the COVID-19 pandemic.

“With COVID, it was a huge disappointment we were not able to meet people in person,” Dr. Gih said. “Safety was important to our institution and the national organizations overseeing medical education. We encouraged our interviewers to talk about their personal experiences with Omaha and what may surprise people unfamiliar with our city. We also did four major virtual residency fairs that we hope increased the appeal of our program and expanded our applicant pool. Not being able to show off PES and our other facilities were major setbacks under COVID.”

Jeana Benton, MD, Co-Director of the Department of Psychiatry Residency Program, said she was impressed by the applicants for the 2021 class.

“Although the recruitment process was significantly changed by COVID this year, our interview season went extremely well,” Dr. Benton said. “We received 577 applications for our five interns spots and one transfer spot, and we interviewed 66 candidates. The overall quality of our applicant pool was outstanding.  We’re anxiously awaiting Match Day and are excited to welcome what we believe will be a fantastic incoming residency class.”

National Medical Association honors UNMC Addiction Psychiatrist

The American Medical Association Foundation (AMAF) has honored Alëna Balasanova, MD, FAPA, with the AMA Foundation Award for Health Education.

According to a release announcing the awards, judges said Dr. Balasanova has demonstrated leadership in addiction medicine and psychiatry and has built a legacy at the University of Nebraska. While there, she has developed an outpatient addiction psychiatric clinic, an in-patient addiction psychiatric program, and wrote the curriculum for clinical rotations for medical students, residents, and fellows in addiction medicine and psychiatry.

Dr. Balasanova directs Nebraska Medicine’s Addiction Psychiatry Outpatient Clinic, an integrated care model providing concurrent treatment for substance use disorders co-occurring with other psychiatric illness. She also helped develop and is the co-director of the inpatient Addiction Psychiatry Consultation-Liaison Service for the hospital.

“As a long-standing member of the American Medical Association, the House of Delegates, and former elected member of the Council on Med Ed, it is a great pleasure to congratulate Dr. Balasanova on this honor,” said UNMC Chancellor Jeffrey Gold, MD. “The AMA Foundation Award for Health Education is an extremely prominent national award established to recognize educational accomplishments in ways that the community has benefited. Dr. Balasanova’s work in addiction medicine, and most importantly, in the education of healthcare professionals and soon-to-be healthcare professionals, is critically important and is inspiring from both a regional and a national level.”

Dr. Balasanova, MD, FAPA, is a board-certified Psychiatrist with subspecialty board certification in Addiction Medicine. Her clinical expertise lies in integrated treatment for co-occurring psychiatric and substance use disorders.

Dr. Balasanova is a Fellow of the American Psychiatric Association and the Nebraska delegate to the YPS Assembly of the American Medical Association, where she serves on the Strategy and Leadership Committee. She is also an active member of the Education and Public Policy Committees of the American Academy of Addiction Psychiatry (AAAP) and was recently appointed the Director of Medical Student and Resident Education for AAAP. She has spent her career as a physician, educator, and innovator, contributing to the development of addiction and psychiatric clinical service.

The AMA Foundation Award for Health Education is made possible through the generous support of the John P. McGovern Foundation.

The video of the awards ceremony is here: Dr. Balasanova (Dr. Balasanova receives her award at the 16:26 mark.)  

Read more about Dr. Balasanova:

Mutum helps in various ways

Before joining the Department of Psychiatry in June 2013, Lea worked for 10 years at the Creighton Cardiac Unit as an Inpatient Rounds Coordinator.

What are your roles/duties with the department?

I have several roles in the department including administrative support for Dr. Ashish Sharma, Inpatient Division Director, Dr. Kenneth Zoucha, Addiction Division Director, and Jeanne Lincoln, Department of Psychiatry Administrator. I handle credentialing for the Department of Psychiatry and Psychiatric Emergency Services, and am the Human Resources Coordinator for all UNMC employees in Psychiatry, besides helping with Poynter Hall facility needs.

What made you decide to work at UNMC?

While working at Creighton I wanted to steer my career towards administration. I heard that UNMC was a great place to work, so I took a couple of courses through Iowa Western:

  • Administrative Professional Certificate
  • Microsoft Master Certificate

After I completed those courses, I applied for several positions at UNMC and within a short time, I was offered a position in the Department of Psychiatry.

What do you love about working in psychiatry?

I love that the department really encompasses a caring environment that looks out for one another. I appreciate the opportunities that I have been given to learn and grow in my position.

What are your hobbies?

My most favorite thing to do is spend time with my family, grandchildren, friends, and of course our dog, Kylo. I like to cook and bake and cannot wait to have a huge crowd of people at our house again! My husband and I love to travel and spend time exploring together. I am also really good at home remodeling and enjoy doing projects!