SACRAMENTO -- UC Davis medical school residents will benefit from a $1.35 million grant that will provide increased opportunities to combine psychiatry with family medicine or internal medicine training, with an emphasis on care of underserved populations.
"Well over half of all mental heath care in this country is delivered in the primary care setting," said principal investigator Robert McCarron, an assistant clinical professor in the UC Davis Department of Psychiatry and Behavioral Sciences and Department of Internal Medicine. "Our goal is to train more residents who will have dual board-certification in both primary care medicine and psychiatry. We also hope to improve patient care by providing psychiatric educational opportunities for community-based primary care practitioners."
The California Department of Mental Health has awarded UC Davis the Mental Health Services Act/Workforce Education and Training Development grant to establish a new Integrated Medicine/Psychiatry Ambulatory Residency Training program. Dubbed IMPART, the program will expand two existing UC Davis combined residency curricula, family medicine/psychiatry and internal medicine/psychiatry, the only residency program in the Western United States combining psychiatry with both internal medicine and family medicine.
With the goal of developing a replicable, integrated medicine/psychiatry curriculum that can be used at other training programs throughout the West and beyond, IMPART will expand not only the number of faculty and students in the residency programs, but also their curricula.
"Most of our faculty see patients who have no private insurance, Medi-Cal or Medicare," said McCarron. "We hope that the IMPART graduates will stay within the public sector, not only improving the access to and quality of medical and psychiatric care of those who are underserved but also acting as ambassadors to advance medicine/psychiatry education and research, along with community outreach and engagement."
"California leads the nation in diversity, and Sacramento has been identified as the most integrated city in the U.S.," said Center for Reducing Health Disparities Director Sergio Aguilar-Gaxiola, a UC Davis professor of clinical internal medicine. IMPART is a collaborative effort between the center and the Sacramento County Divisions of Mental Health and Primary Care, as well as the UC Davis Departments of Psychiatry and Behavioral Sciences, Internal Medicine, and Family and Community Medicine.
"Ethnically, culturally and linguistically diverse populations tend to use mental-health services less than their majority counterparts, in large part because there is some institutional distrust of health services in many ethnic and cultural groups," he said. "IMPART brings together a unique group of qualified, diverse faculty who are fully committed to training medical residents to become culturally and linguistically competent so that they can actively reach out, engage and serve these vulnerable communities."
IMPART also will train physician assistants and nurse practitioners by sharing its curricula across many medical professions through national workshops and lecture series, among other activities. By so doing, it will help address medical professional shortages in such areas as child psychiatry, geriatric psychiatry and primary care psychiatry.
"All of the organizations collaborating on IMPART are very enthusiastic about this program," said Aguilar Gaxiola, "because it addresses significant gaps in dealing with the complexities of co-occurring mental and physical health conditions. It also addresses the need to implement integrated care to appropriately address the multiple health challenges posed by mental-physical comorbidities."
He added, "We know how important it is to serve the needs of diverse populations, and to do so in a way that considers the whole person, including his or her cultural and linguistic background, physical well-being and mental health."
About Mental Health Services Act grants
Voters passed landmark legislation in November 2004 that places a 1-percent tax on the adjusted gross income of Californians earning $1 million or more and commits these revenues to the support of county-operated mental health services. When Proposition 63 became state law in January 2005, it became known as the Mental Health Services Act.
It is estimated that by FY 2006-07, the act had already raised more than $700 million annually. This injection of funds represents a 10 to 15 percent increase in funding for mental health care.
Each California county has developed collaborative, community-driven processes to determine priorities and submit three-year plans to seek funding for Mental Health Services Act grants, which are intended to expand California's mental-health services and programs.