Health Equity, Community Psychiatry and Advocacy
The OHSU Division of Child and Adolescent Psychiatry focuses on a mixture of clinical services, teaching, research, and public health and advocacy. Health equity efforts are at the center of our work. The division is active in improving access and mental healthcare quality across the state, with many of our efforts expanding beyond the OHSU campus.
Our program offers fellows opportunities to build knowledge and experience in public-academic partnerships, healthcare leadership, collaborative care, and outcomes-based research. Fellows gain enhanced understanding of the impact of social justice and health equity topics in child psychiatry. We aim to help improve the system of mental health care for underserved youth. Participation in these efforts offers child psychiatry fellows unique opportunities to see how collaborative interdisciplinary relationships can improve the lives of families and young people.
Karina España, MD teaches in the division on conceptualizing traditional Native American healing practices in child and adolescent psychiatry. Dr. España and Dr. Mariah Racicot are developing a partnership with the Native American Youth and Family Center (NAYA), specifically NAYA’s high school Many Nations Academy, which provides education with integration of local Native traditions and wrap around services. Dr. España and Dr. Racicot envision involvement of fellows in this opportunity to learn about and provide community-driven interventions supporting the mental health needs of Native youth and families.
Karen Bos, MD MPH serves as the child psychiatry consultant to Oregon Health Authority (OHA), working to implement health policies and programs to improve care for youth and families across the state. She also consults to the Oregon Department of Human Services, focusing on improving mental health care and reducing systems barriers for youth in foster care. Dr. Bos is board certified in community and public psychiatry by the American Association for Community Psychiatry.
Linda Schmidt, MD leads our statewide consultation line, the Oregon Psychiatric Access Line about Kids (OPAL-K). OPAL-K connects local primary care and mental health providers statewide to consultation with a child psychiatrist, increasing providers’ ability to manage complex cases in the youths' home communities. OPAL-K has provided consultation on over 8,000 calls from across the state.
Rebecca Marshall, MD MPH leads the Data, Evaluation and Technical Assistance (DAETA) team. The DAETA team works with state government and community behavioral health partners to track and evaluate the progress of statewide behavioral health programs for youth and families. This includes recent expansion of the continuum of care for children through Intensive In-Home Behavioral Health Treatment and Mobile Response and Stabilization Services. These efforts aim to improve access, quality, and workforce development within the youth behavioral health system. Click here to watch the DAETA team present their work at an OHSU Department of Psychiatry Grand Rounds.
Collaboration between our division, LifeWorks NW (a local community mental health agency), and CareOregon (a nonprofit providing health insurance services to low-income Oregonians) led to the development of a community mental health Child Psychiatry Bridge Clinic. The Bridge Clinic is staffed by OHSU child psychiatry fellows and supervised by LifeWorks NW Medical Director and OHSU affiliate faculty member, Cortney Taylor, MD. The Bridge Clinic has collected data demonstrating improvements in access to care, as well as increased interest among trainees in working in community psychiatry.
Program Director, Craigan Usher, MD is the medical education consultant for the Early Assessment and Support Alliance Center for Excellence (EASAC4E). EASA is a coordinated specialty care program for first-episode psychosis, a model adopted by communities across Oregon and in several other states. Dr. Usher welcomes fellows in providing consultation, building education modules and lectures, and contributing to research projects. He invites fellows to engage with EASA teams and participants in rural and frontier county sites, encouraging the next generation of leaders in comprehensive early psychosis care.
We have affiliate faculty members who provide organization leadership in community psychiatry settings across the Portland metropolitan area and the state. David Rettew, MD is the Medical Director of Lane County Behavioral Health in Eugene and has served as the co-chair of AACAP's Health Promotion and Prevention Committee. He has written extensively on child mental health, including the recent article “Widening our lane: How child psychiatrists can embrace the full spectrum of mental health.” Our affiliate faculty also include Nikhil Rao, MD MSc a community child psychiatrist with CCS where he works with marginalized and underserved youth, those with significant trauma and child welfare involvement, and youth with neurodevelopmental disorders. Dr. Rao is the current president of the Oregon Council of Child and Adolescent Psychiatry (OCCAP).
As we expand our fellowship training program, we are growing opportunities for fellows in their second year to engage in a community experience which extends throughout the entire year of fellowship. This will help ensure completion of projects and engagement in a community/health-equity area of interest and build expertise to launch a career of service to individuals, as well as the community at-large.