UCSF Psychiatry HEAL Fellowship in Global Mental Health

The UCSF Department of Psychiatry offers a one-year fellowship in Global Mental Health in partnership with the HEAL Initiative. The goal of this innovative and rigorous program is to train psychiatrists as leaders in clinical practice, capacity building, health systems-strengthening and health services research in low-resource settings in the United States and abroad. In addition to the curricular activities described below, fellows will have the option of receiving a fully paid masters degree in public health.

Rotation sites

Fellows will complete two mentored rotations at a local site (Navajo Nation) and an international site (Possible in rural Nepal). Each rotation is approximately six months and each site hosts HEAL fellows from other clinical specialties as well. For fellows who are not able to be away from home for the entire fellowship, we will work with you on a case-by-case basis to develop a suitable arrangement for clinical rotations.

Navajo Nation

Fellows will provide clinical services to residents of Navajo Nation. They will address the challenge of expanding mental health services to a rural population by health systems strengthening, telemedicine, mobile medical van, and an integrated care program with the General Medical Clinic.

Achham, Nepal

Fellows will lead an integrated mental health program at a healthcare system that is operated in partnership between the Nepali government and Possible, a non-profit organization working in Nepal since 2008. Possible has a robust infrastructure with a 65-bed general hospital, an outpatient clinic where 20 generalist clinicians see over 200 patients every day, over 30 community health workers, 24-hour solar electricity, an electronic medical record system, and a strong implementation science research team. Fellows will implement a collaborative care model to gain expertise in leading a complex mental health system in one of the most resource-constrained regions in South Asia. The context and healthcare delivery model in Achham are described in this journal article and this feature blog post.

Bayalpata Hospital

Bayalpata Hospital in Achham, Nepal provides comprehensive healthcare services and is the site for GMH fellows.

Curriculum

The curriculum was developed over 18 months using a structured process. It identified critical gaps in competencies between those acquired at the end of a U.S. residency in general psychiatry and those required to build mental healthcare delivery systems in low-resource settings. Advice was sought from trainees and experts in multiple low-resource settings, locally and globally.

The competencies that were identified to become a leader in global mental health have been synthesized in this document. The fellowship provides these competencies via educational experiences that include a custom-designed collection of original online lectures, reading materials, online Q&A sessions, opportunities for targeted professional development opportunities with modest funding, and dedicated experiential learning in mental healthcare delivery systems in low-resource settings. Experiential learning will include working with the local stakeholders and fellowship mentors to identify areas of need in collaborative mental health care delivery at the rotation sites and implementing a systems-wide intervention to address them.

Fellows will engage in the global mental health curriculum and participate in HEAL’s global health curriculum, which includes a boot camp at the beginning of the fellowship, and they will have sustained interactions with UCSF-wide global health fellows in multiple specialties. The following are the core competencies of the fellowship:

  • Describe cultural expressions of illness and implement culturally appropriate treatments.
  • Utilize locally available resources, including limited/essential medications, to provide high-quality clinical care to address the local burden of mental illness.
  • Describe and implement a collaborative care model in two resource-poor settings.
  • Lead an interdisciplinary team of generalist health workers and psychosocial counselors for strengthening the mental health system and expanding access to health services.
  • Develop effective teaching skills to build the capacity of local health workers to care for the mentally ill using evidence-based protocols like the WHO Mental Health Gap Action Programme (mhGAP).
  • Develop research skills in health services and implementation science to strengthen health systems.
  • Obtain clinical competence in managing common mental health conditions with clinical supervision for child, adolescent and geriatric populations.
  • Adhere to principles of ethical, equitable and reciprocal training and clinical practice.
  • Develop a career plan that incorporates global mental health work after completion of the fellowship.
     

For the full list of competencies for the fellowship, please click here.

Flowchart

Possible’s integrated mental health program provides the academic, clinical, and research environments for fellows.

Mentorship

Mentorship is an integral aspect of the fellowship. Mentorship focuses on clinical sub-specialty services, collaborative care models, health services research, cross-cultural practice, ethics, teaching and supervisory skills, and career development. Structured mentorship is provided at various levels:

  1. On-site mentors: Each fellow is assigned a mentor on-site who will guide them through the health system and assist with clinical challenges. In Navajo Nation, on-site mentors will include the leadership of the behavioral health team. In Achham, the on-site mentor is the medical director who has completed MD-GP training. Additional mentorship is provided by a faculty psychiatrist based at an academic center in Nepal and a UCSF-based mentor who will visit each site twice per year to augment in-country mentorship.
  2. HEAL mentors: Global health mentors from HEAL Initiative will provide guidance for the 20+ fellows across all disciplines. This includes UCSF faculty who have extensive experience mentoring global health clinicians in building health systems in resource-poor settings.
  3. Mental health faculty: The fellowship director will hold biweekly online meetings with the mental health fellows throughout the fellowship. In addition, a panel of faculty members will provide teaching and mentorship via a longitudinal curriculum on key topics in global mental health, such as clinical protocols based on WHO’s essential medications list, task-sharing with non-specialists, key skills in education, training and supervision to assist with task-sharing, collaborative care models, cross-cultural inquiry and treatment of mental illness, health services research, implementation science in program development, geriatric psychiatry, child psychiatry, evidence-based psychotherapy, and career development.
     

Global Mental Health Fellows

Back (L-R): Pragya Rimal, MA (site fellow, Nepal); Bibhav Acharya, MD (program director); William Shunkamolah, PhD (site fellow, Gallup Indial Medical Center, NM); Viet Nguyen, MD, MPH (rotating fellow).

Front (L-R): Barbara Kamholz, MD (faculty); Rebecca White, MD (rotating fellow)

 

Faculty

Bibhav Acharya, MD
Director, UCSF Psychiatry HEAL fellowship in Global Mental Health
Assistant Adjunct Professor, UCSF Department of Psychiatry
Co-founder and Mental Health Advisor, Possible

Craig Van Dyke, MD
Co-Director, UCSF Psychiatry HEAL fellowship in Global Mental Health
Professor Emeritus, UCSF Department of Psychiatry

Maithri Ameresekere, MD
Faculty Lead, Women's Mental Health and Trauma
Staff Psychiatrist, San Francisco VA Health System, Women's Mental Health Program and PTSD Clinical Program
Health Sciences Assistant Clinical Professor, UCSF Department of Psychiatry

James Dilley, MD
Faculty Lead, HIV Psychiatry
Executive Director, UCSF Alliance Health Project
Director, AIDS Health Project
Professor Emeritus, UCSF Department of Psychiatry

David Elkin, MD
Faculty Leader, Self-Reflection and Self-Care
Attending Psychiatrist, Zuckerberg San Francisco General
Health Sciences Clinical Professor, UCSF Department of Psychiatry

Peter Ferren, MD, MPH
Faculty Lead, Child and Adolescent Psychiatry
Attending Psychiatrist, Zuckerberg San Francisco General
Health Sciences Clinical Professor, UCSF Department of Psychiatry

Anna Fiskin, MD, MS
Faculty Lead, Cross-Cultural Psychiatry
Volunteer Assistant Clinical Professor, UCSF Department of Psychiatry

Erick Hung, MD
Faculty Lead, Education and Supervision
Endowed Chair in Psychiatry Medical Student Education
Director of Curricular Affairs for GME
Director of the Adult Psychiatry Residency Training Program, UCSF Department of Psychiatry
Associate Professor of Clinical Psychiatry, UCSF Department of Psychiatry

Barbara Kamholz, MD
Faculty Lead, Geriatric Psychiatry
Attending Psychiatrist, San Francisco VA Health System

Paul Linde, MD
Faculty Lead, Emergency Psychiatry
Attending Psychiatrist, Psychiatric Emergency Services at Zuckerberg San Francisco General
Health Sciences Clinical Professor, UCSF Department of Psychiatry

Christina Mangurian, MD, MAS
Faculty Lead, Health Services Research
Director, UCSF Public Psychiatry Fellowship at Zuckerberg San Francisco General
Professor of Clinical Psychiatry, UCSF Department of Psychiatry

Jonathan Nye, MD
Faculty Lead, Severe Mental Illness and Inpatient Services
Attending Psychiatrist, Zuckerberg San Francisco General
Health Sciences Clinical Professor, UCSF Department of Psychiatry

Application

Applications are now open for fellows entering the program in July 2020. Applications will be reviewed on a rolling basis. Please click here to apply online.

For other questions and information about eligibility, please visit the FAQ page.