Introduction
Global mental health education, scholarship, and advocacy for human rights are core missions for the George Washington University (GW) School of Medicine and Health Sciences (SMHS) Department of Psychiatry and Behavioral Sciences. Our Global Mental Health Program is grounded in ethical commitments to further mental health and relieve suffering for those who live in low- and middle-income countries and zones of armed conflict, as well as for immigrants and refugees who live in our country. The centrality of global mental health in our department’s mission is also a product of our patient populations, faculty, and institutional resources in metropolitan Washington.
The Washington-metropolitan area is one of our nation's most multi-ethnic regions, with as many as 180 countries and 100 languages represented in District of Columbia and suburban Northern Virginia and Maryland public schools. Complementing this diversity, our full-time and clinical faculty include teachers, scholars, researchers, and clinicians who are internationally recognized for their expertise in cultural psychiatry, torture-survivor rehabilitation, treatment of traumatic stress disorders, ethnopharmacology, medical diplomacy, mental health response to disasters and human catastrophes, human rights advocacy, psychiatric evaluation of refugees seeking political asylum, and development of mental health services in low- and middle-income countries.
GMH Residency Curriculum
Our GMH curriculum provides all our psychiatry residents with expertise that is as usable within the U.S. as it is in low-income countries. At GW, we recognize that GMH skill sets are also those needed for multicultural urban populations and underserved rural populations in the U.S. GMH training is ideal preparation for future community psychiatrists. GMH requires clinicians to learn how to address adversities other than psychiatric illnesses, such as demoralization, grief, loss of dignity, and human rights violations, all of which our residents learn to help patients through using a variety of therapeutic skills. GW teaches residents to support patients in building resilience, not just to treat psychopathology.
All of our residents train in a Global Mental Health curricular thread that spans throughout their training at GW. GW psychiatry residents study global mental health and cultural psychiatry during PGY-II and PGY-III seminars and learn therapies for posttraumatic symptoms. In addition to these didactic global mental health educational opportunities, residents may elect to train in multiple clinical settings applying their learning to clinical practice treating patients in a clinic for immigrants and refugees. The GW Department of Psychiatry and Behavioral Sciences provides the psychiatric component of mental health services at Northern Virginia Family Services, whose multilingual psychosocial programs include the Program for Survivors of Torture and Severe Trauma. Through a year-long, half-day weekly clinic for PGY-III residents at NVFS, residents can grow advanced levels of expertise in psychiatric care for immigrants, refugees, and political torture survivors. At NVFS, residents treat a patient population of immigrants and refugees, collaborating closely with patients’ therapists who also serve as interpreters for non-English-speaking patients. Furthermore, residents can conduct asylum evaluations for political refugees alongside GW faculty members.
Residents also learn in didactics about the role of spirituality in mental health and coping with medical and psychiatric illnesses. Opportunities for further study are available at the George Washington University Institute on Spirituality and Health (GWISH) in educational programs that assist physicians seeking to respond to spiritual needs of patients in their provision of health care. Drawing upon patients’ spiritualities for resilience can be vital for promoting mental health in many cultures.
Additional GMH Opportunities
Residents in the GW Psychiatry Residency Program may explore global mental health interests through educational and research opportunities to complement their clinical training. Residents at GW have the option to pursue additional graduate degrees through part-time studies, including an MPH with complete tuition remission at the leading GW Milken Institute School of Public Health. In MPH studies, residents may choose to focus on global health, health policy, health promotion, or multiple other scholarly tracks. Multiple GW Psychiatry Department of Psychiatry and Behavioral Sciences faculty have joint appointments in the School of Public Health.
Finally, motivated residents have the unique opportunity to contribute to research under the mentorship of psychiatrist and anthropologist Brandon Kohrt, MD, PhD, Charles and Sonia Akman Professor of Global Psychiatry, now leads a GMH division with grant-funded research in 15 countries. Most recently, Kohrt’s research team was awarded an NIMH R01 $2,900,000 grant. Dr. Kohrt’s mental health services research in the GW Global Mental Health EQUITY Lab spans access, availability, affordability, and acceptability of mental health services for those who live in low- and middle-income countries, as well as prioritization of these same GMH principles to the delivery of mental health services in the U.S.
Global mental health has been a good fit for the natural strengths of our department. It also has extended the reach of our person-centered commitment into the wider world. The training that our residents have gained has outfitted them well for psychiatric careers at home or abroad. After 21 years, our global mental health program has shown how the global is also local for psychiatry.