Monday, Oct. 31, 2005 | 8:11 a.m.
Train them and they will stay.
That's the philosophy behind the University of Nevada School of Medicine's recent expansions, including a Las Vegas residency program in psychiatry.
Now seven students strong, the psychiatry division hopes to grow to 16 within the next two years and then add fellowships in child, forensic and addiction psychiatry. The first residents started in July 2004 and will graduate in about 16 months.
Keeping the post-medical school training in-state is essential to ensuring those specialists stay in Nevada, said Dr. Ole Thienhaus, chairman of the psychiatric department. Nevada desperately needs more mental health care, particularly psychiatrists to screen patients who may need medical as well as psychological help.
About 60-70 percent of residents stay in the cities in which they train because by the time they finish their residencies they have spent four years working in that community, learning the options for mental health offered and making contacts, Thienhaus said.
"We really decided that if we want to make a difference we really needed to be in charge of the production," Thienhaus said.
Nevada ranked 44th in the nation for the number of psychiatrists per capita in a 2000 U.S. Health and Human Services report, with only 117 psychiatrists in the whole state or 6.9 per 100,000 people. The ratio has not changed much in the last five years, Thienhaus said, and because the need for psychiatrists is so great in Nevada he is worried that the shortage will force the state mental hospitals to hire less qualified psychiatrists to meet the needs.
"Inevitably you get people who can't get a job elsewhere," Thienhaus said.
Mental health issues continue to make headlines in the Las Vegas Valley, as hospital emergency rooms are inundated with people needing care. Psychiatrists are needed to screen those patients, many of whom need medication as well as counseling.
Psychiatrists, as medical doctors, can treat the whole person and are able to ascertain whether the problem is physical or mental or both, Thienhaus said. The psychiatrist can then refer the patient to psychologists or others for appropriate treatment.
It was the mental health needs of the city that brought resident Dr. Paul Nguyen to Las Vegas. His brother, Dr. Tam Nguyen, a local oncologist, repeatedly told him of the troubles he went through to get psychiatric evaluations for patients, Nguyen said.
But when he was looking for residencies following graduating from Ross Medical School in Chicago, there was nothing available in Las Vegas, Nguyen said. He spent two years training in Hawaii before the residency program opened here. He immediately transferred.
He plans to stay and work here post-residency, but said he doesn't know if he would have moved here if he had finished his residency work in Hawaii.
Nguyen said many of his fellow residents plan to stay in Las Vegas as well, and, as chief resident, he is trying to recruit more students to the program.
He believes the residency program will improve mental health care because it will produce several psychiatrists who really know the community.
The fellowships will similarly improve patient care by training much needed specialists, Thienhaus said.
Thienhaus, who lives in Las Vegas but travels across the state for his job, believes that the need for child psychologists is the greatest. In rural and urban communities, he sees more and more children dealing with drug problems, suicidal tendencies or who are acting out in anti-social ways, he said.
Child psychiatry will be the first fellowship to start in Reno in July 2006, said Thienhaus, who hopes to open a similar fellowship in Las Vegas within the next few years.
Next in line is a fellowship in forensic psychiatry, where psychiatrists work with the courts to evaluate claims of insanity as well as competence to stand trial.
The state also needs a fellowship specializing in substance abuse, but that is more difficult to develop.
Few hospitals focus on alcohol or drug abuse issues because "basically, those are patients nobody wants," Thienhaus said.
He has some state money to support graduate education related to addictions, as well as support from the veterans hospital, so he is hoping to have an addictions fellowship set up in the next five years.
Christina Littlefield can be reached at 259-8813 or at [email protected].
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