Helping people around us
Department of psychiatry builds community engagement cornerstone through growing number of outreach programs
Carol Mathews, M.D., DLFAPA
Feb. 7, 2023 — Since the early 1980s, community engagement has been a key tenet of the University of Florida College of Medicine Department of Psychiatry. The late Richard C. Christensen, M.D., a beloved faculty member who championed medical ethics and health care access for underserved populations — particularly people experiencing mental illnesses and homelessness — led the department to provide free psychiatric care to community members through the Helping Hands Clinic and Equal Access Clinic Network.
Decades later, his legacy is carried on by the department’s faculty, staff and trainees, who serve the community through a growing number of educational and therapeutic outreach programs.
“Because mental health and psychiatric disorders are so stigmatized, it is critical that we as a department actively work to engage the community, decrease stigma and identify new ways to increase access to care and engage folks in seeking out and obtaining needed care,” said Carol Mathews, M.D., DLFAPA, chair of the department of psychiatry at UF. “Community engagement is a critical piece of what we do as professionals. It is an important part of our mission and keeps us anchored to why we went into medicine — to help the people around us.”
Read about five ways the University of Florida College of Medicine Department of Psychiatry is helping community members below.
Helping Hands Clinic
Robert Averbuch, M.D. ’95
As a medical student and psychiatry resident at the University of Florida in the 1990s, Robert Averbuch, M.D. ’95, looked up to Christensen as an admirable, charismatic mentor and change-maker. He joined a volunteer rotation for residents and supervising attendings at the Helping Hands Clinic, where he was eager to work and learn alongside Christensen. He has continued in his mentor’s footsteps, caring for uninsured and homeless community members ever since.
Averbuch now offers free psychiatric services via telehealth on Monday nights, while another faculty member, Louis Solomon, M.D., holds traditional in-person hours.
“There’s such a gap with mental health,” Averbuch said. “Access to care is challenging. One of our main goals is to get people reconnected … The difference you make with it is what keeps you going.”
Mobile Outreach Clinic
Carol Lewis, Ph.D., M.P.H., C.P.H.
To help meet the varied health needs of medically underserved communities in and around Alachua County, the College of Medicine also operates the Mobile Outreach Clinic, a large bus with exam rooms, a laboratory, a waiting area and health care staff who drive primary and specialized care resources directly to patients.
Clinical associate professor Carol Lewis, Ph.D., M.P.H., C.P.H., has been a volunteer with the clinic since the early 2010s, when she first interned there as part of her public health master’s degree program. She runs a behavioral consultation clinic twice a month, providing free telehealth appointments ranging from 30 to 60 minutes long to evaluate patients, provide tools and referrals and help train graduate students in consultation. Lewis said she sees people with depression, anxiety, trauma and physical disabilities. Anyone needing assistance can make an appointment.
“Transportation is a big barrier to care for many people,” Lewis said. “It can be very hard to find health care services if you do not have enough resources. Access to quality, state-of-the-art care could be life-changing. It’s important for our students to see health care providers who value and participate in the safety network of outreach into the community.”
She is also developing a short training program to equip interested community members with skills and tools to become well-being mentors who can provide consultation and education for their peers.
“Our jobs are to help people reduce their own suffering and increase their well-being,” she said. “So, it’s important to meet people where they are, from those who have a lot of resources to those who have very few.”
Center for Autism and Related Disabilities and Center for Autism and Neurodevelopment
For community members with autism in Alachua County and nearby counties, UF and the department of psychiatry offer two collaborative centers with resources for therapies, education and other support: the Center for Autism and Related Disabilities, or CARD, and the Center for Autism and Neurodevelopment, or CAN.
“Autism and related disabilities are so complex that no one discipline can really address all the issues,” said Ann-Marie Orlando, Ph.D., a research assistant professor of psychiatry and the associate director of CARD, which has been helping patients for over 30 years.
About 1 in 44 children has been diagnosed with autism spectrum disorder, according to the U.S. Centers for Disease Control and Prevention. Through CAN, patients of all ages can be evaluated, diagnosed and connected with many types of treatment suited to their individual needs. Through CARD, they and their loved ones, caregivers, teachers and more can receive education and professional development resources to build the capacity of individuals with autism, their families and communities to better support people.
Ursula P. Crews, R.N., M.S.N.
“A lot of people in the community don’t know what we do or that we even exist,” said Ursula P. Crews, R.N., M.S.N., a patient navigator who has worked with CAN since its start in 2020. “We are trying to help the community understand what’s available and how we can help them.”
Crews is passionate about serving others and intimately understands both the family and provider sides of an autism spectrum disorder through her work and her experience raising a son with autism.
“Families need to know they’re not alone in this journey,” she said.
Fear Facers
For almost 30 years, UF has offered intensive services for patients with obsessive-compulsive disorder. Some would come in weekly, while others needed more frequent care to face their fears and find support.
To meet this need for children and adolescents, Mathews started the Fear Facers Camp in 2017 with colleagues Robyn R. Nelson, a clinical research manager, and Joseph McNamara, Ph.D., an associate professor, chief of the division of psychology, director of the OCD Treatment Program and co-director of the Center for OCD, Anxiety and Related Disorders.
Participants ages 7 to 15 come to the summer camp from all over the world to join in daily therapy, opportunities to bond with other children with OCD and anxiety and activities to promote personal growth and improved behaviors.
Robyn R. Nelson
“The idea of implementing a camp was that the kids could address their specific phobias but also get to enjoy fun camp experiences in a comfortable environment,” said Nelson, who also has OCD. “We understand what they’re going through, and they’re also engaging with other kids who are struggling just like they are. It breaks down barriers when they can let us experience their anxiety with them. There’s something very freeing in recognizing you’re not alone when you’re having these intrusive thoughts and feelings and being able to recognize that in somebody else.”
In addition to helping break stigmas and improve access to therapy, Fear Facers Camp is also a training resource for graduate students, therapy aids and more. There is a need for better-equipped OCD care providers and educators, as patients can sometimes wait 14 to 17 years before getting the right treatment, McNamara said.
“The idea is if you drop a rock in water, it ripples, and it has a positive impact on both patients and providers,” he said. “Camp really has that effect.”
Street Psychiatry Program
Dawn-Christi Bruijnzeel, M.D.
The newest community engagement effort from the department of psychiatry is the Street Psychiatry Program, a grant-funded collaboration with GRACE Marketplace, a nonprofit serving homeless individuals in Gainesville and Alachua County.
Street psychiatry is a method of bringing care to people wherever they live or sleep in an effort to remove barriers, said Dawn-Christi Bruijnzeel, M.D. ’01, an associate professor, director of the Street Psychiatry Program at UF and associate chief of psychiatry with the Malcom Randall VA Medical Center. If someone does not have a mailbox, internet access, transportation, employment, insurance or other socioeconomic tools, they may be unable to access the traditional health care system. But they are no less deserving of care, she said.
Every Wednesday morning for four hours, Bruijnzeel, a rotating psychiatry resident and a social worker from GRACE Marketplace meet homeless community members with free psychiatric care and supplies, like bus passes, food, water and clothing. Some patients have appointments established by the GRACE Marketplace outreach workers for the team, while others have been recommended by friends to receive help from the multidisciplinary team.
The goal is to reconnect people with clinical and social resources. Since the program started about a year ago, Bruijnzeel said, at least 10 people have gotten housing after receiving mental health care.
“Anytime we can help folks manage their medical health and mental health, it benefits the whole system,” she said. “But my main goal is to benefit the individuals. It’s important that someone advocates for them and tries to help them get back on their feet.”
