Integrating a College Mental Health Track into a Public Psychiatry Fellowship.

Abstract

The onset of mental illness most commonly occurs between the ages of 15 and 25 years old, the time of transition from adolescence to early adulthood. The impact of mental illness at this stage of life is far reaching, causing many to drop out of school [1, 2]. Counseling centers report that the number of incoming students taking psychotropic medications has been steadily increasing, yet only about half of US colleges offer psychiatric consultation on campus [3, 4]. Workforce development is needed to address this growing need for psychiatric services on college campuses. Youths who do not attend college are equally, if not more, at risk, particularly if they have developed mental illness before age 18 years and have been engaged in the child mental health system. Once individuals have “graduated” out of the child system, successful transition to the adult system is neither tracked nor facilitated. Studies show that there is a large drop-off in care at this pivotal point, resulting in increased morbidity and mortality [5–7]. In 2013, an exhaustive Internet and literature search uncovered just two formal college mental health fellowships and no formal programs devoted to work with transitional age youth. Both programs offered one full-time position for an academic year to work for college mental health services that funded the positions. Neither program included a formal didactic curriculum, but fellows attended trainings with psychology interns and, at one program, were encouraged to attend any relevant psychiatric resident didactics. In addition, fellows attended various administrative meetings to better understand the college organizational system. Here, we present a pilot college mental health program in conjunction with a public psychiatry fellowship. The execution of this combined training program resulted in parallel treatment of college students and their transitional age counterparts in the public mental health system. We consider the implications of this experience and propose a new paradigm for a broader transitional youth fellowship moving forward.