Roberto Montenegro, MD, PhD, knew how to help his patient when she became agitated while in the hospital.
He and colleagues downloaded two Led Zeppelin albums onto the woman's iPod shuffle, then watched her settle in and enjoy the music.
“She sat down next to the staff and began to rock out. She played her imaginary air drums for at least four minutes,” Montenegro said of the 45-year-old woman, who while in the hospital’s inpatient psychiatric unit became upset during nursing shift changes. “She kept listening to her iPod for the rest of the day. Thereafter her treatment team noticed a significant decrease in her use of (medication). She began to be less violent on the unit and began to speak to her treatment team significantly more than prior days.”
Montenegro, a third-year resident with the Yale Department of Psychiatry, experimented with personalized music for patients as part of his grant-funded American Psychiatric Association (APA) Minority Fellowship.
He is one of five Yale residents participating in the program, which provides money for training and research in psychiatry where minority groups are underrepresented.
Other Yale residents and MFP fellows are Jerome Taylor, MD, (PGY-5); Ayana Jordan, MD, PhD, (PGY-5); Kali Cyrus, MD, MPH (PGY-3); and Daniel Moreno De Luca, MD, MSc (PGY-4).
Fellows receive training opportunities by attending and participating in APA meetings, and grants support initiatives like Montenegro’s personalized music research.
“The examples that personalized music has had on the inpatient unit are endless,” Montenegro said. “In short, however, it appears that personalized music can trigger happy memories in our patients as well, and, in turn, shift a patient’s mood even while they are psychotic, disorganized, delusional, and severely depressed.”
Jordan is using her fellowship grant to train faith leaders in cognitive behavioral therapy for substance use disorders, and to decrease the burden of substance use by parishioners in the Black Church.
She is also creating the first online database of professionals who want to research mental illness in the African nation of Sierra Leone, where she has worked to improve access to mental health services.
“This interactive website will not only be educational, but also provide a platform to foster collaboration amongst researchers in the African diaspora, and facilitate opportunities for consultation on clinical cases in Sierra Leone … while also serving as a base for potential indigenous researchers seeking mentors,” she said.
Jordan has also used the fellowship for professional development. She has enrolled in The Kauffmann Clinical Neurology Course for Psychiatrists, and will attend the 2016 APA Annual Meeting, where she will present, “The Exploration of Faith and Spirituality in the Psychiatric Assessment and Treatment of Minority Patients.”
In collaboration with the Department of Pediatrics and Bright Bodies Weight Management, Taylor will examine how self-esteem and family functioning affect weight and metabolic outcomes in a family-centered healthy lifestyle program for children, most of whom are African-American and Hispanic.
She sat down next to the staff and began to rock out. She played her imaginary air drums for at least four minutes
Roberto Montenegro, MD, PhD, (PGY-3), Yale Department of Psychiatry
He will also research factors, including race and socioeconomic status, which affect treatment outcomes in anxiety disorders.
He has used his grant to present at several national meetings and conferences, and he will present, “The Context of Psychosis: Cultural Curiosity and Enhanced Clinical Care,” at the 2016 APA Annual Meeting.
Cyrus has served as a course advisor for the U.S. Health and Social Justice Elective, a course designed by and for medical, nursing and PA students that examines social justice themes not typically explored through traditional medical education.
For the elective, she has designed and implemented a patient communication skills session with innovative standardized patient case scenarios. The goal is to challenge students to explore implicit biases about marginalized populations.
Cyrus also helped to create, implement, and fund a similar mandatory exercise for third-year medical students to increase awareness about implicit assumptions made about lesbian, gay, bisexual, transgender, and queer people, and immigrant populations.
She has worked within the Yale Department of Psychiatry to support the use of standardized patients to practice the Cultural Formulation for the Cultural Psychiatry didactics for second-year residents.
At the 2016 APA Annual Meeting, she will present, “Queerly Invisible: LGBTQ People of Color as Psychiatrists and Patients.”
Moreno De Luca has traveled to Paris through his fellowship to continue his work in translational psychiatric genetics. His focus is on identifying genetic risk factors for psychiatric disorders, especially autism and schizophrenia, across diverse populations, including minorities.
During his studies, Moreno De Luca and colleagues discovered that a known mutation, a copy number variant in chromosome 2q13, which was initially thought to have no clinical consequences, could be one of the most frequent risk factors for a range of psychiatric disorders.
He said the support of the APA Minority Fellowship was essential because it enabled him to travel to France, and to have resources to launch the project and present its results.
Besides his work with music, Montenegro is completing a collaborative national mixed-methods study (surveys and biological markers) that examines the mental health of women and racial and ethnic minority physician residents.
He is working on the project as the department’s first Equity Research and Innovation Center fellow.