Yale Psychiatry Grand Rounds: June 9, 2023

Transcript

• 00:00The 2023 State of the Department address
• 00:04and just before I get started to let
• 00:10everybody know that next Thursday
• 00:14evening is residency graduation,
• 00:17which will be at the lawn Club next
• 00:20Friday's grand rounds, is from Mr.
• 00:22Dave Brown from the Human Rights Campaign.
• 00:25He's vice president,
• 00:26the Human Rights Campaign.
• 00:28And he'll be doing a special grand rounds
• 00:31with Christie Olazeski about L GB TQ issues.
• 00:35This is the graduation address, and Mr.
• 00:38Brown and Human Rights Campaign were
• 00:41selected by the graduating class as as
• 00:44their graduation speaker and then at the
• 00:49Ann Lien Center in the TAC auditorium.
• 00:52And and then that afternoon we'll have the
• 00:56graduation of the fellowship programs.
• 00:59And then on the 19th we have a special
• 01:04program for Juneteenth that has been
• 01:07organized and and was just chaired
• 01:10in a in a e-mail to the department.
• 01:14So to begin the grand rounds state of the
• 01:17department presentation is as I've done.
• 01:20For the last several years,
• 01:21I've invited a number of people to reflect
• 01:25on the past year and I'm going to start
• 01:30to this isn't in the form of a video,
• 01:34and I'm going to start that video
• 01:36now if I can manage the technology,
• 01:41Push the button, here we go.
• 01:47Good day. Hello. My name is Maria
• 01:49Crouch and my degnock name is Tavo.
• 01:52I'm Degaton and Quavi Tekken from
• 01:53the native village of Anvic, Alaska.
• 01:57Today Ioffer acknowledgement and respect
• 01:59to the indigenous peoples who belong
• 02:01to the land on which I live and work.
• 02:04These tribal nations include the Mohegan,
• 02:06Machentucket, Pequot, Eastern Pequot,
• 02:10Shagacoke, Golden Hill, Pagusa,
• 02:12Niantic and the Quinnipac and
• 02:14other Algonquin speaking peoples.
• 02:17They have stewarded through generations
• 02:18the lands and waterways of what
• 02:20is now the State of Connecticut.
• 02:22We honor and respect the enduring
• 02:25relationships that exist between these
• 02:27peoples and nations and this land.
• 02:29We recognize that these indigenous
• 02:31people's sovereignty was never seated.
• 02:33Rather, they had and still have society,
• 02:36governance, and jurisdiction.
• 02:37The Quinnipiac or the Long Water people
• 02:41were inhabitants of where we are today.
• 02:43And what my culture we would call
• 02:46the native village of Quinnipac.
• 02:47We stand on Quinnipac land.
• 02:49We stand on their tears,
• 02:51their laughter and their heartaches,
• 02:54The first breaths of their babies and
• 02:56the last breaths of their elders.
• 02:59We stand on their histories
• 03:01during colonization.
• 03:02They were ultimately pushed onto
• 03:04reserves and all land holdings
• 03:06were eventually extinguished.
• 03:08The Quinnipac are not a federally nor
• 03:10state recognized tribal nation, but.
• 03:13We recognize them and their
• 03:15cultural resilience, survivance,
• 03:17and indomitable spirit.
• 03:18We honor them and acknowledge
• 03:21their ancestors and ancestry.
• 03:23We pay our respects to the
• 03:26elders past present,
• 03:27the seven generations yet to come into
• 03:29their culture as well as their continued
• 03:32connection to land and community.
• 03:35I encourage you to learn more about the
• 03:37indigenous peoples of this region by
• 03:39visiting the Mashantucket Pequot Museum
• 03:41or the Tantukwidge in Mohegan Museum,
• 03:43amongst many others.
• 03:44I also encourage you to connect with the
• 03:48Native American Cultural Center at Yale.
• 03:50Lastly, Ioffer you this blessing
• 03:52as written by Joy Harjo,
• 03:55a member of the Muskogee Nation and
• 03:57the 23rd United States Poet Laureate.
• 04:00Bless the poets.
• 04:02The Workers for Justice,
• 04:04the dancers of ceremony,
• 04:05the Singers of Heartache, the visionaries,
• 04:08all makers and carriers of fresh meaning.
• 04:12We will all make it through.
• 04:14Despite politics and wars,
• 04:17despite failures and misunderstandings.
• 04:20There is only love.
• 04:22Yogadin.
• 04:22Thank you.
• 04:25And I think about this year
• 04:26and what it means to me.
• 04:28I think challenges, what comes up.
• 04:31I think we've dealt with so
• 04:34many challenges as communities,
• 04:35as a department,
• 04:37as a university, as a country,
• 04:41and these last few years have really
• 04:45taught us ways in which challenges
• 04:47can help us come together and build,
• 04:50and also the ways in which challenges can.
• 04:53Divide us and and make it harder
• 04:55for us to connect with each other.
• 04:56And so I've thought a lot about
• 04:59challenges and within that how
• 05:01we can find community and how
• 05:03those communities can change.
• 05:04And I think this year has been
• 05:08a time of being able to seek
• 05:10community in and outside of the
• 05:12department in in new ways and in
• 05:15ways that we're also familiar.
• 05:16And lastly I think about inspiration
• 05:20and really being inspired by.
• 05:23The the interns and other residents, the
• 05:30the PRA and all the work that's been done
• 05:34to really move the department forward
• 05:37and keep it progressive and evolving.
• 05:41And I've been really inspired by the
• 05:43collective action of my coresidence and and
• 05:48members of the faculty who have also been.
• 05:53Been helpful in moving things forward.
• 05:56So, you know, I think throughout the
• 05:59challenges as we continue to find
• 06:02community and inspiration among each other,
• 06:04we can continue to build a better department
• 06:08that can really make an impact for for
• 06:12our community here and globally. Good
• 06:15morning, everyone.
• 06:15My name is George Rogoy.
• 06:17I'm an Associate professor of Psychiatry.
• 06:20At Yale School of Medicine,
• 06:22I'm also a member of the molecular
• 06:24division in the department,
• 06:26so I was asked by John to give
• 06:29a 5 minute presentation of what
• 06:31the last year meant for me,
• 06:34so I'm happy to do it.
• 06:35My commitment is over 90% of research in
• 06:39basic basic science with implications
• 06:42for neuropsychiatric diseases,
• 06:44so I'd like to start by acknowledging.
• 06:47Some of our research which is which
• 06:50is done by very talented postdocs
• 06:52in the lab and just highlighting
• 06:54three of the projects who have that
• 06:57have made quite a lot of progress
• 06:59in the last year and we're hoping
• 07:01you will be able to see them as
• 07:03publications in the next year or so.
• 07:04So one is developmental approach into
• 07:08understanding the neural ensemble
• 07:10mechanisms underlying our episodic memories.
• 07:13Which is a is a major component
• 07:15of our cognitive life.
• 07:17So here we we raised animals from
• 07:22birds into a geometrically altered
• 07:25environments such that experience with
• 07:28Euclidean geometry is is abolished
• 07:31and noticed that that that that
• 07:33influenced the way the neural ensembles
• 07:36shape encoding of context later in life.
• 07:42So we're happy that this project is gonna
• 07:45highlight the role of prior experience,
• 07:48particularly special and temporal experience,
• 07:50which are otherwise pretty
• 07:52hard to to monitor.
• 07:54On a second project,
• 07:56we took a more liberal view on
• 07:58what it what it means to have
• 08:00experiences within the day.
• 08:01And we acknowledge that most most
• 08:05previous research has been focused
• 08:07on one isolated experience and try to
• 08:10analyze what's happening with that.
• 08:12However, we took we we exposed the animals,
• 08:15in this case rats, adult rats,
• 08:16to over 30 sequential experiences
• 08:19within the day and
• 08:23how the brain avoids interference
• 08:26between these experiences and how is
• 08:28able to keep a record of of everything
• 08:31that happened during the day.
• 08:33And probably most interesting,
• 08:34the brain is also able to keep a
• 08:38record of the whole day within.
• 08:41Flashes of of of memories or supported
• 08:45by brain activity which which
• 08:46resembled a little bit the time of
• 08:49compression that I have to do today,
• 08:51compressing a full year into
• 08:535 minutes or so presentation.
• 08:55And finally we had the longstanding
• 08:56interest in the role of prior knowledge,
• 08:59prior experience in accelerating
• 09:01learning of new information.
• 09:03So we think of this as a simulation
• 09:06into preexisting schema more
• 09:08of a yes yes type of thinking.
• 09:10But we we getting to the neural
• 09:13mechanisms distributed between the
• 09:15hippocampus and mediaperfrontal cortex,
• 09:18distributed between activity during
• 09:20awake States and then sleep.
• 09:22So it's a lot of fun to to finally,
• 09:26I think,
• 09:27add our contribution to the general
• 09:30understanding of of accelerated learning.
• 09:33I have a strong commitment to
• 09:35teaching and mentoring,
• 09:36mentoring in the lab and outside.
• 09:39I'm I'm very pleased to see the
• 09:42diverse batch of of mentees to
• 09:44which I had interacted with.
• 09:46I had contributions towards have
• 09:49been offered tenant track positions
• 09:51in prestigious universities.
• 09:52So three of them in this last year
• 09:56have moved on to continue research
• 09:58in their own lab and continue the
• 10:00line of thinking and and develop
• 10:02new lines of thinking on their own.
• 10:06In addition I.
• 10:07More of a premiere for me here at Yale.
• 10:12I had deliver a full semester
• 10:14course graduate course on critical
• 10:17thinking of in learning and memory,
• 10:20which achieved in the end two goals,
• 10:23two major goals.
• 10:24One was to cover the major
• 10:27discoveries in the field of learning,
• 10:29a memory that guide our research to,
• 10:33and second was a parallel approach
• 10:36to study the critical thinking.
• 10:38In in in understanding and
• 10:41judging those discoveries.
• 10:42So this was done either through
• 10:45dual perspectives that argue
• 10:47or complement those research,
• 10:49and also to a series of additional
• 10:54commentaries on on prior research.
• 10:57And finally,
• 10:58as no no research can can
• 11:00be possible without funding,
• 11:02I'd like to acknowledge that this past year.
• 11:07We received a very generous grant from
• 11:11the NIH that that will bring to Yale
• 11:15a total sum of $4.6 million over the
• 11:19next eight years, with all that cost
• 11:23costs directed to to my laboratory.
• 11:26So, as as Aristotle long said, the whole
• 11:31is greater than the sum of its parts.
• 11:34We all acknowledge that this
• 11:36this great department.
• 11:37Is is goes well beyond what what each part,
• 11:42each laboratory,
• 11:43each person can contribute to.
• 11:45But today I gave you a slice of
• 11:47of what a part of this department
• 11:50could mean and and also I'd like
• 11:52to acknowledge the fact that the
• 11:56whole cannot exist without a part.
• 11:58And and with this I'd like to thank
• 12:00all my laboratory members and all
• 12:02the mentors that throughout the
• 12:04years have guided me with this.
• 12:07I'd like to give give time back to the John.
• 12:10Thank you.
• 12:12My name is Danita Monta Vertice.
• 12:14I'm an assistant professor in
• 12:16the Department of Psychiatry.
• 12:17I am honored and thankful to
• 12:19have been invited to reflect on
• 12:21what the year has been for me.
• 12:23After several years of the
• 12:25covidnineteen pandemic,
• 12:26this year I felt that we finally
• 12:28started to see the light at the end
• 12:31of the tunnel and getting out from it.
• 12:33It was so refreshing to be
• 12:34able to see in person,
• 12:36away from the soon fatigue,
• 12:37a lot of my colleagues and friends attending
• 12:41seminars and going to conferences.
• 12:44It felt like going back to normal.
• 12:46And as a very social person myself,
• 12:48I am so happy, happy seeing my
• 12:50boys going to birthday parties,
• 12:53traveling to see our family
• 12:55in Puerto Rico and Spain,
• 12:56see my boys playing with
• 12:58their cousins and friends.
• 12:59It has been a blessing.
• 13:01In my lab, things are also running smoothly.
• 13:04When the lockdown happened
• 13:06back in March 2020,
• 13:07I was just starting my lab with a one
• 13:10year old and pregnant of my second one.
• 13:13These were very difficult
• 13:15and challenging times,
• 13:16but with the hard work of the
• 13:18talented people in my lab, Shayla,
• 13:20Diana, Jaime, Batista, and Diego.
• 13:23In the support of my mentors,
• 13:24collaborators, family,
• 13:25friends,
• 13:26my husband,
• 13:27and community building efforts such as
• 13:31Lara Latinas revolutionizing academia,
• 13:33we were able to surpass them.
• 13:36The work of my lab focuses on
• 13:38studying genomics and epigenomics
• 13:39of psychiatric disorders.
• 13:41We pioneer the characterization of
• 13:44novel epigenetic mechanisms associated
• 13:46with organ use disorder and post
• 13:49traumatic stress disorder in the human brain.
• 13:52This work has been supported by R21,
• 13:55the first thing I each grant of my lab,
• 13:57a Career development award from the VA.
• 13:59And potentially,
• 14:00and fingers crossed since I'm still
• 14:02waiting for the notice of Award,
• 14:04an Ave.
• 14:05award from the National Institute
• 14:06on Drug Abuse which could support
• 14:09award for the next 5 years.
• 14:11I am a strong believer that in
• 14:12order to do excellent science,
• 14:14collaboration is key.
• 14:15That's the coshare of the Psychiatry
• 14:18Genomics Consortium Substance Use
• 14:20Disorders Epigenetic Workgroup.
• 14:21I'm sorry for the very long name.
• 14:24Researchers from the US,
• 14:26Germany,
• 14:26Canada,
• 14:26Mexico and Brazil are uniting forces and
• 14:29resources to conduct the best power genome
• 14:32wide studies in epigenetics and other omics,
• 14:35not only human postmortemic tissue,
• 14:37but also peripheral tissue,
• 14:39IPSC cells and organoids.
• 14:42This work will be unprecedented.
• 14:45As a Puerto Rican,
• 14:46I see myself and my community unfortunately
• 14:49often underrepresented economic studies,
• 14:51which now has the promise of developing
• 14:54novel tools that can guide treatment,
• 14:56prognosis,
• 14:57and even prevention of disease risk.
• 15:01With the lack of representation
• 15:03of populations like mine,
• 15:04there is a risk of exacerbating
• 15:07health disparities in our
• 15:08already underserved communities.
• 15:11That's a Latin American.
• 15:12We also have a complex that
• 15:14makes sure bans the streets,
• 15:15which which makes it even
• 15:18more challenging to study.
• 15:19As a result,
• 15:21we confounded the Latin American
• 15:23Genomics Consortium with now more
• 15:25than 150 investigators from 9
• 15:27different Latin American countries,
• 15:29the US and others.
• 15:30Our aim is to tackle beyond their
• 15:33representation of Latin American
• 15:35population and genomic studies.
• 15:37We develop novel methods that can
• 15:39allow us to account and study
• 15:41the complex that make sure in our
• 15:44populations and support capacity
• 15:46building efforts across Latin America
• 15:48to conduct this study in a local,
• 15:50equitable and sustainable manner.
• 15:52My interest in diversifying
• 15:54genomic studies is not limited
• 15:57to Latin American population,
• 15:58but also across traditionally
• 16:00underrepresented populations
• 16:01in our country and globally.
• 16:04In the US,
• 16:05the All of Us Research program
• 16:07represents the largest and most
• 16:09ambitious petition meditating
• 16:10efforts with the goal of recruiting
• 16:13more than 1,000,000 people and
• 16:15representing the most diverse
• 16:17cohort for genomic studies ever.
• 16:19This also represents a rich and
• 16:21unique resource for the study of
• 16:23social determinants of health.
• 16:25To understand how things like income,
• 16:27education, housing,
• 16:28access to healthcare,
• 16:30and social support can inform
• 16:32help these parties and its
• 16:34impact on health outcomes.
• 16:35Currently all of us has more than
• 16:37half million people enrolled,
• 16:39most of these with HR data and genomic
• 16:42data accessible to researchers.
• 16:44And I'm happy to announce that
• 16:46this year Yale will become a new
• 16:49recruitment site for all of us,
• 16:50and I have the honor to leave this
• 16:53important work with the white CCI.
• 16:55We will be launching in early June,
• 16:57so feel free to reach out For
• 16:59more information.
• 17:00This is a valuable opportunity
• 17:02for clinicians and scientists to
• 17:04expand their ongoing research work
• 17:06and become part of all of us.
• 17:08Thank you very much.
• 17:10Good morning everyone.
• 17:12It's my real pleasure to talk
• 17:15about some of the exciting things
• 17:17in from the psychology section.
• 17:19In the past year that have that have
• 17:21happened that I'd love to share with you.
• 17:23I'm going to go ahead and share my
• 17:26screen just to keep us very organized
• 17:28because there's so many good things and
• 17:31I've had to select from from several.
• 17:34And so I'm just going to go ahead
• 17:38and start with our very first one
• 17:40which is that the Yale pre doctoral
• 17:44psychology internship program which
• 17:46has been longstanding and is.
• 17:49Well established across the steam,
• 17:52HC and Yale New Haven health
• 17:55systems went through accreditation
• 17:57and we passed with blind colors
• 17:59and we were renewed for 10 years.
• 18:01And I want to thank Amber Childs,
• 18:03who is the director of the Prepactual
• 18:05training program and she led the training
• 18:08faculty through this whole process,
• 18:10which took place over really two years,
• 18:13two to three years because of the pandemic.
• 18:16And she was joined with the by Jack
• 18:19Cheebs and Dwayne Fan who lead the
• 18:22institutions that Timothy and and
• 18:24Young Human Health and of course
• 18:27all of our training faculty at both
• 18:29of those institutions and are a new
• 18:31psychology administrator, Patrick Riley.
• 18:33This was a joint effort and with the
• 18:38Dean's office of course John Crystal
• 18:40and several of you were involved,
• 18:43our full time faculty,
• 18:45voluntary faculty.
• 18:46I would just really want to thank
• 18:48everybody for their wonderful
• 18:50efforts in showing off our program
• 18:53and we did really well.
• 18:55And I want also share this new
• 18:58initiative initiative called the
• 18:59Getting Racism Out of the Workplace,
• 19:01the grow program,
• 19:02you may have already heard about it.
• 19:04The cofounders are again Amber Childs,
• 19:08Rebecca Miller and Cindy Cresto.
• 19:10And this the goal of this program is
• 19:13to create racially and culturally
• 19:15responsive clinical leaders,
• 19:17supervisors and practitioners.
• 19:19And the program builds competency skills,
• 19:24cultural competency skills and a
• 19:27related training so that we can
• 19:29get racism out of the workplace.
• 19:32And this is really taking off.
• 19:33It's getting regional and national attention.
• 19:35And real kudos to our faculty here,
• 19:40Amber,
• 19:40Replica and Cindy for leading this effort.
• 19:44I want to also note Doctor Galena Portnoy,
• 19:48who has just started and received
• 19:50funding for an intimate partner
• 19:52violence Center of Innovation and
• 19:55Research at the VA Healthcare System.
• 19:57The center focuses on screening for
• 19:59IPB and veterans and the provision of
• 20:02treatment simultaneously and of course
• 20:04evaluation and outcomes assessment.
• 20:05So thank you Galena for this
• 20:09wonderful center that I think
• 20:10is going to be doing very,
• 20:11very important work.
• 20:13I also want to acknowledge the Yale
• 20:15Measurement Based Care Collaborative.
• 20:17This is the collaboration across
• 20:20the Yale Movement Health VA and
• 20:23the Consultation Center to deliver
• 20:25training and care that is tied to
• 20:28measurable changes and outcomes.
• 20:30It's a three-part training,
• 20:32video training that has been
• 20:34now launched across the nation.
• 20:36We already have 1500 registrants
• 20:39and of course the cofounders are.
• 20:42Amber Childs,
• 20:43Elizabeth Connors,
• 20:44Jessica Barber and Sandy Resnick,
• 20:46thank you all for this
• 20:48beautiful collaborative effort.
• 20:49I think it's going national and and
• 20:52you all are showing really wonderful
• 20:54national leadership in this in this area.
• 20:56It's being cited by the American
• 20:59Psychological Association as a primary
• 21:01resource for education on MVC.
• 21:05I also want to acknowledge David Klemanski,
• 21:07who's led the effort in developing
• 21:09the CL Patient Experience tool
• 21:11to assess patient healthcare
• 21:13experiences and patient reported
• 21:15outcomes during hospitalization
• 21:17and other healthcare settings.
• 21:19This has been highlighted by CMS
• 21:21and endorsed by them and it's on
• 21:23its way to becoming a national
• 21:25standard for reporting on behavioral
• 21:28health patient satisfaction metrics.
• 21:30So thank you David for that,
• 21:31for that wonderful work.
• 21:33I want to acknowledge this new program.
• 21:35Some of you may have heard about it,
• 21:37the Elm City Compass,
• 21:39Compassionate Allies Serving our streets.
• 21:42This initiative creates a sustainable
• 21:44system of supports for individuals
• 21:46with mental illness in New Haven.
• 21:48And it's in partnership with a
• 21:51number of community organizations
• 21:52and the City of New Haven DMS&CMHC.
• 21:55And this is led by Jack Teebs
• 21:59and Derek Gordon.
• 22:00And I it has already received the
• 22:032023 Yale Nammy Advocacy Award.
• 22:06So please look it up.
• 22:07And this is you.
• 22:08I'm sure you will hear about it
• 22:10in in the coming months.
• 22:12This is a new initiative.
• 22:15I want to also just acknowledge several
• 22:17faculty awards and recognitions.
• 22:19Donna Lapaglia and who has taken over
• 22:21as a PA Division Twelve president.
• 22:24Allison Ponsey and she is chair
• 22:27of an APA task force on doctoral
• 22:30competencies Kim Smulderin,
• 22:32Who's APA Division 38,
• 22:33Chair for Health Advocacy and Policy Council.
• 22:36Dwayne Fan,
• 22:37Chair of the Council of Clinical
• 22:39Health Psychology Training Councils.
• 22:41Michelle Silva received the 2022
• 22:43STAR Vega Distinguished Service
• 22:45Award from the National Latinx
• 22:48Psychological Association and Cle.
• 22:50Has just been elected chair of the
• 22:52APA Board of Professional Affairs,
• 22:54and Derek Gordon is receiving
• 22:55the Ron Mincy 2022 Research and
• 22:58Scholarship Award for the National
• 23:00Partnership for Community Leadership
• 23:02for his research on fatherhood.
• 23:04I want to acknowledge 2 exciting
• 23:07large center grants that we've
• 23:10received in the last year.
• 23:13Our faculty in the psychology section
• 23:15have been getting numerous grants and
• 23:18they've just been doing fantastic work.
• 23:21I want to highlight Elon Harper's
• 23:23rotem who has received a large
• 23:26grant over $6,000,000 on Academy to
• 23:29extinguish Geo memories in PTSD.
• 23:31And Declan Berry,
• 23:32who received a large center grant
• 23:34along with our medicine colleagues
• 23:36William Becker and David Filene.
• 23:38And this is on chronic pain
• 23:41and opioid use disorder.
• 23:43And so with that,
• 23:44I want to thank all of our
• 23:46psychology faculty for just the
• 23:48a wonderful year that we've had,
• 23:50a very productive year and for all
• 23:52of your accomplishments and your
• 23:54hard work and I really we are very,
• 23:56very grateful for all of your efforts.
• 23:58Thank you so much.
• 24:06I think that's the
• 24:09end of this part. So first I want to thank
• 24:16So how do I? What
• 24:19did I do here
• 24:23a day? Hello. My name is.
• 24:25There we go. All right.
• 24:28So first I want to thank
• 24:31everybody who took time out to
• 24:33make those wonderful vignettes.
• 24:35And I'll try to speak to issues in some,
• 24:40to some extent raised by those vignettes,
• 24:42but also try not to overlap on on
• 24:45the issues that I highlight in terms
• 24:48of progress in the department.
• 24:50So am I sharing?
• 24:53I'm going to share my screen
• 24:57like this one.
• 25:01All right?
• 25:04You know, but I'm in the wrong slide show.
• 25:05It's Okay, it's not showing
• 25:07up on there. All right, good.
• 25:12So let's continue and and and I'll I'm
• 25:18really pleased to have the opportunity
• 25:21to talk about the department today.
• 25:24Before I go further,
• 25:25I want to share my financial disclosures.
• 25:29Particularly my role in cofounding
• 25:31Freedom Biosciences in consulting
• 25:33to another number of companies and
• 25:36involvement in patents that have
• 25:38been licensed particularly to Jansen
• 25:41Pharmaceuticals related to to use
• 25:44of catamine to treat depression.
• 25:48I also want to acknowledge folks
• 25:50who helped make some of the
• 25:52slides today Vicki D'agostino,
• 25:54Mary Kate DeMarco, Issa Dube Dube.
• 25:57Chris Gardner, Steve Gentile and Steve Healy.
• 26:01And so I'd like to begin with our
• 26:04new Mission Vision Value statement,
• 26:08and I'm going to read it to you,
• 26:09and I may read it to you every year.
• 26:12It's a wonderful statement and it says
• 26:15a lot about who we are as a community,
• 26:17as well as the community
• 26:19that we aspire to become.
• 26:21The old Department of Psychiatry is
• 26:23dedicated to enhancing holistic wellbeing,
• 26:26facilitating recovery,
• 26:27and reducing the suffering and oppression
• 26:31associated with mental illness.
• 26:33We do this through the education
• 26:35of transformative leisures,
• 26:37excellence in research practice and policy,
• 26:40and restorative and reciprocal
• 26:43community engagement.
• 26:44We embrace multiple approaches to learning,
• 26:47levels of analysis, and ways of knowing.
• 26:51And throughout this work,
• 26:52we strive to nurture a diverse
• 26:55community of trainees, staff,
• 26:57faculty and partnerships characterized
• 27:00by compassion, inclusivity,
• 27:02humility, dignity, and justice.
• 27:06This is a wonderful statement and I
• 27:08would like to acknowledge the group
• 27:12that that pulled this together.
• 27:16This is an outgrowth of the
• 27:18Anti Racism Task Force.
• 27:21Cochaired by Sonya Udalin and Mirage.
• 27:25And I want to thank you for your
• 27:28leadership of this effort and
• 27:31for everybody for their input.
• 27:33I think this will be a wonderful
• 27:36document to refer to going forward.
• 27:43You know Biden declares pandemic over.
• 27:50What a remarkable several years it has been.
• 27:55I think it will take us many years
• 27:58to come to understand the impact that
• 28:02the pandemic has had on our lives,
• 28:05on our children's lives, on our department,
• 28:10on our trainees and their careers.
• 28:13It is in inestimable and estimable.
• 28:19It's difficult to estimate the the
• 28:25impact that it that it has had on all
• 28:27of us and the impact has been terrible.
• 28:30We've lost friends, relatives, colleagues.
• 28:35It has been terrible in the
• 28:37burden in which we've shouldered.
• 28:39It's been terrible in with respect
• 28:44to all the issues that we have
• 28:47had to face in our country.
• 28:50During this time,
• 28:54and it's been wonderful,
• 28:56it's been wonderful to pull together
• 28:59with all of you to care for the people
• 29:03who've struggled with the stress and
• 29:06burden of of COVID in their lives
• 29:08as we have supported them through
• 29:11providing mental health services,
• 29:13through providing mentorship,
• 29:15through supporting our colleagues
• 29:17in the healthcare community.
• 29:19Through providing guidance nationally
• 29:22in ways that people could cope,
• 29:26we have been a remarkably resilient
• 29:33community in adapting rapidly to
• 29:36provide services in the in the
• 29:39changing context created by COVID.
• 29:43But now Covid's over and and as if.
• 29:48All that we have built up would suddenly
• 29:52become better once the pandemics,
• 29:56medical urgency had passed.
• 29:59In large part, that is obviously a fallacy.
• 30:06Instead,
• 30:07we find that we are continuing to
• 30:11deal with the fact that COVID did
• 30:16not create many issues that we face,
• 30:18but rather.
• 30:19Highlighted and drew our attention
• 30:21to them and that while the pandemic
• 30:26risks have passed,
• 30:27the the residual of that time remains
• 30:32as we continue to deal with the
• 30:36impact of the pandemic on our lives,
• 30:39on our work, on our families,
• 30:42on our careers,
• 30:44on our children and their careers.
• 30:47This is this is a remarkable of time
• 30:51which in its own way is challenging
• 30:54our capacity for resilience
• 30:58and and our ability to be focused
• 31:02on the mission and vision and
• 31:04values that I just articulated.
• 31:08There are some hidden changes in the
• 31:11community and as you can see I I have
• 31:14brought in some of the best photographers.
• 31:16Around to help take pictures of things.
• 31:19Actually this is my phone that
• 31:21took a picture of a slide.
• 31:24But in the background in the
• 31:27everything that we do are the kind
• 31:29of broader kind of contextual issues
• 31:33that affect the Medical Center,
• 31:36the medical school the the the department
• 31:38and I I just wanted to share this with
• 31:41you because it was really striking.
• 31:44This is the.
• 31:45Operating margin of the average operating
• 31:49margin of hospitals in the United States
• 31:52and you can see that until December 2021,
• 31:57these hospitals maintained
• 31:59about a 4% profit margin.
• 32:02And then beginning January 2022
• 32:06and continuing through all of
• 32:092022 and we're still in this.
• 32:13Basically,
• 32:13the average hospital in the United States
• 32:17lost money and and we're not out of it.
• 32:22And Yale New Haven Hospital and
• 32:24Yale New Haven Health System
• 32:26are no exception to this trend.
• 32:29We are all struggling as an
• 32:32institution with the fact that the
• 32:35context of delivering healthcare
• 32:37changed dramatically during COVID.
• 32:40The economic context.
• 32:42And so the shape of healthcare going forward,
• 32:46what it's going to look like is uncertain,
• 32:49but it's not likely to simply revert
• 32:52to business as usual that that a
• 32:56new kind of way of thinking about
• 32:59healthcare will be healthcare delivery
• 33:02is evolving and will shape the future
• 33:07of what Healthcare is like here at Yale.
• 33:11This is a time when we are fundamentally
• 33:14reworking our institutional relationships.
• 33:17The hospital and the medical school
• 33:20are engaged in a level of dialogue to
• 33:24transform the nature of the collaboration
• 33:28between these institutions in fundamental
• 33:31ways that have no precedent in the
• 33:34history of either institution,
• 33:36to my knowledge.
• 33:39The way in which money will move back
• 33:41and forth between the medical school
• 33:43and the hospital and vice versa,
• 33:45The way that accountability
• 33:48for administration,
• 33:49yeah, is taking place,
• 33:51the level of transparency,
• 33:53the integration of the collaboration
• 33:55and the delivery of healthcare,
• 33:58all of these things are moving in
• 34:02novel directions that where the
• 34:06outcome is not yet entirely clear.
• 34:08But the one thing we can say is that it
• 34:11will have an impact on all that we do.
• 34:14A second issue,
• 34:16which is also obvious in some ways
• 34:19but not so obvious in other ways,
• 34:22is that having a new Dean who arrived
• 34:25at the start of COVID with a new
• 34:29vision for how for the future of
• 34:32the medical school and how we as
• 34:34departments relate to the medical school.
• 34:37And to each other is now rolling
• 34:41out and we will see how this plays
• 34:44out in the years ahead.
• 34:46As we have a number of new collaborations,
• 34:50some of which are really extremely exciting
• 34:53like the Center for Brain and Mind Health,
• 34:55which will bring psychiatry,
• 34:57neurology and neurosurgery together
• 35:00in an academic collaboration that
• 35:02that could have profound benefits
• 35:04for all of us going forward.
• 35:08One of the messages that I wanted to
• 35:11send today is with so much change,
• 35:15with so much baggage, if you will,
• 35:20with so many distractions and so much to do,
• 35:25it's important to recognize that it's easy
• 35:27for us to lose sight of how wonderful
• 35:31and special the work that we do together.
• 35:35Really is We have so much to celebrate
• 35:40and the videos helped to identify many
• 35:45areas both of of work and of celebration.
• 35:51But I just wanted to highlight some
• 35:53statistics which I I know many
• 35:55of you are already familiar.
• 35:58We continue to be #2 in the country and NIH
• 36:02funding our residency is continued to be.
• 36:05Among the top residencies in the country,
• 36:10we had 14140 applicants to the
• 36:14psychiatry residency this year.
• 36:16In 1992, there were 425 matched
• 36:22residents in psychiatry.
• 36:25This year there are 17150 match
• 36:29residents in psychiatry and we had 14140.
• 36:35Applicants.
• 36:36The psychiatry as a field is thriving
• 36:40with many people attracted to many of
• 36:44the exciting developments in the field
• 36:47as well as its traditional commitment
• 36:50to understanding another person.
• 36:54And it's become extraordinarily competitive.
• 36:58I think in the end this is a very good and
• 37:01important development for us and something.
• 37:04That in invisible ways will
• 37:06drive the field forward.
• 37:08In our class, that entering class
• 37:12of a very diverse candidates,
• 37:1711 of the 16 entering residents have advanced
• 37:21degrees in addition to the MD degree,
• 37:25speaking to both the depth of
• 37:29experiences that they've pursued to
• 37:31prepare themselves for psychiatry.
• 37:33As well as the level of accomplishment
• 37:36that they have achieved,
• 37:39our department and the Department
• 37:41of Psychology are ranked the number
• 37:43four department of psychiatry in the
• 37:46world in terms of medical student
• 37:48education and psychiatry number six,
• 37:50psychology program with psychiatry
• 37:53number six,
• 37:54Our psychiatric hospital #8 the internship
• 37:58ranked among the top group in psychology.
• 38:03So by these big external metrics,
• 38:08this is really an incredible community.
• 38:11I'd like to highlight at
• 38:13this point some people,
• 38:15some programs and some advances
• 38:18in the field which have made this
• 38:21past year in some ways both very
• 38:24exciting and and perhaps pivotal.
• 38:28Charles,
• 38:29DK.
• 38:30Deputy Commissioner and Medical
• 38:32Director for DEMIS and interim leader
• 38:37of the upcoming interim leader of
• 38:40the Division of Law and Psychiatry
• 38:43after Howard Zananna steps down has
• 38:47is an really important figure in
• 38:49the field of forensic psychiatry.
• 38:52In the Forensic Psychiatry Association,
• 38:55Apple has created the Charles
• 38:58DK Diversity Scholarship.
• 39:01RINA Pechotto,
• 39:03I think it's now ready to begin in November.
• 39:08Is that right? Your presidency?
• 39:10Finally,
• 39:10after being elected the president
• 39:12of the Society for Neuroscience,
• 39:15the largest and most impactful
• 39:18organization in the field of neuroscience,
• 39:21Ezra Griffith received the Cato
• 39:23Lorenson Lifetime Research Award from
• 39:26the National Medical Association.
• 39:28Fujita Sinha, who,
• 39:30enlisting many of the accomplishments
• 39:32of the Psychology section,
• 39:34neglected to mention that she
• 39:36too was elected president of the
• 39:39Research Society and Alcohol,
• 39:40the most important society
• 39:42in that field of research.
• 39:44And this year we received news
• 39:47of the creation of the Ale Center
• 39:50for the Science of Cannabis.
• 39:52It can cannabinoids led by Cyril D'souza,
• 39:56who also this year.
• 39:58Was a word of the Albert
• 40:00E Kent professorship.
• 40:03Two other important words signal really a
• 40:07transformative evolution in neuroscience.
• 40:10The first from this cover.
• 40:13It has to do with the emergence of
• 40:16cellular models for psychiatric disorders,
• 40:18whereby stem cells collected from the
• 40:23blood can be cultured and converted into.
• 40:27Neurons and various cells in the brain
• 40:30and used to to tell us something
• 40:33fundamental about the neurobiology and
• 40:35genetics of psychiatric disorders.
• 40:37And we are very fortunate to have
• 40:39in the department Kristin Brennan,
• 40:41the first person to create neurons
• 40:44from stem cells from a person with
• 40:47schizophrenia who received the A/C and
• 40:50P Daniel Efron Basic Research Award.
• 40:54Another kind of.
• 40:57Shocking a bit of research from
• 41:01someone with a secondary appointment
• 41:03in our department was celebrated
• 41:05in this cover of Nature,
• 41:07which is the work of Nenad
• 41:10Sestan to understand
• 41:14the biology of neural preservation,
• 41:18and he has studied ways to restore
• 41:22brain function after death.
• 41:25In tissue from in animal tissue
• 41:29and he received the for this work.
• 41:33The National Geographic
• 41:34Amazing Discovery Ward.
• 41:36You know you can just imagine what the
• 41:38other National Geographic awards were
• 41:40like happy pandas and and you know,
• 41:44who knows but this fundamental work may
• 41:48open a new window in ways for curing stroke.
• 41:54And other neuro neural injuries I
• 42:01I don't have time to go over all
• 42:03the honors that and accomplishments
• 42:05that people have gotten.
• 42:07But I do want to show you the people
• 42:13who we should all celebrate each one
• 42:17for their wonderful accomplishments
• 42:19like the A/C and P travel awardees or.
• 42:25The Zhao Duquino,
• 42:29the ICCTM New Investigator Award,
• 42:33or Godfrey Pearlson giving the floor
• 42:35Henry Lecture at the University of Alberta?
• 42:38Or are three new members to the
• 42:41Connecticut Academy of Science
• 42:43and Technology,
• 42:44such as Knee Addie Laura Hawkins
• 42:46and his Meanie Petrakis.
• 42:52Or Matt Gigenti, who received the CIMP
• 42:56Raffleson Young Investigator Award
• 42:58and of course our Seymour Lustman
• 43:01Awardees who we celebrated earlier.
• 43:06I thought I would just take a few moments
• 43:09to talk about how the last year was
• 43:12potentially A pivotal year in terms
• 43:14of a new generation of treatments in
• 43:17psychiatric disorders historically.
• 43:21For the last 20 years at least,
• 43:24maybe even more, CNS drug development
• 43:28has lagged behind other areas
• 43:30in medical research.
• 43:32As you can see here in red,
• 43:36the number of treatments with
• 43:38really novel mechanisms in in
• 43:41psychiatry have been nearly zero.
• 43:44Shocking. But this year?
• 43:48In a study led by Chris Van
• 43:50**** in our department,
• 43:52we had the first
• 43:56disease modifying treatment
• 43:58for Alzheimer's disease,
• 43:59an antibody for the amyloid protein.
• 44:02The a beta part of the amyloid protein
• 44:08and signaling a new generation of
• 44:11treatments that are not only aimed at
• 44:14trying to alleviate the behavioral.
• 44:18Consequences of Alzheimer's disease,
• 44:20but affect the actual biology
• 44:24of the disease itself.
• 44:26As many of you know,
• 44:27we are revisiting the Age of Aquarius
• 44:31in that psychedelic research is
• 44:35blossoming at Yale and elsewhere,
• 44:38and we saw not from Yale,
• 44:40but in a but a large national study from.
• 44:45Multicenter consortium led by
• 44:47the Compass Pathways Company,
• 44:51the first really informative study about
• 44:54the impact of psilocybin treatment.
• 44:56And what you can see in this slide
• 44:59is that from a single dose of
• 45:03psilocybin that people who got the
• 45:06full psychedelic dose had 12 weeks of
• 45:11persisting benefit including a rapid.
• 45:15Reduction in depression symptoms.
• 45:18What's what's really striking
• 45:21here is not only the magnitude
• 45:23of the fact in a population that
• 45:25had treatment resistant symptoms,
• 45:27but the persistence of the and magnitude
• 45:30of the benefits from a single dose.
• 45:33Now psilocybin is something that
• 45:35has been studied here at Yale
• 45:38and and it's A and it's a very
• 45:42exciting advance an opportunity.
• 45:44But treatment sessions are
• 45:45long and very involved.
• 45:46The process is very taxing,
• 45:49with several preparatory treatments,
• 45:52psychotherapy treatments,
• 45:53the 68 hour infusion,
• 45:55and then then followup treatments.
• 45:58And one idea about where this
• 46:00field may be heading comes
• 46:02from a work done here at Yale.
• 46:05Cyril D'souza and his colleagues at the
• 46:09VA have studied dimethyltryptamine,
• 46:11a short acting.
• 46:13Psychedelic whose effects may only
• 46:15last an hour or less and yet already
• 46:19show signs of antidepressant efficacy.
• 46:22So this is a very exciting and very
• 46:25rapidly evolving area of research.
• 46:27We will be very much engaged
• 46:30in trying to understand the how
• 46:33to implement these clinic,
• 46:35these treatments as they are
• 46:37shown to be effective,
• 46:38as well as trying to understand
• 46:40how they work.
• 46:44And I should say that this whole
• 46:47field of work of psychedelics has
• 46:50an important part of its history
• 46:52here at Yale, with pioneers,
• 46:55particularly George Agajanian
• 46:57and his mentor Daniel X Friedman,
• 47:01who really opened the study of the
• 47:05signaling mechanisms through which
• 47:07psychedelics produce their effects.
• 47:09The acerotonin systems in the brain
• 47:14schizophrenia another area where for
• 47:1750 years, 60 years all the treatments
• 47:20in schizophrenia have worked by
• 47:22blocking the dopamine D2 receptor.
• 47:25A model of the pathophysiology
• 47:28of schizophrenia developed in
• 47:30part from work here at Yale,
• 47:33beginning with some initial
• 47:35findings from B to Mogadom.
• 47:37Going way back into the 1990s and
• 47:40amplified through the work of many people,
• 47:42Alan and Tichevich,
• 47:44John Murray and many others
• 47:47have led to kind of
• 47:50an additional story to the
• 47:53neurobiology of schizophrenia.
• 47:54Many of you know that the main
• 47:56information highways of the brain,
• 47:58the glutamate system in the cerebral cortex,
• 48:02is compromised in schizophrenia.
• 48:04But what's often not appreciated
• 48:06is that downstream from that,
• 48:09the inhibitory neurons,
• 48:10the GABA neurons,
• 48:12are also compromised,
• 48:15resulting in disinhibition
• 48:17of glutamate neurons,
• 48:20increased noisy communication in the cortex,
• 48:24and excessive excitatory drive
• 48:26to the Strida in the area in the
• 48:31brain traditionally targeted
• 48:33by antipsychotic medications.
• 48:36What's exciting about this year is
• 48:40that 2 new mechanisms have moved
• 48:43forward as potential alternatives to
• 48:45dopamine D2 receptor antagonism as
• 48:49antipsychotic treatments for schizophrenia.
• 48:52One of these is M4 muscarinic
• 48:56receptor stimulation.
• 48:57The other one is trace amine associated
• 49:00receptor 1 receptor stimulation.
• 49:02And these may have an effect for
• 49:06compensating for disinhibition within
• 49:08the cortex by suppressing noisy
• 49:11or excessive glutamate release,
• 49:13and for compensating for the
• 49:16disinhibition of cortical inputs
• 49:18into the striatum.
• 49:20Too much dopamine,
• 49:21too much glutamate by reducing
• 49:23both the release of both of those
• 49:26transmitters in the striatum and,
• 49:28in a series of studies with
• 49:31a drug called ulanorant.
• 49:33A drug called CAR XT and a
• 49:37drug called emraclidine.
• 49:39We saw a very exciting and novel pattern
• 49:44of clinical efficacies associated
• 49:47with these antipsychotics that block,
• 49:50that have actions on psychosis without
• 49:53blocking dopamine D2 receptors.
• 49:55First and most importantly across
• 49:57all of these studies it looks
• 50:00like these medications.
• 50:04Treat psychosis, but are relatively very
• 50:07good at treating the negative symptoms
• 50:10of schizophrenia that traditionally have
• 50:13not been so effectively treated with our
• 50:17traditional antipsychotic medications.
• 50:19And these medications seem to be
• 50:22very tolerable and they in particular
• 50:24they don't make people feel so dull.
• 50:29And they don't have,
• 50:30they don't produce extra pyramidal
• 50:32side effects and it is raised the
• 50:35possibility that we over the next
• 50:385 to 10 years will enter a time
• 50:40when the traditional concerns
• 50:43about antipsychotic treatment i.e.
• 50:45I don't want to take these medications
• 50:47because they make me feel dull.
• 50:49They make me feel less of myself,
• 50:52they they make me feel drugged
• 50:55that those effects.
• 50:56May not be so much associated with
• 50:59these new medications and if so,
• 51:02this could be a really
• 51:05transformative advance.
• 51:06As you heard in in Regina's comments,
• 51:08progress is being made in
• 51:10many areas in the department,
• 51:12digital health,
• 51:13biomarker development and here
• 51:17we recently celebrated at the
• 51:20Yale Innovation Summit two
• 51:21of our department faculty.
• 51:23Who made advances in biomarker development
• 51:27or digital health and are launching
• 51:31new companies based on their work.
• 51:36At this point,
• 51:37I'd like to transition to
• 51:39making some general comments
• 51:40about our our department.
• 51:42As you know,
• 51:43we're the second largest department in
• 51:45the medical school 270 ladder faculty
• 51:5169.26%. Caucasian and 55% female.
• 51:58And that's really an important
• 52:00characteristic for our department
• 52:02that distinguishes us from not every
• 52:05department but nearly every department.
• 52:07In the medical school,
• 52:09we're now 50% MD or MDPHD and 50% PhD,
• 52:17and so we're a very professionally
• 52:21diverse department.
• 52:23We're 15% in the clinical track,
• 52:26a little less than half in the
• 52:29clinician educator track and
• 52:31then the remainder about 40%
• 52:34in the various research track.
• 52:36So we're we are relatively balanced in
• 52:42our clinical educational and research
• 52:45missions and we're obviously making very,
• 52:48very important.
• 52:49Commitments in all of those areas
• 52:54our our book of business continues to grow.
• 52:58This year our budget was $212 million,
• 53:02fifty four, 4% of that budget
• 53:05comes from our research grants,
• 53:1141% or 87 million comes from our collective
• 53:15clinical activities which come from
• 53:17our work at Yale New Haven Hospital.
• 53:20Our work through the faculty
• 53:21staffing contract of the
• 53:23Connecticut Mental Health Center,
• 53:24our work within Yale Medicine and
• 53:27our other related clinical activities
• 53:30through Yale by Alvaro Health.
• 53:33About 9% of our our revenue or
• 53:38support comes from a hospital
• 53:42support for educational mission
• 53:44and 1% support for administration.
• 53:48As I mentioned earlier,
• 53:50our department research portfolio
• 53:52continues to grow.
• 53:54We've we took a hit with the loss
• 53:58of a number of really exceptional
• 54:00scientists in our department
• 54:02over the past several years,
• 54:04but we are building back and we
• 54:08remain #2 in the country again.
• 54:12In terms of new leaders in the department,
• 54:14I really want to acknowledge and
• 54:17thank on Millard for stepping up as
• 54:20Frank Fortunati's illness advanced
• 54:21and and for her assuming of the
• 54:25interim leadership of Yale New Haven.
• 54:27Psychiatry
• 54:31revenues at Yale New Haven
• 54:32Hospital have continued to grow,
• 54:34but so have our costs and so
• 54:37it's always a challenge to
• 54:39manage the balance of our.
• 54:42Of our costs and revenues,
• 54:44but things are I'd say relatively
• 54:47stable there for the moment.
• 54:51One interesting trend in the department as
• 54:53we look at the composition of our faculty
• 54:56as that is as you remember the number of
• 55:00faculty has gone up from about 250 to 270,
• 55:04but the number of Caucasian faculty at each
• 55:08rank has gone down and what that is saying.
• 55:12Is that that the the faculty
• 55:18is diversifying slowly.
• 55:20We have a long way to go,
• 55:23but we are making slow progress.
• 55:27A very this is an interesting moment
• 55:30in terms of gender diversity in
• 55:32the apartment many years ago now,
• 55:35probably a decade or so ago,
• 55:38maybe even more.
• 55:40Our assistant professors were
• 55:43first predominantly female this
• 55:45year for the first time.
• 55:47We have transitioned in our associate
• 55:51professors from 2222 when we were
• 55:56had more male than female associate
• 55:59professors to 2023 where we have more
• 56:03female than male associate professors.
• 56:06And I think you know where
• 56:08this story is going.
• 56:09In in a few years that red box is going
• 56:12to move over to the professors and and
• 56:17we will continue to grow and diversify
• 56:20in very positive ways as an apartment.
• 56:23And so I think this is,
• 56:25this is wonderful
• 56:29in terms of our education mission.
• 56:31This has been in as you can imagine
• 56:34an extraordinarily challenging
• 56:35year we have been through.
• 56:37A lot. As a community,
• 56:39we continue to try to come to grips with
• 56:43all the changes of the past year or so,
• 56:47but we continue to have amazing,
• 56:50dedicated, accomplished leadership.
• 56:53I want to thank Richard Belitsky
• 56:56for his continued interim leadership
• 56:58of the Residency program,
• 57:00Esperanza Diaz and Katie Klingensmith
• 57:03for their continued leadership as well.
• 57:05And for Katie.
• 57:07For her leadership of this remarkable
• 57:10recruitment season that we had for
• 57:13the Residency and to welcome 2 new
• 57:15leaders to the residency program who've
• 57:18already who are already hard at work.
• 57:21Ruby Lekwawa and Mu and King who are
• 57:25have stepped in seamlessly and are
• 57:28really playing an important role.
• 57:31Our Residency is looking forward, Richard.
• 57:35Solitsky will head the search
• 57:37for a new program director.
• 57:40He is structuring roles in his
• 57:42leadership team to enable greater
• 57:44focus on the core missions of our
• 57:47residency training program and
• 57:49actually structuring restructuring
• 57:51rotations in the upcoming year
• 57:54to reduce tensions between the on
• 57:57unit responsibilities of residents
• 57:59and their offunit activities to
• 58:02to minimize those attentions.
• 58:05With restructuring call to some
• 58:07extent that dactics and and how
• 58:10big vacation time is utilized,
• 58:12I think that these will be very
• 58:14positive steps and another positive
• 58:16step will be the initiation of
• 58:18an outside program review which
• 58:21I committed to in in the context
• 58:24of the last round of of residency
• 58:29program director search.
• 58:31We hope that that external review
• 58:33will help us to build a platform for
• 58:35future growth of the residency program,
• 58:41climate and communication.
• 58:44As as I noted earlier,
• 58:46the pandemic were some longstanding
• 58:49unaddressed issues in our
• 58:51department and we saw over the
• 58:53past years for a lot of reasons,
• 58:56erosion of community spirit
• 58:58at many levels between groups.
• 59:00Attentions say for example between
• 59:03residents and faculty within groups as well.
• 59:07And we are have engaged an external
• 59:10group of consult and consultation to
• 59:13help us to think about our community
• 59:16and ways to build the community.
• 59:21Spirit want to acknowledge now Retirements
• 59:24in the department Howard Sonana.
• 59:27Really.
• 59:28Such a pivotal and critical leader
• 59:32in the department in so many ways.
• 59:35His leadership of the, of the,
• 59:37of the forensic programs in the department,
• 59:41but also stepping in on so many
• 59:44challenging ethical issues that we have
• 59:46faced as a department over the decades.
• 59:51And Howard, you can't thank you
• 59:53enough for all of your contributions.
• 59:56To our community and for
• 59:58your dedication and service,
• 01:00:02I want to also acknowledge our losses.
• 01:00:06The 1st is Chris Andreazzi.
• 01:00:08Now many of you may not know him.
• 01:00:10He was an advanced Practice nurse
• 01:00:13on the L V2 unit at Yale New Haven
• 01:00:16Hospital and he died this year at the
• 01:00:19age of 35 in a tragic car accident.
• 01:00:22His loss is really felt.
• 01:00:25Very painfully throughout of the Yale
• 01:00:28psychiatry Yale New Haven community,
• 01:00:32and I wanted, wanted to acknowledge him here.
• 01:00:37William Sledge in some way.
• 01:00:40The most youth,
• 01:00:41most youthful person that
• 01:00:43I will commemorate today.
• 01:00:45William died at the age of 77.
• 01:00:49After serving in so much,
• 01:00:51so many critical roles in our department
• 01:00:55from interim department chair,
• 01:00:57deputy chair for Yale
• 01:00:59New Haven Health System,
• 01:01:01leader of the psychiatry residency program,
• 01:01:04Innovative leader of the outpatient
• 01:01:07community services at at the
• 01:01:09Connecticut Mental Health Center.
• 01:01:11A remarkable figure the life of
• 01:01:14every party that he attended.
• 01:01:16A wonderful colleague, mentor,
• 01:01:19friend who will miss terribly.
• 01:01:23And then Frank Fortunati.
• 01:01:28I don't know if you know that
• 01:01:30fortunati in if you translate
• 01:01:33the word fortunati into English,
• 01:01:35it means one of the lucky ones.
• 01:01:39And Frank lived his life
• 01:01:41to the absolute fullest.
• 01:01:43He was committed.
• 01:01:45To his family, he was committed.
• 01:01:49To his patients,
• 01:01:50he was committed to his colleagues
• 01:01:54and and pretty much everybody he met.
• 01:01:57He was a person of remarkable humility,
• 01:02:03selflessness, generosity,
• 01:02:05kindness and his death at the age of 58.
• 01:02:12Is really a a terrible loss
• 01:02:15for for all of us and and
• 01:02:21to lest we ever forget what a remarkable
• 01:02:27model he provided for us about
• 01:02:30selfless commitment to our community,
• 01:02:34many of us came together to
• 01:02:37create a an award in his memory.
• 01:02:40Which will be presented each
• 01:02:42year at residency graduation.
• 01:02:48I didn't want to end on sad note
• 01:02:51and so I want to highlight the
• 01:02:53incredible work of the Anti Racism
• 01:02:55Task Force in the department.
• 01:02:57And we had a chance to get together
• 01:03:00in person recently at a celebration
• 01:03:02and it was truly, truly wonderful.
• 01:03:05This is a group of people.
• 01:03:09Over 90 people who've worked together,
• 01:03:12mostly meeting at least every week.
• 01:03:15For some people who are both on a
• 01:03:17committee and the steering committee,
• 01:03:19they would meet twice a week for the
• 01:03:22last more than 2 1/2 years and in
• 01:03:26their work have developed a kind of
• 01:03:30a community that can help us model
• 01:03:34what we seek for our department.
• 01:03:37A model of inclusive collaboration,
• 01:03:40of commitment to equity, transparency,
• 01:03:44transparency and accountability of
• 01:03:47collaboration across disciplines,
• 01:03:50across levels of seniority,
• 01:03:54across hierarchy,
• 01:03:57and to identify and target areas
• 01:04:00that we could work on and build
• 01:04:03on in the department that work.
• 01:04:07Has carried us to this point in the
• 01:04:10anti racism work in our community and at
• 01:04:14this point where we have accumulated,
• 01:04:18collated,
• 01:04:19sorted the recommendations
• 01:04:21from the six subcommittees,
• 01:04:23we are now ready to move
• 01:04:26towards implementation,
• 01:04:27just as the anti racism task force work
• 01:04:31up and to this point has been inclusive.
• 01:04:36Welcoming,
• 01:04:36inviting process.
• 01:04:38We want this next implementation phase
• 01:04:42to similarly be open and engaging,
• 01:04:45and we just circulated
• 01:04:51to everybody a request for people
• 01:04:55to volunteer to be engaged in this
• 01:04:58implementation phase of the recommendation
• 01:05:01of the Anti Racism Task Force.
• 01:05:03We're looking for people who
• 01:05:05wish to lead the five identified
• 01:05:07implementation groups and to serve on
• 01:05:11the five implementation committees.
• 01:05:14This is really an important
• 01:05:16and pivotal pivotal time,
• 01:05:18just as pivotal to having a treatment
• 01:05:21for Alzheimer's or a new treatment for
• 01:05:24depression or a digital technologies
• 01:05:26or other kinds of leadership
• 01:05:29healing our community from within.
• 01:05:33Is so important to us and I hope
• 01:05:38those of you listening today will
• 01:05:42consider playing a part in that.
• 01:05:49Yeah.
• 01:05:51So in conclusion.
• 01:05:58You know, I, I, I don't know the
• 01:06:00origin but I'm I'm reminded at this
• 01:06:02moment about that of the saying if
• 01:06:04you want to go quickly you should go
• 01:06:06by yourself but if you want to have
• 01:06:08it you know impactful you should.
• 01:06:11We go together and we are a
• 01:06:14community organized around impact
• 01:06:17and to do that we all we all
• 01:06:22go together this is. That we are.
• 01:06:25We are such a good department not
• 01:06:27because we have one great person,
• 01:06:30but because everybody is remarkable,
• 01:06:32everybody contributes everybody as
• 01:06:37part of our success and and I hope
• 01:06:42everybody feels ownership for the
• 01:06:45kind of community that we have and
• 01:06:49commitment to making us even better.
• 01:06:53I I realized before I closed that I I
• 01:06:56one person who has played a particularly
• 01:06:58important role over these last 2
• 01:07:011/2 years is Cindy Crusto and Cindy,
• 01:07:04I want to thank you for your leadership
• 01:07:06of the Anti Racism Task Force and helping
• 01:07:09us as a community to to move forward,
• 01:07:13have the kind of community where
• 01:07:15we can all move forward together.
• 01:07:17So with that I will stop and.
• 01:07:23If there is,
• 01:07:24if you have questions or comments
• 01:07:27anyone would like to make,
• 01:07:28we could we could try to do that
• 01:07:31and people can put questions into
• 01:07:33the chat and there are.