UCSF Psychiatry HEAL Fellowship in Global Mental Health

The UCSF Department of Psychiatry and Behavioral Sciences offers a one- or two-year fellowship in Global Mental Health in partnership with HEAL Initiative. The goal of this innovative and rigorous program is to provide training and mentorship in clinical practice, capacity building, health systems-strengthening, and health services research in low-resource settings in the United States and abroad. Fellows include rotating fellows (board-eligible/board-certified U.S.-trained psychiatrists who will rotate between sites) and site fellows (practitioners interested in global mental health and based in HEAL’s partner sites). All eligible rotating fellows can apply directly via the HEAL Initiative website; site fellows are nominated by the existing partner sites.

Rotation sites

Rotating fellows will complete mentored rotations at a local site (Chinle Comprehensive Health Care Facility in Navajo Nation) and an international site (Dolakha Hospital, part of Kathmandu University in Nepal), both lasting approximately six months. Each site hosts HEAL fellows from other clinical specialties as well. We have had fellows who have partners and children staying with them during the rotation. For fellows who are not able to be away from home for the entire fellowship, we will work with you on a case-by-case basis to develop a suitable arrangement for clinical rotations.

Chinle Comprehensive Health Care Facility, Navajo Nation

Fellows will provide clinical services to residents of Navajo Nation. They will address the challenge of expanding mental health services to a rural population by health systems strengthening, telemedicine, mobile medical van, and an integrated care program with the general medical clinic.

Dolakha, Nepal

Fellows will support the expansion of an integrated mental health program at a rural/peri-urban hospital, Dolakha Hospital, one of 16 community healthcare centers that are part of Dhulikhel Hospital’s care delivery network under the Kathmandu University School of Medical Sciences. Fellows will select an important problem in mental health delivery and work with the local staff, leaders, and fellowship faculty to implement and test an intervention to address the issue. The fellowship director has a long history of working in Nepal and at the rotation site. The context and mental healthcare delivery model were described in a 2017 article in Globalization and Health.

If fellows have a specific background (e.g., fluent in Spanish) or expertise related to another partner site, please include that information in your application so we can explore a rotation with them rather than in Nepal.

Dolakha is a rural/peri-urban region about 4 hours from Kathmandu.

Dolakha Hospital provides comprehensive healthcare and is a community-based academic center under the Dhulikhel Hospital system of Kathmandu University School of Medical Sciences.

Curriculum

The curriculum was developed over 18 months using a structured process and has been refined with feedback from fellows. It is customized to the needs and capacities of the fellows and their rotation sites. The needs assessment process used advice from trainees and experts in multiple low-resource settings (locally and globally) to identify critical gaps in competencies between those acquired at the end of a U.S. residency in general psychiatry and those required to build mental health care delivery systems in low-resource settings.

The fellowship provides competencies that were identified to become a leader in global mental health via educational experiences that include a custom-designed collection of original online lectures, reading materials, online Q&A sessions, opportunities for targeted professional development opportunities with modest funding, and dedicated experiential learning in mental health care delivery systems in low-resource settings. Experiential learning includes working with the local stakeholders and fellowship mentors to identify areas of need in collaborative mental health care delivery at the rotation sites and implementing a systems-wide intervention to address them.

Fellows will engage in the global mental health curriculum and participate in HEAL’s global health curriculum, which includes in-person global health training with fellows from multiple medical disciplines, faculty mentorship, and an online master's degree (for fellows selecting the 2-year option). The longitudinal curriculum specific to mental health is led by UCSF Department of Psychiatry and Behavioral Sciences faculty members. By utilizing online lectures, reading materials, biweekly calls and weekly 1:1 mentorship meetings, the longitudinal curriculum prepares the fellows to meet the following core competencies:

  • Describe cultural expressions of illness and implement culturally appropriate treatments.
  • Utilize locally available resources, including limited/essential medications, to provide high-quality clinical care to address the local burden of mental illness.
  • Describe and implement a collaborative care model in resource-poor settings.
  • Lead an interdisciplinary team of generalist health workers and counselors for strengthening the mental health system and expanding access to health services.
  • Develop effective teaching skills to build the capacity of local health workers to care for the mentally ill using evidence-based protocols like the WHO Mental Health Gap Action Programme (mhGAP).
  • Develop fundamental research skills in health services and implementation science to strengthen health systems.
  • Obtain clinical competence in managing common mental health conditions with clinical supervision for child, adolescent, and geriatric populations.
  • Adhere to principles of ethical, equitable and reciprocal training and clinical practice.
  • Develop a career plan that incorporates global mental health work after completion of the fellowship.
     

Flowchart

An integrated mental health program developed by Possible and currently being implemented in Dolakha Hospital provides the academic, clinical, and research environments for fellows.


 

Mentorship

Mentorship is an integral aspect of the fellowship. Mentorship focuses on clinical sub-specialty services, collaborative care models, health services research, cross-cultural practice, ethics, teaching and supervisory skills, and career development. Structured mentorship is provided at various levels:

1. On-site mentors

Each fellow is assigned a mentor on-site who will guide them through the health system and assist with clinical challenges. In Chinle, on-site mentors may be psychiatrists or general medical doctors. In Dolakha, the on-site mentor is the medical director who has completed MD-GP training.

2. HEAL mentors

Global Health mentors from HEAL initiative provide guidance for the 20+ fellows across all disciplines. This includes UCSF faculty who have extensive experience mentoring global health clinicians in building health systems in resource-poor settings.

3. Mental health faculty

The three core fellowship faculty hold biweekly online meetings with the mental health fellows throughout the fellowship. In addition, each fellow is paired with a faculty member for 1:1 weekly calls to provide in-depth mentorship and support for project work, personal and professional challenges, career development, presentation skills, and writing skills.

In addition, a panel of faculty members will provide teaching and mentorship via a longitudinal curriculum on key topics in global mental health such as clinical protocols based on WHO’s essential medications list, task-sharing with non-specialists, key skills in education, training and supervision to assist with task-sharing, collaborative care modes, cross-cultural inquiry and treatment of mental illness, health services research, implementation science in program development, geriatric psychiatry, child psychiatry, evidence-based psychotherapy, and career development.
 

Global Mental Health Fellows

Back (L-R): Pragya Rimal, MA (site fellow, Nepal); Bibhav Acharya, MD (program director); William Shunkamolah, PhD (site fellow, Gallup Indial Medical Center, NM); Viet Nguyen, MD, MPH (rotating fellow).

Front (L-R): Barbara Kamholz, MD (co-director); Rebecca White, MD (rotating fellow)

Faculty

Core faculty

Content experts

Maithri Ameresekere
Faculty Lead, Community-based Mental Health
Attending Psychiatrist, San Francisco General Hospital
Clinical Instructor, UCSF Department of Psychiatry and Behavioral Sciences

James Bourgeois, OD, MD
Faculty Lead, Collaborative Care
Clinical Professor and Vice Chair of Clinical Affairs, UCSF Department of Psychiatry and Behavioral Sciences

James Dilley, MD
Faculty Lead, HIV Psychiatry
Chief, Department of Psychiatry at San Francisco General Hospital
Director, AIDS Health Project
Vice Chair and Clinical Professor, UCSF Department of Psychiatry and Behavioral Sciences

Peter Ferren, MD, MPH
Faculty Lead, Child and Adolescent Psychiatry
Attending Psychiatrist, San Francisco General Hospital
Clinical Professor, UCSF Department of Psychiatry and Behavioral Sciences

Erick Hung, MD
Faculty Lead, Education and Supervision
Associate Dean for Student, UCSF
Director of the Adult Psychiatry Residency Training Program and Director of Education
UCSF Department of Psychiatry and Behavioral Sciences

Paul Linde, MD
Faculty Lead, Emergency Psychiatry
Attending Psychiatrist, Psychiatric Emergency Services at San Francisco General Hospital
Clinical Professor, UCSF Department of Psychiatry and Behavioral Sciences

Christina Mangurian, MD
Faculty Lead, Health Services Research
Director, UCSF Public Psychiatry Fellowship at San Francisco General Hospital
Professor, UCSF Department of Psychiatry and Behavioral Sciences

Susan Meffert, MD, MPH
Faculty Lead, Health Service Scale-up and Research in GMH
Associate Professor, UCSF Department of Psychiatry and Behavioral Sciences

Jonathan Nye, MD
Faculty Lead, Severe Mental Illness and Inpatient Services
Attending Psychiatrist, San Francisco General Hospital
Professor, UCSF Department of Psychiatry and Behavioral Sciences

Application

Applications are open a year before enrollment and will be reviewed on a rolling basis. Please apply online via the HEAL Initiative website. The answers to many frequently asked questions, including those about eligibility, are also available there.