Obstacles

1. The Child and Adolescent Mental Health Studies (CAMS) Undergraduate Minor at New York University Jess P. Shatkin, M.D., M.P.H., and Nadia M. Addasi, B.A. NYU Child Study Center, New York University School of Medicine OBJECTIVES METHODOLOGY RESULTS CONCLUSIONS • Outline the development, structure and operation of the CAMS Minor so that others may replicate the program • Identify how a school of medicine can have a positive impact on undergraduate education • Illustrate how psychiatrists can encourage undergraduate students to enter the field • Suggest a novel method for psychiatry residency programs to offset the costs of residency training • Obstacles • The CAS Curriculum Committee, which is composed of a Dean and faculty and must approve of all new courses, had many concerns: • Would psychiatrists and psychologists, who had spent the majority of their careers in schools of medicine teaching professionals, be able to teach undergraduates? • Would the psychiatric approach to teaching be more fact and skill driven, rather than one of open inquiry befitting a liberal arts education? • How would the NYU Child Study Center physically manage a college minor, considering our two-mile distance from campus? • Would CAMS courses compete with courses from established CAS departments? • The Academic Senate must approve of all new programs of study, and many members doubted the veracity of child psychiatric illness. Gaining Approval • An Advisory Committee was formed of individuals who supported the development of the CAMS program; the committee was composed of the Vice Provost of NYU, full-time and volunteer clinical faculty from the NYU Child Study Center, and various professors of psychology, sociology and neural science from CAS. • The Advisory Committee assisted us in thinking about how to address the concerns of Curriculum Committee and Academic Senate. • CAMS was approved in April of 2006 on its second pass through the Academic Senate; our first course launched that September. Establishing Goals • The goals of the Minor were established from the outset as part of the initial proposal submitted to the Academic Senate (see table 2). Structure of the Minor • Five courses (20 credits) must be completed to confer the Minor degree. • At least three of these courses must be from within the CAMS department, and two can be from eligible non-departmental offerings. • Psychology majors may receive the Minor with only four courses. • A Director of Undergraduate Studies administers the program from the NYU Child Study Center, on location at the School of Medicine. • Carefully paired instructors from different backgrounds offer a diverse perspective to students (see table 3). Financing the Minor • CAS provides the Child Study Center with a 70% share of the per credit fee per student (see table 4). • The income generated allows us to provide reasonable incentive payments to faculty who teach CAMS courses (see table 5). Experiential Learning • Many CAMS courses involve clinical observation at the Child Study Center, Bellevue Hospital Center, and elsewhere throughout NYC. • Through Independent Study, students gain research experience and contribute to ongoing investigations at the Child Study Center. • 8 students graduated with the CAMS degree in May 2008. • 42 students have officially declared the CAMS Minor. • Income for the fall 2008 semester was over $530,000; we expect over $600,000 in the Spring of 2009 (see table 5). • Enrollment data substantiates the popularity of our courses (see table 6). • Course evaluation data indicates students are highly satisfied with CAMS courses (see table 7). • Qualitative data indicate that students are changing their career paths. • Independent Study is highly popular among students and offers faculty free research assistance. • We believe that our first 3 program goals are currently being met (Table 1). • The 4th goal is lofty and difficult to assess but will be followed; over time we hope to offer an image of how CAMS affects student career choices. • There is no doubt that many CAMS students are self-selected and likely to have already decided to build a career in child mental health, thereby introducing bias into the final program goal. • In an effort to appeal to students with diverse interests, we have developed courses in media, literature, divorce, and drug abuse (see table 3). • CAMS demonstrates that Schools of Medicine, particularly Departments of (Child and Adolescent) Psychiatry, can have a positive impact on undergraduate education. • Based on course evaluations and increasing enrollment, it is clear that the CAMS Minor has been successful. • Independent Study in particular benefits the Department, as it offers no-cost research assistance to faculty from students receiving credit. • Income generated makes CAMS self-sustaining and offers discretionary funds to the Department of Child and Adolescent Psychiatry. • Future directions involve: (1) Expanding our program into a full college major; and (2) encouraging the development of CAMS-like programs nationally through presentations at academic conferences and publications in peer-reviewed journals. BACKGROUND • The challenge of child and adolescent mental health • Half of all chronic cases of mental illness are now recognized to begin by age 14; three-quarters of cases begin by age 24 (1). • Child and Adolescent Psychiatry is themost underserved of all medical subspecialties (2). • According to the AACAP, there are currently 7,000 child and adolescent psychiatrists practicing in the United States, yet the need is estimated to be as high as 30,000 (see table 1). • The need for child and adolescent specialists in the fields of social work, education, and psychology is equally as great (2, 3, 4). • Why reach out to undergraduates? • 70,000 B.A. degrees are conferred annually in Psychology (4). • Undergraduates generally have little or no exposure to psychiatrists in an academic setting. • Mentorship by psychiatrists could potentially increase the number of students who choose to study medicine and, ultimately, psychiatry. The birth of CAMS at NYU • Over the past five years, there has been a growing national awareness of the mental health needs of college students. • At NYU, a series of 6 suicides occurred during the 2003 – 04 academic year; another in 2007. • Mental health promotion and disease prevention was pushed to the forefront of the campus agenda. • In the summer of 2005, the Dean of the College of Arts and Science (CAS) requested that the NYU Child Study Center consider the development of a program of study in child and adolescent mental health to add to the University’s academic offerings. Table 4: Financing CAMS Table 7: Course evaluations Table 5: Income per semester Table 3: Courses and Instructors Table 2: CAMS Minor Goals Table 1: The Workforce 1. Students will explore the relationship between human behavior and its biological and environmental bases; 2. Students will increase their intellectual curiosity and build analytic and problem-solving skills; 3. Students will be challenged to think critically about the concepts of “normal” or “typical” versus “abnormal” behavior and engage in a meta-level analysis of the social, historical, and cultural context of mental health, illness, and diagnosis; and 4. We will encourage those students with a natural interest and inclination toward careers in social work, education and special education, psychology, law, medicine, sociology, nursing, public health, scientific journalism, and psychiatry, to consider focusing their future career in some significant capacity on children and adolescents. Table 6: Enrollment per semester Bibliography 1. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry. 62(6):617-27, 2005. 2. U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General—Executive Summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999. 3. Hughes HM. The need for more child-oriented training in clinical psychologists. Journal of Clinical Child Psychology. 14(2):165-66, 1985. 4. Braslow KJ, Feeney DJ, Elliott GR, Matthews KL, Bush AC. Improving recruitment and funding in psychiatry by teaching college undergraduates. Academic Psychiatry. 29(5):459-463, 2005. 5. Shatkin JP, Koplewicz HS. Innovation in education: The Child and Adolescent Mental Health Studies (CAMS) minor at New York University. Academic Psychiatry, 32(5), 2008, in press. More information available at: www.aboutourkids.org/education/undergraduate_minor