Implementing Change, Advancing Care for Women’s Mental Health

With approximately 25% of the patients admitted into the Klarman Eating Disorders Center having a co-occurring substance abuse issue, Esther Dechant, MD, medical director for the program, recognized a significant need to treat both the eating disorder and the substance abuse simultaneously—a course that is not typically taken.

“On admission, many of our patients do not even realize that they have a substance abuse problem or how serious the problem is,” said Dechant. “Few eating disorder programs provide integrated eating disorder and substance abuse treatment. McLean has a unique opportunity to do this because of our expertise in each of these fields and the increased collaboration between the various clinical services that focus on women’s mental health. By adding this specific track, we strengthen our already existing services and fill a clinical need nationally.”

In the summer of 2012, Dechant began using the women’s recovery group manual, a series of treatment modules first developed by chief academic officer Shelly F. Greenfield, MD, MPH, to treat women with substance abuse issues.

“We realized that the manual was very appropriate for this population and, with some modifications, will help us meet our patients’ needs even more and develop measurement tools that we can then use to improve patient outcomes. Eating disorders and their companions—trauma and substance abuse—are difficult to treat,” said Dechant. “What we’re developing now will allow us to provide the best care possible and is an example of McLean going beyond to meet the needs of our patients.”

“Few eating disorder programs provide integrated eating disorder and substance abuse treatment. McLean has a unique opportunity to do this because of our expertise in each of these fields and the increased collaboration between the various clinical services that focus on women’s mental health. By adding this specific track, we strengthen our already existing services and fill a clinical need nationally.”
– Esther Dechant, MD

Women’s Mental Health Initiative Goals

To develop an infrastructure for clinical care that integrates a comprehensive approach to women’s mental health across programs and disciplines while promoting research and training within the field, the leaders of the WMHI have developed a robust list of goals in each area of the hospital’s tripartite mission.

Clinical Care

• Emphasize mental health services that integrate care for co-occurring disorders among women
• Foster wellness and well-being throughout the lifespan
• Utilize a holistic approach that incorporates both mental and physical health promotion
• Encourage outreach and collaboration with community-based programs

Education and Training

• Create a network of clinicians knowledgeable about women’s mental health
• Offer professional development for clinicians at McLean and in the community of women’s mental health
• Provide training, including early career development training fellowships, for psychiatrists and psychologists

Research

• Procure funding and support for research on women’s mental health concerns
• Promote cross-program research collaborations
• Develop clinical trials for new treatments and interventions that address specific aspects of women’s mental health
• Implement standardized screening instruments utilized across programs and units for research as well as clinical input, including eating and mood disorders, substance abuse, and self-injury