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April marked the fifth anniversary of the launch of McLean’s Center of Excellence in Psychotic Disorders. We checked in with Division Chief Dost Öngür, MD, PhD, to learn more about the latest developments, greatest challenges, and most exciting endeavors of the division.
Horizons: What programs does McLean offer for patients with psychotic disorders?
Dr. Öngür: The division serves more than 1,500 individuals each year through our inpatient, residential, day treatment, and outpatient programs. We offer specialized tracks for college students, older adults, and patients who are experiencing their first episode of psychosis. No matter how acute their symptoms are, there is a treatment model for each patient with a psychotic disorder who comes to McLean.
Horizons: What are some of the common misconceptions about psychotic disorders?
Dr. Öngür: Until recently, the ingrained thinking was that every patient with a psychotic disorder would be impaired for life. McLean has been at the forefront of shifting this notion within the field. There is ample research on brain abnormalities in patients with psychotic disorders which demonstrates that these conditions can be treated or, in some instances, reversed. This is consistent with the clinical reality of recovery in some patients and should serve as a message of hope to families.
While we acknowledge that psychotic illnesses can be serious and chronic, most patients can make progress and lead fulfilling lives. Our goal in every patient’s case is recovery and prevention of long-term disability. We approach each patient with optimism and encourage families to never give up hope.
Horizons: What is the greatest challenge facing clinicians and researchers in the field?
Dr. Öngür: A significant challenge is that the medications we have are not good enough and leave patients with many difficult side effects. There have been no pharmacological [medication] innovations for decades.
McLean is addressing this by ramping up research. We are also testing novel nonpharmacological treatments such as computer-based cognitive remediation, which stimulates plasticity in the brain and alleviates some patients’ cognitive symptoms. Finally, McLean is helping patients mitigate side effects and lead healthier lives through a proactive metabolic screening effort and coordinated wellness program.
Our goal is to discover and test exciting new treatments for psychotic disorders and make them available to patients here at McLean. Through research, professional training, and other forms of outreach, we can disseminate these new methods widely so that they ultimately reach patients and families everywhere.
Horizons: How has philanthropy propelled the work of the division?
Dr. Öngür: One of the most impressive examples is McLean OnTrack, a program for patients who are experiencing symptoms of psychosis for the first time. The clinic helps patients and families navigate the continuum of care. The pilot was launched in 2012, and initially funded exclusively by the O’Keefe Family Foundation and the Gildea Family Foundation.
Since then, McLean OnTrack has become an incredibly successful program that is almost self-sustaining. In just two years, our operating budget has grown to approximately four times the original gifts. This support has made a tremendous difference in the lives of more than 50 patients and their families, and we hope that number will reach 100 by the end of the calendar year.
Donors have supported a number of other initiatives across the division—from basic and biological research to professional training and education. For example, The Katz Family Fellowship for advanced practice nurses who specialize in psychotic disorders, and flexible support from longtime donors such as Barbara and Bill Boger, have enabled us to develop new programs that would not exist without private funding. Our donors play an integral role in bringing promising ideas to fruition.
Horizons: What does the division have planned for the next five years?
Dr. Öngür: Helping individuals struggling with psychotic disorders has been a strength of McLean’s for two centuries, but there is still room to grow. Moving forward, we plan to recruit clinicians and investigators with fresh ideas and approaches, tirelessly pursue new treatment models, grow McLean OnTrack, and pilot a “behavioral health home” to serve the holistic needs of our patients.
In 2015, McLean will begin construction of a new wing onto the Admissions Building, which will accommodate an additional 31 patient beds and clinical offices for care as well as clinical research. The space will serve as the “home base” of the Center of Excellence in Psychotic Disorders—a place that will foster our culture of collaboration by uniting clinicians, researchers, and trainees working in different spaces and disciplines.
Ultimately these efforts, we hope, will lead the field into a new era of discovery and elevate the standards of patient care.