Q & A: Joseph Gold, MD, Discusses Child and Adolescent Mental Health at McLean

The Nancy and Richard Simches Division of Child and Adolescent Psychiatry was launched in 2012 through the generosity of the Simches family. The hospital’s chief medical officer, Joseph Gold, MD, heads up the division and we sat down with him recently to get an update on its activities.

Horizons: What have been the division’s greatest accomplishments?
Dr. Gold: Our team has made state-of-the-art treatment available to thousands of youth and families each year by creating new programs in greater Boston and southeastern Massachusetts.

We have grown our inpatient collaboration with Franciscan Hospital for Children and added an autism spectrum track; expanded our 3East continuum for adolescents and college students with borderline personality disorder; and evolved programs in our Belmont-based adolescent residential unit, Arlington School, Pathways Academy, and Klarman Eating Disorders Center.

An anonymous $1.2 million gift allowed us to open a new outpatient clinic this past year, just a few miles from our Belmont campus. We have added elements of the College Mental Health Program and plan to offer specialized parenting groups as well as a clinic for patients who are in the earliest stages of a psychotic disorder.

Last winter, our division moved its Brockton-based programs to a beautifully renovated site in Middleborough, Massachusetts. That move allowed us to expand our adolescent residential services and open a new adolescent day program. It also is home to the new Child and Adolescent OCD Institute.

A significant gift from Bob and Nancy Anthony provided the resources to extend our Massachusetts Child Psychiatry Access Program (MCPAP) hub for pediatricians to public school nurses in southeastern Massachusetts, the Cape, and Islands.

Finally, we are participating onsite at the Lurie Center for Autism in Lexington, Massachusetts, and are closely linked to McLean’s innovative College Mental Health Program. McLean has done all of this at a time when many other hospitals and agencies have down-sized or closed their mental health services for children and adolescents.

Horizons: Are there notable trends in the world of child and adolescent psychiatry that are playing out at McLean?
Dr. Gold: Three immediately come to mind: the development of highly effective, diagnosis-specific therapies; a “tidal wave” increase in the prevalence of autism spectrum disorders; and the integration of child psychiatry with primary care and school-based services.

Our division has responded to the surge in Asperger’s and autism disorders by expanding our Pathways Academy day school, adding specialized services to our McLean-Franciscan inpatient unit and joining hands with the Lurie Center to provide diagnostic testing and college student support.

And our MCPAP hub now serves nearly all primary care pediatricians and many family practitioners in southeastern Massachusetts, and will soon support the region’s school nurses. We also hope to provide embedded consultative support in the Merrimack Valley in the near future.

Horizons: Given the expansion of programs for children and adolescents, has McLean’s clinical workforce kept pace?
Dr. Gold: It is a challenge, but we have energetically embarked on training the next generation of child psychiatrists, psychologists, social workers, nurses, educators, and line staff in evidence-based treatments. Many of these trainee positions and intensive didactics are funded by the generosity of the Simches family and other donors (see “Fellowship Creates Ripples”).

McLean remains a highly sought after training site and has some of the country’s leading experts in treatments like dialectical behavior therapy (DBT) and other new therapies. Philanthropy has enabled a number of creative efforts aimed at disseminating our expertise far and wide.

Horizons: What role has philanthropy—including the Simches family’s—played in the division?
Dr. Gold: The Simches family’s vision and generosity have been transformative—allowing us to create new programs, train expert clinicians and measure the impact of our therapies. The research funded by the Simches gift—especially the pioneering work of Dr. Randy Auerbach in better understanding and preventing adolescent suicide—has begun to shape the thinking and daily work of our devoted clinical staff.

In addition to the gifts mentioned above, philanthropy has seeded pilot research, underwritten training, and enhanced clinical services. Our partnerships with donors have been a major driver of growth and will continue to be important as we seek to address the unmet mental health needs of our youth.