Kimberlyn Leary, PhD, MPA, joined the McLean faculty as executive director of policy outreach in 2016, and in late 2018, she took on an additional role as executive director of the Division of Women’s Mental Health, working closely with division chief Shelly F. Greenfield, MD, MPH. This critical externally facing role is charged with advancing strategic planning, leading policy outreach, and developing partnerships locally, nationally, and globally.
The division’s leadership triad, which also includes Amy Gagliardi, MD, as clinical director, oversees McLean’s extensive clinical, research, and training programs focused on girls and women as well as a growing effort to engage these issues in the community. We sat down with Leary to talk about the division, its current goals, and its aspirations for the future.
Horizons: Why do we need a division focused on the mental health of females?
Dr. Leary: Women’s and girls’ emotional and mental health needs—through the lifespan—have long been overlooked. Women suffer disproportionately from certain conditions and receive inadequate treatment for others. But we have limited understanding of the complex interplay between biological vulnerability and sociocultural and environmental factors—and how they uniquely affect women.
McLean is working to create awareness of these mental health disparities, pursue research to investigate their causes, and establish better standards of care to benefit women and girls worldwide.
Horizons: What is the division’s current focus?
Dr. Leary: We’ve been engaged in a strategic planning process with Harvard’s Community Action Partners over these last eight months, which has helped us define our strategic direction. We are currently evaluating a range of opportunities—from serving as conveners of the public conversation to incubating new programs and collaborations to engaging in deeper research, policy analysis, and direct consulting. Our overarching aim is to disseminate evidence-based insights that advance mental health outcomes for women and girls.
Horizons: What is the connection between your two roles—heading up policy outreach at McLean and directing the Division of Women’s Mental Health?
Dr. Leary: There is a global gap in knowledge about health disparities and social determinants of the mental health of women and girls, yet, no single entity is established as a dedicated “think tank” focused on these issues. Over time, the division will bring leading voices in policy, practice, and research to focus on specific topics addressing the mental health of women and girls. We believe the division is uniquely positioned to build bridges across different sectors to ensure that the needs of women and girls are understood fully.
My prior work with the Obama Administration focused on improving life outcomes for women and girls of color and has given me the experience of bringing together government, public, and not-for-profit leaders to make progress toward a specific set of aims—which is exactly what we need to do in the realm of mental health for women and girls.
Horizons: What are McLean’s strengths when it comes to women’s mental health services?
Dr. Leary: As the top-ranked freestanding psychiatric hospital in the country, McLean has a world-class reputation for providing innovative care for mental health conditions for both genders. But unlike other hospitals, many of our clinical services focus specifically on women—women with substance use issues, eating disorders, trauma, borderline personality disorder and more. We also have ongoing research programs that focus on how these illnesses differ in women. So, we have these strengths already in our clinical care, training, and research. Now, we want to go from a site where we provide these critical services to a center that also serves as a convener, a clearinghouse, and a center of engagement around the broader conversation about women’s mental health.
Horizons: What sorts of conversations are you hoping the division will encourage?
Dr. Leary: If you look at the proportion of federal dollars spent on behavioral health, it’s much less than other health spending. And if you further drill down into the proportion of dollars focused on women’s mental health, it’s not well funded at all. So, part of the division’s role will be to elevate an understanding of the importance of a discrete focus on women’s mental health.
Horizons: Why is that important?
Dr. Leary: We know that women experience or are the victims of trauma disproportionately to men, and that trauma is a major risk factor for many severe and chronic mental illnesses. Women are twice as likely as men to suffer from mood disorders. In the substance use realm, women metabolize substances very differently than men. So, if research and treatment protocols are based solely on the male standards, they may not address the unique and specific needs of women. We already know that women fare better with gender-specific treatments for substance and alcohol-related disorders. But there is much we don’t know yet about prevalence, course, and outcomes for many other mental illnesses, and McLean’s leadership can help narrow this knowledge gap.
Horizons: How did you get into the field of women’s mental health?
Dr. Leary: I have a longtime interest in equity and health care—looking at the social determinants of health, for example, how access, or lack of access, to things like safe, affordable housing, and healthful food affects your health. I worked with The Office of National Drug Control Policy on initiatives that focused on neonatal abstinence syndrome in the context of the opiate crisis. My work with the White House Council on Women and Girls was focused on helping to develop and direct an initiative to improve health, education, and economic outcomes for women and girls of color. As a result, my research and scholarly interests have become ever-more focused on gender and health.
Horizons: Anything else you’d like to add about the division?
Dr. Leary: I’ve talked a lot about the external-facing aspects of the division, but it also has become a center of gravity within McLean as a whole. We celebrated Women’s History Month this spring with a lively discussion about women, ambition, and power, inspired by the TEDWomen’s conference. We also co-sponsored, with Harvard Law School, a documentary screening about Jessica Lenahan, whose husband killed her three daughters. She and the lead lawyer in her case participated in a Q & A afterward. It brought McLean into an important conversation, not only about the impact of trauma, but also about the other public systems that are encountered by those who have experienced trauma.
Internally, we are also training clinicians in the growing evidence base around women’s mental health. We offer a unique one-year clinical psychiatry post-graduate fellowship, which provides training in behavioral and mental health disorders that most impact females. The fellow spends time in each of McLean’s women’s treatment programs and does a rotation in reproductive psychiatry in the women’s health program at Brigham and Women’s Hospital.
Gender-specific research is essential for closing a gap and creating new treatments in a field that conducted research primarily—or only—on men until the mid-1990s. So, we also sponsor pilot research and help mentor young, emerging scientists to pursue new discoveries and acquire the data and skills to successfully compete for federal grants.
Taken together, our efforts are aimed at promoting mental and physical health and well-being for women and girls at every age.
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