Innovation can happen anywhere.
Doing whatever it takes to bring quality mental health and addiction treatment to rural America.
In 2015, our Montana-based inpatient psychiatry team still wasn’t able to refer our adolescent patients with treatment-refractory depression to treatments like ECT or TMS. No one in our state was willing to treat patients under 18 with ECT (electroconvulsive therapy), and TMS (transcranial magnetic stimulation) wasn’t yet widely available. One of my classmates from child and adolescent psychiatry fellowship had recently emailed me a scientific paper about triple chronotherapy (TCT), an experimental treatment that combined sleep deprivation, shifting sleep-wake cycles, and bright light therapy. The four-day intervention proved remarkably effective for improving mood and reducing suicidality in adult patients, according to the paper. Our team figured that our patients deserved a chance at quick relief from despair, so we designed a pilot study to replicate the findings in teens. We enrolled adolescents with severe depression who hadn’t responded to a battery of prior interventions, including medications and psychotherapy. They also had to be experiencing acute sadness, sleeplessness, and suicidality. The results exceeded our expectations. After just four days, many patients reported having the best sleep and mood in years. More importantly, they started feeling hope that things could actually get better. We published our results in a peer-reviewed journal in 2019 and felt an enormous sense of pride that we contributed to the science of depression treatment. Our intrepid team wasn’t based at an urban academic center. We didn’t have any research funding. We knew that our rural patients needed access to something better, so we decided to innovate. Innovation isn’t always a shiny new gizmo. It can be a new way of working together and it can happen anywhere.
DMSc, PA-C, MPAS
5mocould you link the paper I would love to read it