The Connecticut Mental Health Center: Celebrating 50 Years of a Successful Partnership Between the State and Yale University.

September 28, 2016, marked the 50th anniversary of the Connecticut Mental Health Center, a state-owned and state-operated joint venture between the state and Yale University built and sustained with federal, state, and university funds. Collaboration across these entities has produced a wide array of clinical, educational, and research initiatives, a few of which are described in this column. The missions of clinical care, research, and education remain the foundation for an organization that serves 5,000 individuals each year who are poor and who experience serious mental illnesses and substance use disorders.

Report of a mental health survey among Chinese international students at Yale University.

Objective: To examine the prevalence of depression and anxiety symptoms in Chinese international students, to identify factors that might be associated with these 2 symptom complexes, and to investigate their perception of mental health issues and counseling services.

Participants: Chinese students (N = 130) at Yale University.

Methods: Participants completed an anonymous online survey in fall 2009.

Public-academic partnerships: early intervention for psychotic disorders in a community mental health center.

Early intervention may improve long-term outcomes for psychotic illnesses. Early-intervention services in other countries have focused on reducing the duration of untreated illness and adapting interventions for younger patients. This column describes the process of building such a service, called specialized treatment early in psychosis (STEP), at the Connecticut Mental Health Center.

Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11.

Background: Bereavement is a universal experience, and its association with excess morbidity and mortality is well established. Nevertheless, grief becomes a serious health concern for a relative few. For such individuals, intense grief persists, is distressing and disabling, and may meet criteria as a distinct mental disorder.

An exploration of associations between separation anxiety in childhood and complicated grief in later life.

Recent studies have suggested that the vulnerability to complicated grief (CG) may be rooted in insecure attachment styles developed in childhood. The aim of this study was to examine the etiologic relevance of childhood separation anxiety (CSA) to the onset of CG relative to major depressive disorder, posttraumatic stress disorder, and generalized anxiety disorder in bereaved individuals. The Structured Clinical Interview for the DSM-IV, Inventory of Complicated Grief-Revised, and CSA items from the Panic Agoraphobic Spectrum Questionnaire were administered to 283 recently bereaved community-dwelling residents at an average of 10.

Teaching psychiatric residents about women and leadership.

Objective: The purpose of this project was to develop a seminar on women as leaders within an academic department of psychiatry and to evaluate its effectiveness.

Methods: A seminar was offered as an elective to all residents within the Yale University Department of Psychiatry. Didactic presentations and open discussion were structured around the following topics: 1) exploration of leadership roles in various areas, including research, clinical practice, teaching, and administration; 2) organizational dynamics and gender; 3) negotiation skills and conflict resolution strategies; 4) role of consultation, seminars, peer support and mentoring by both men and women in the development of leadership skills; and 5) "keeping the balance: work, relationships, and personal health.

Rates and risks of complicated grief among psychiatric clinic patients in Karachi, Pakistan.

The aim of this study was to determine rates and risks of Complicated Grief (CG) among psychiatric clinic patients in Karachi, Pakistan. The Inventory of Traumatic Grief, an early version of Inventory of Complicated Grief--Revised, was administered to 151 recently bereaved patients, with validated criteria applied to determine CG "caseness." Thirty-four percent of the sample met criteria for CG.

Stressful life events interacting with cognitive/personality styles to predict late-onset major depression.

The current work evaluated the interaction of life stressors with cognitive/personality styles in predicting late-onset depression in 42 elderly outpatients with DSM-IV unipolar Major Depression and 42 nondepressed controls. Control subjects were matched to cases on age, sex, race, and years of education. As suggested by Beck's cognitive theory of depression, a multivariate model indicated that specific stressful-event types interacted with specific cognitive/personality styles in strongly predicting depression onset, adjusting for the positive associations of medical illness and reduced physical functioning with depression.

The integration of treatment and rehabilitation in psychiatric practice and services: a case study of a community mental health center.

After briefly reviewing the relationship of psychosocial rehabilitation to psychiatric practice, the authors recommend a renewed commitment of psychiatrists to bridge and integrate psychiatric treatment with psychosocial rehabilitation in practice and in the organization of services. They use the case example of an urban, community mental health center to illustrate a strategy for achieving greater integration of these two, relatively independent fields of professional practice. The Center's strategy for integration includes (1) center-wide planning, (2) structuring the medical staff office to support the task of integration, (3) establishing a model of practice and principles of care that supports both domains of intervention, (4) educating medical staff about psychosocial rehabilitation, (5) inter-disciplinary team building, including a definition and discussion of professional roles, (6) expanding services research on psychosocial rehabilitation, and (7) advocating in alliance with rehabilitation colleagues for expanded psychosocial rehabilitation services and their integration with treatment.