Integrating mental health care in primary care

Behavioral health issues such as depression and anxiety are debilitating conditions and, unfortunately, common. But the integration of behavioral health and primary care services is proving successful in improving patient outcomes.

The College of Community Health Sciences is exploring such an integrated model of care for University Medical Center, which it operates. In September, the College will host a group from the University of Washington AIMS Center, short for Advancing Integrated Mental Health Solutions, that will present about its Collaborative Care model to providers and resident physicians who care for patients at UMC.

“This is a way to improve access to mental health care,” says Dr. Tom Weida, UMC’s chief medical officer. “This is a great opportunity for folks who have mental health needs to get the care they need.”

Collaborative Care treats common mental health conditions such as depression and anxiety that require systematic follow-up due to their persistent nature. Primary care providers and embedded behavioral health professionals provide medications or psychosocial treatments and are supported by psychiatric consultation.

According to the AIMS Center, offering mental health care in primary care is convenient for patients, builds on existing provider-patient relationships and can help improve care for patients who have both medical and mental issues.

Weida said the use of such a model at UMC could have a social worker or psychologist working with a patient and linking the patient with a psychiatrist if needed. He said the social worker and psychologist would keep in regular contact with the patient to monitor outcomes.

West Nile Virus

By Jared Ellis, MD
Assistant Professor of Family Medicine,
Associate Residency Director,
University of Alabama Family Medicine Residency Program

Late summer brings excitement about football, and hopes that the weather will soon cool off. However, it brings a risk that some have heard of, but few are familiar with: West Nile Virus (WNV) infection. This infection is rather common, and most cases occur in August and September (see chart below), but the diagnosis is infrequently made. For many, it only gives mild symptoms, but for a few, it can lead to devastating consequences or death. It is important to be familiar with the signs and symptoms of this infection, but even more so on how to prevent it.

WNV is not new, having been first identified in 1937 in the African county of Uganda. It was first diagnosed in 1999 in the US in New York. It has rapidly spread across the country. It is transmitted from mosquitoes that have bitten infected birds and then bite humans. Fortunately, 60-80 % of persons who contract the virus have no symptoms. 20-40 % of infected persons have only mild to moderate nonspecific symptoms, which may include fever, headache, muscle aches, swollen lymph nodes, and loss of appetite. 25-50% of these have a rash on the trunk and arms. See picture:

Studies estimate that in the US, one of every 140 to 250 persons has been infected at some point, few of whom were diagnosed. However, about 1 % of persons who get this infection develop serious neurologic (brain) effects, known as West Nile Neuroinvasive Disease (WNND). Symptoms of WNND include tremor, confusion, severe headache, weakness in one or more limbs, and coma. Of these, between 3-15% die. This is more common in younger children and older persons, and those with significant chronic diseases.

If you are concerned that you may have any form of WNV, see your doctor, and mention your concerns. Blood and other tests can be performed, but take a number of days to return. If symptoms are not severe, it may not be necessary to be tested as there is no specific treatment that cures WNV or WNND.

Awareness and prevention are the keys to avoiding this infection. Avoid mosquito bites! Avoid being outside at dusk or dawn. Wear long sleeves and long pants when outdoors if possible. Use mosquito repellants, whether applied to the body, or placed near you or those that they you can attach to yourself. Drain any standing water in your area to limit mosquito breeding. Communities with higher rates of WNV may choose to spray appropriate insecticides in key areas. All of these things may prove helpful.

College leading UA’s United Way fundraising campaign

The College of Community Health Sciences is leading this year’s United Way of West Alabama fundraising campaign for The University of Alabama.

UA has set a goal of raising $375,000, just a little more than last year’s goal, which was exceeded.

“This University is very special,” Sarah Patterson, former head coach for UA women’s gymnastics, told University employee volunteers assisting with the fundraising effort during a meeting at CCHS earlier this month. “If it weren’t for you, this campaign wouldn’t be successful.”

Patterson is heading the overall United Way of West Alabama fundraising campaign, which has set a goal of raising $3.8 million.

United Way of West Alabama covers nine counties and has 26 partner agencies, including Good Samaritan Clinic, Big Brothers Big Sisters, the Phoenix House and Temporary Emergency Services.

Patterson said another of her goals is to make people more aware of the services provided by United Way’s partner agencies. “There are things about United Way agencies that if you let people know about, you can make a difference in their lives.”

New faculty join College

Dr. Martha Crowther joined the College of Community Health Sciences as a professor in the Department of Community Medicine and Population Health and the Institute for Rural Health Research.

Prior to joining the College, Crowther held faculty positions in the Department of Psychology in The University of Alabama’s College of Arts and Sciences, where she also directed the Clinical Psychology Program. She holds appointments as a Faculty Scholar at the UA Center for Mental Health and Aging and as a Scientist at the Center for Healthy Aging in the Department of Medicine/Division of Gerontology and Geriatric Medicine at the University of Alabama at Birmingham.

Crowther earned a bachelor’s degree at the University of California at Berkley, a Master’s in Public Health degree from Yale University and a PhD from Duke University. She completed a clinical internship and was a postdoctoral fellow at the US Veteran’s Administration Palo Alto Health Care System.

Her research interests include aging and racial diversity in urban and rural populations with a focus on eliminating mental and physical health disparities in older adults. Her work at the College will focus on the teaching of and research in Population Health.

Crowther has presented and published extensively, and is the recipient of numerous honors, including the National Role Model Award from the National Institute on Minority Health and Health Disparities.


Dr. Abbey Gregg joined the College of Community Health Sciences as an assistant professor in the Department of Community Medicine and Population Health and the Institute for Rural Health Research.

Previously, she was a program coordinator for Navigating the Road to Health for Nebraska Families Collaborative in Omaha, and manager of public health services for Three Rivers Public Health Department in Fremont, Nebraska.

Gregg earned a Bachelor’s Degree in Nutrition Science from the University of Nebraska in Lincoln, a Master’s in Public Health degree in Community Health Education from the University of Nebraska, and a PhD in Health Services Research, Administration, and Policy from the University of Nebraska Medical Center in Omaha.

She has published in peer-reviewed journals and has received grant funding for research focusing on improvement initiative and activities in local health departments.

Dr. Mercedes Morales-Aleman selected for national Future Research Leaders Conference

Dr. Mercedes Morales-Aleman, assistant professor in the Department of Community Medicine and Population Health and the Institute for Rural Health Research at the College of Community Health Sciences, was one of 30 faculty nationwide selected for the National Institutes of Health’s Future Research Leaders Conference.

It is an honor to be selected,” said Morales-Aleman. “Few early career scientists have the opportunity to showcase their research and receive feedback from NIH leadership and investigators.”

The conference is an opportunity for talented biomedical and behavioral scientists early in their careers for career-development. During the conference, selected scientists will showcase their research and gain insights from NIH leadership and investigators about developing independent scientific careers.

Dr. James Leeper Celebrates 40 Years with CCHS

The College of Community Health Sciences congratulates Dr. James Leeper for 40 years of service. Leeper joined the College in 1977 and is a professor in the Department of Community Medicine and Population Health. He additionally serves as Rural Programs Director of Education and Evaluation. Beyond his extensive research support of the College, Leeper has impacted the academic careers of countless students through both teaching in the classroom and guidance along the path to medical school. A recipient of The University of Alabama Outstanding Commitment to Teaching Award, Leeper exemplifies the core values and standards of both the University and the College. We offer him our sincere thanks for his dedication to the fulfillment of our mission through his leadership in medical education and scholarly achievements.

Medical students at College recognized for patient-centered care

Six University of Alabama School of Medicine students completing their clinical years of education at the College of Community Health Sciences have been recognized as 2017 Gold Humanism Honor Society inductees.

The students are: Rachel Daniell and Amie Lemley of the Class of 2017; and Mary Craig, Luke Iannuzzi, John Pickering and Christopher Ray of the Class of 2018.

CCHS serves as the Tuscaloosa Regional Campus of the School of Medicine.

The Gold Humanism Honor Society was established to recognize medical students, residents and faculty who practice patient-centered care by modeling such qualities as integrity, excellence, compassion, altruism, respect and empathy. Each year, the Gold Humanism Honor Society extends membership to medical students in their clinical years who are committed to these qualities. Between 10 percent and 15 percent of each class can be selected cumulatively during the third and fourth years of medical school.

The Gold Humanism Honor Society is a signature program of the Arnold P. Gold Foundation, which works to create “compassionate, collaborative and scientifically excellent health care and to support clinicians throughout their careers so that that the humanistic passion that motivates them at the beginning of their education can be sustained throughout their practice.”

Protecting UA employees, students from the flu

The annual University of Alabama flu shot campaign, an effort by UA to protect students, faculty and staff from the flu, kicks off in September and continues through early November with free flu shots provided at locations across campus, including the Quad, university buildings and student residence halls.

The goal of the flu shot campaign, which is led by UA’s College of Community Health Sciences and now in its sixth year, is to make getting a flu shot as easy and convenient as possible. The shots are free and no insurance is required, although students and employees will need to provide their Campus Wide Identification.

Last year, more than 8,000 vaccinations were given.

The shots will be administered by nurses from University Medical Center, which CCHS operates, and the University’s Student Health Center and Capstone College of Nursing. WellBAMA and UA’s Division of Financial Affairs are also partners in the flu shot campaign.

Spouses of employees can receive the free flu vaccines at the campus flu shot stations or at the Faculty-Staff Clinic in University Medical Center, and insurance is not required. Children of employees with UA health insurance can receive flu vaccinations at University Medical Center, and children of employees with non-UA health insurance can receive flu shots at the Faculty-Staff Clinic if their insurance has previously approved nurse practitioner coverage.

In addition to the campus flu shot stations, flu shots will also be provided at University Medical Center and its Faculty-Staff Clinic.

The US Centers for Disease Control and Prevention recommends everyone aged six months and older get a flu shot annually. According to the CDC, a flu vaccine is needed every year because flu viruses are constantly changing and it is not unusual for new viruses to appear. The flu vaccine is formulated each year to keep up with the flu viruses as they change.

Dr. Richard Streiffer, dean of CCHS and a family medicine physician, said flu, or influenza, is not just a bad cold but can present a serious threat to many people. While the risk for severe illness is highest for children, the elderly and those with chronic medical conditions, even healthy people who get sick can miss up to two weeks of work, and may experience serious complications and even require hospitalization.

“You want to take every opportunity to protect yourself, as we do know that flu shots work to lower the risk of getting influenza,” Streiffer said. “If we can vaccinate enough people in the community and especially at and around the UA campus, and in our families and social circles, we are starting to create a ‘herd immunity,’ which is a more effective way to protect yourself and those around you.”

Risks associated with receiving a flu shot are extremely small, and the viruses in the flu shot are inactivated so they cannot cause the flu, according to the CDC. For more information, visit http://cchs.ua.edu/flu.

Flu shots are scheduled at the following locations, and additional dates and locations are expected to be added:

Date Location Time
September 7, Thursday North Lawn Classroom Building 9 am to 4 pm
September 12, Tuesday Russell Hall 7:30 am to 11 am
September 13, Wednesday Student Health Fair, Ferguson Student Center 9 am to 4 pm
September 13, Wednesday Quad in Motion, Quad 8 am to 4 pm
September 14, Thursday Tutwiler 9 am to 4 pm
September 18, Monday Capstone College of Nursing 10 am to 1 pm
September 19, Tuesday Law School 7:30 am to 11 am
September 21, Thursday Quad, Northeast Corner (across from Smith Hall) 9 am to 4 pm
September 26, Tuesday Procurement 7:30 am to 11 am
September 27, Wednesday Quad, Northeast Corner (across from Smith Hall) 9 am to 4 pm
September 28, Thursday Presidential Two 1 pm to 4 pm
September 28, Thursday Presidential One 9 am to noon
October 4, Wednesday UA Employee Health Fair, Coleman Coliseum 6:30 am to 4 pm
October 10, Tuesday Systems Office 7 am to 10 am
October 12, Thursday Paty Hall 9 am to noon
October 17, Tuesday Reese Phifer Hall 7:30 am to 11 am
October 18, Wednesday Quad, Southwest corner (across from Graves Hall) 9 am to 4 pm
October 24, Tuesday Ferguson Center 7:30 am to 11 am
November 1, Wednesday Ridgecrest South 9 am to 4 pm
November 1, Wednesday UAPD 7:30 am to 10 am
November 7, Tuesday Gorgas Library 7:45 am to 11 am
November 8, Wednesday Mary Burke Hall 9 am to 4 pm
November 9, Thursday Quad, Southeast corner (across from Gallalee Hall) 9 am to 4 pm

Dr. Caroline Boxmeyer is new Assistant Dean for Academic Affairs

Dr. Caroline Boxmeyer is now Assistant Dean for Academic Affairs for the College. Her responsibilities as assistant dean will include providing support and cross communication to the academic programs offered within the College, supporting faculty, and leading an initiative to create an Academic Oversight Committee and Process to centralize oversight of the undergraduate and graduate education offered in the college.

“This [new] work has the potential to have broad, lasting impact on health and well-being, which has always been a central motivating factor for me professionally,” said Boxmeyer, a professor in the Department of Psychiatry and Behavioral Medicine.

Boxmeyer, who is also a practicing clinical psychologist, hopes her contributions will grow CCHS to offer an innovative and supportive learning environment for all learners.

“I consider it a tremendous privilege to be part of this work and to contribute to the training the next generation of health care providers.”

University Medical Center to open Demopolis location

University Medical Center is adding a permanent location in Demopolis, AL, adjacent to the Bryan W. Whitfield Memorial Hospital, within the hospital’s outpatient facility, effective August 1, 2017.

The initiative began as a temporary response to an immediate need to help Demopolis physician, Dr. Gerald Hodge, cover his practice and to sustain the availability of care to his patients and the community in his absence. With that, clinicians from the College of Community Health Sciences—including family medicine faculty physicians, the OB fellow and a nurse practitioner—stepped in to provide interim clinical care. However, with the recent retirement of Hodge, the only local physician still providing pre-natal care following the closure of the hospital’s obstetrical unit in February 2015, it quickly became apparent that there was a significant, and growing, need for family medicine and pre-natal care in the communities immediately surrounding Demopolis. To that end, the temporary coverage has transitioned to a new, third location for University Medical Center, the practice run by CCHS.

The establishment of UMC-Demopolis is a means by which the College can help that community directly, and support the local hospital, while also developing a model that combines a full spectrum rural practice with medical education, all linked to the larger infrastructure of University Medical Center and the CCHS. Similarly, in an independent effort, administrators from the UAB Health System are working with hospital leadership to develop strategies to improve the hospital’s financial operations and viability.

The serendipity of our work in Demopolis on the physician side with that of the UAB Health System working with the hospital is unique, and strengthens the likelihood of sustained success. UAB will no doubt be very helpful in operational strategies for the hospital. But what the hospital most needs for success is more local physicians, particularly primary care docs. That will be our principal contribution to this unique three-way partnership.

—Dr. Richard Streiffer

Dean and Professor of Family Medicine, College of Community Health Sciences

While UMC-Demopolis will officially be open to patients beginning this week, the plans for further growth are still in motion. The planning and development phase will continue over the coming months, and a grand opening in the fall is anticipated.