Southern California PSYCHIATRIST November 2024

Phrenology Redux or the Functional Elements of Consciousness?

by J. Zeb Little, MD, PhD

Back in college, I had a plaster phrenology bust on my desk. Phrenology, of course, was one of the early efforts to understand and measure individual differences in mental capacity by measuring the contours of one’s skull. And, today while we may contemn these kinds of pseudoscientific efforts to explain personality traits, we might also empathize with the desire to find those features of the brain that can explain the products of mind (consciousness, perception, emotion, behavior) and their differences between individuals.

The shift from phrenology to the modern neuronal basis of mental processes was encouraged by the development of the compound microscope and Ramón Y Cajal’s discovery of a variety of distinct cell types within the brain using Golgi’s cell-staining technique. Subsequently, the development of theories of functional units in the brain, now known as Brodmann Areas, were predicated on appreciation that distinct cell types clustered in areas that could also be associated with functional impairment through lesion studies. This progression of insights into the biological underpinnings of consciousness were made possible by technological advancements that allowed for increasingly sophisticated observations of functional elements in the nervous system.

Over the last 3 decades, a new set of technological innovations have produced a growing body of literature that suggests the presence of large-scale neural networks whose activity and interaction reliably produce phenomena typically associated with core features of mammalian consciousness. Early efforts to investigate the loci and connections making up these functional networks were hampered by problems of resolution and difficulty measuring neural physiology in vivo, but recent advancements in imaging, network tracing, and machine learning methodologies have demonstrated the capacity to reproducibly identify these networks of activity, their influence on each other, and the mental phenomena with which they are associated. Today’s large-scale network theory provides a novel construct through which to investigate the causal basis of differences in mental function including individual differences in the presentation of psychopathology and response to treatment. Below I highlight three such networks, their major loci, and their role in producing functional elements of consciousness and its perturbations.

The Default Mode Network (DMN):

The Default Mode Network (DMN) is one of the most studied networks in the brain, and it is primarily active when we are at rest and not focused on external tasks. The DMN is typically associated with internally directed processes, such as daydreaming, self-reflection, recalling personal memories, and imagining future events. It is considered crucial for our sense of self and elements of autobiographical consciousness.

The DMN spans several key brain regions, including the Posterior Cingulate Cortex (PCC), medial Prefrontal Cortex (mPFC), Angular Gyrus, medial Temporal Lobe, and Hippocampus. These regions collectively work to support high-level cognitive processes including self-referential thinking, episodic memory, and social cognition. The activity of the DMN is believed to allow us to construct and reflect on our self-identity which enables us to maintain a coherent sense of who we are across time. This includes introspection, evaluating past experiences, and projecting ourselves into the future.

In current theoretical models, the DMN is thought to provide the scaffolding for what is known as the “narrative self,” and it gives us the ability to reflect on our experiences and emotions in a personal and continuous way. This internal narrative is unique to each individual and is a key part of what makes human consciousness so complex and multifaceted. Abnormalities in the functional connectivity between nodes of the DMN have been identified in a wide range of psychiatric conditions associated with alterations in perceptions of ourselves: these include Major Depressive Disorder, Autistic Spectrum Disorder, Generalized Anxiety Disorder, Schizophrenia, and Alzheimer’s Disease.

There is a large body of research that attempts to explain how different perturbations in the DMN relate to distinct psychiatric conditions. For example, reduced functional connectivity of the Hippocampus and PCC are found in Alzheimer’s Disease; whereas in Major Depressive Disorder, there are abnormalities in mPFC activation, and in Autistic Spectrum Disorder we find reduced activity in multiple loci of the DMN including the mPFC and PCC. While how these alterations produce the core symptoms of various disorders remains to be clarified, the presence of dysfunction within nodes associated with the DMN are a consistent finding in conditions defined by abnormalities of memory and self-referential mental processes.

The Salience Network (SN):

In contrast to the DMN, the Salience Network (SN) is associated with the detection and parsing of stimuli from multiple sources including the autonomic nervous system and other sources of external and internal stimuli. Its functional characteristics involve identifying and shifting our attention between internal and external environments based on emotionally or biologically relevant inputs. Functional connections between regions of the SN appear crucial for identifying, shifting attention, and filtering relevant sensory inputs. It allows us to continuously monitor and focus our attention on what is most relevant for our well-being in any given moment whether that is a physical sensation, emotional signal, or social cue.

The major loci of the SN include the Anterior Insula, the dorsal Anterior Cingulate Cortex (dACC) and the dorsal and ventral lateral Prefrontal Cortex (vlPFC, dlPFC), as well as the subcortical structures the Amygdala and Substantia Nigra. These regions receive input from sensory systems to support stimulus-driven attention such as orienting to a loud noise, a salient social cue, or a biologically relevant internal sensation. Thus, it is thought the SN is involved in processing emotions and interoceptive signals — bodily sensations that inform us about internal states like hunger, pain, or stress. The functional connections of the SN also appear to be responsible for cognitive control of task-switching such as shifting from internal to external stimuli. By guiding attention and prioritizing stimuli, it is thought the SN helps modulate consciousness in a flexible manner ensuring we are alert to changes that may require immediate action.

Disruptions in the SN have been linked to various disorders, including Schizophrenia, Generalized Anxiety Disorder, Post-Traumatic Stress Disorder, and Addiction. All of these are conditions in which core features of the pathology relate to impairment in selecting between different homeostatically relevant stimuli for their utility in guiding behavior. Examples include deficits in the activation of the anterior insula and dACC loci of the SN in schizophrenia. The degree of reduction correlates with the severity of delusions and auditory hallucinations suggesting abnormalities in assessing the saliency of internal stimuli influence the severity of these symptoms. Similarly, abnormal assessments of internal bodily states and heightened avoidance behaviors seen in some anxiety conditions are associated with increased activity within the anterior insula. Abnormalities in the activity of the SN are also found in studies of pain perception and studies of cue-reward processing in addiction. Taken together they suggest disorders of SN function are present in psychiatric conditions in which cognitive processing of salient internal and external stimuli is abnormal. Understanding differences in the activity within and between networks, such as variation in activation of SN inputs onto loci of the DMN, may one day help us to identify the etiology of subtypes of symptoms and aid in selecting between potential therapies such as whether CBT or Dynamic Psychotherapy is more likely to be helpful for a given individual or choosing the location of rTMS targets in treatment resistant depression.

The Central Executive Network (CEN):

The Central Executive Network (CEN) is proposed to underlie cognitively demanding tasks such as manipulating information in working memory, choosing which aspects of an experience to emphasize for determining behavior, and integrating rule-based decisions with goal-directed behavior. Connections between nodes of the CEN are active in tasks requiring planning, reasoning, and decision making. The activity of nodes associated with the CEN are consistently found in experiments involving the regulation and volitional control of thoughts and behaviors.

Of the three large-scale networks the least is known about the CEN. This is in part due to the relative difficulty separating its activity from the activity of the SN and DMN whose loci overlap spatially and functionally with it. The brain regions affiliated with the CEN include the dorsolateral Prefrontal Cortex (dlPFC), the lateral Posterior Parietal Cortex (lpPC), the Precuneus, the middle Cingulate Cortex (MCC), and subcortical regions including the Caudate Nucleus and the Amygdala.

Impairment in activity and connections within and between nodes of the CEN are found in many psychiatric disorders. In Schizophrenia, disruptions in dlPFC and PPC activity are associated with the severity of working memory deficits. CEN dysfunction is also a hallmark of dementia; differences in CEN activation patterns are found between Alzheimer’s and Frontotemporal Dementias. Several features of PTSD are associated with abnormalities in CEN function including deficits in cognitive control which are correlated with defective dlPFC activation and difficulties in emotional regulation which are associated with abnormal activation of the MCC. Such findings of functional changes in different networks may suggest novel theoretical constructs that would help explain not only the way the brain produces conscious phenomena but would also provide insight into the causes of treatment resistance. For example, if a traumatizing stimulus produces reproducible changes in the loci of each large-scale network this may suggest the presence of multiple unique forms of memory consolidation underlying different forms of traumatic memory, and also the presence of distinct but overlapping neural representations of information available for therapeutic intervention.

In summary, large-scale network theory posits that the temporally and spatially integrated activity of large-scale neural networks encodes the functional units of mental activity associated with conscious experience. Normal and pathological differences in mental experience are explained by differences in the activity and responsiveness of individual loci and the strength of their connections with other loci within the same network and their influence on between network activation and inhibition. There remain many open questions including are the observed changes in network function the cause or the consequence of illness? How does the activity of these networks produce our coherent perception of conscious phenomena? And what are the neuronal mechanisms by which activity within and between networks encodes changes in function? While there are still many unknowns that underscore the current limitations of this theoretical construct, it is hard not to imagine the current ensemble of structural and functional elements contained by these large-scale networks as responsible for orchestrating the symphony of consciousness. Of course, only time and more sophisticated technology will tell.

Geng H, Xu P, Aleman A, Qin S, Luo YJ. Dynamic Organization of Large-scale Functional Brain Networks Supports Interactions Between Emotion and Executive Control. Neurosci Bull. 2024 40(7):981-991

Menon V. Large-scale brain networks and psychopathology: a unifying triple network model. Trends Cogn Sci. 2011 15(10):483-506

Park HJ, Friston K. Structural and functional brain networks: from connections to cognition. Science. 2013 342(6158):1238411

Faculty’s Voice

by Manal Khan, MD

Bernie Sanders compares the price of Ozempic in the United States (US) versus Canada and Germany

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A father holds the body of a toddler without his head against a burning landscape

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A parody video of a Millennial boss giving constructive feedback to their Gen Z employee and getting ambushed in the process

It’s 8 pm. I have a national mentorship meeting with psychiatrists. In this meeting, like many others recently, we discuss “what is wrong with trainees?” I hear the long list of concerns that attendings have; “they are not even hiding their lack of professionalism”, “things that did not need to be said, now do… make your expectations explicit”, “there is a generational shift”, “we have over-corrected”. Every complaint reminds me of my own inadequacies. I have some encounters open. I have not yet responded to that email from two weeks ago. I have a form waiting to be completed.

I hear a loud sound. My two-year-old is determined to break into my makeshift home office. His father ushers him away.

Where are we? Yes, “they are late to clinics”, “they are asking attendings for coverage”, “they want lighter caseloads”. Okay, I concede! Some of this is egregious. The attendings reminiscence about the good old days. “We did not care about going home on time”. “We worked long hours, and that too with a smile”. “We even responded to patient messages over the weekend”. “This is not a job, it’s a calling”.  Attendings brainstorm ideas to reinvigorate the love for medicine and the duty of being a physician for their trainees. Should we tell them what it means for us to be physicians? Should we give them a powerful memoir of a physician to remind them of their duty? Should we ask them what made them choose medicine as a career in the first place?

Knock! It’s my 6-year-old negotiating to end the meeting early and to put him to bed. I tell him I am on camera, and he needs to wait another 15 minutes. He walks away disappointed.

My mind wanders. Two years ago, I wrote, “A Letter to My Future Self”. [1] In that piece, I had aspired to find alternatives to enduring the dark tunnel of training. However, in the past couple of years, instead of light finding its way into the tunnel, the darkness seems to have spread. Can an underground tunnel ever become naturally bright? Similarly, training programs located in a broken healthcare system and a broken healthcare system located in a world struggling to answer existential questions about its values will naturally stumble, falter, and at times, feel less than inspiring. How do you make meaning of Ozempic’s price in the US? What is your duty as a physician while you witness death and tragedy through your social media newsfeed? And how do you motivate a generation faced with diminishing economic prospects to adopt altruistic parts of their work as a core identity when there is no protected time, incentives, and financial compensation for those parts.

Seeing goodness inspires goodness. The conversation has moved on, “the system needs to change”. “Yes, it does … but for now this is what we have, and they need to adapt”. With that, the meeting ends. I rush to my son’s room and lay down with him as he sleepily acknowledges my presence. I scroll through my social media and see discussions reflecting the resentment of physicians towards organized medicine, academic medicine, and healthcare systems. The system is bleeding [2, 3]. I recall the many conversations with colleagues about the impending decline of academic and organized psychiatry. It’s dying, they all say. But how do we save it? The answer can no longer be prestige. The allure of climbing through make-belief ranks by doing free labor for a dossier while taking a substantially lower salary isn’t all that enchanting. If it’s not prestige, can it be an authentic love for creating, collaborating, teaching, and training. We would hope so, but then our leaders in healthcare systems with an academic mission need to answer some existential questions.

Do they really value training and education or is that a byproduct of attending-resident parallel play (clinical labor)? How do you adequately protect time to teach and learn while managing the financial demands of the healthcare system? If a physician’s worth for a healthcare system is only the revenue they generate through clinical encounters, then what motivates them to work for the system and not for themselves? What are the long-term consequences of deprioritizing education and training in service of generating revenue? Will we lose faculty? Will that create and contribute towards the imbalances in access to care? How/who will fill those gaps in our systems of care? What will be the ethos of the next generation of psychiatrists who have trained in a world that teaches that profits take precedence, empathy is not financially viable, and institutions do not love you back?

“A Letter to My Future Self” reflected hope. This one carries the tone of a disillusioned immigrant who arrives at the promised land only to realize that there is no such thing. Land is land, and it’s the promises that you make to yourself that need to be upheld. However, the land can either be conducive or obstructive to the fulfillment of those promises. Figure 1 captures the current system. It’s for us to decide whether this system reflects an inspiring future for faculty and trainees. Maybe in a few years, my disillusionment will morph into reconciliation and acceptance. Maybe I will write another letter in this series – one espousing wisdom and showcasing growth. Maybe I will talk about the magic of delegation, the power of saying no, acceptance for being good enough, and carving out time every day to write.

In the meantime, I must lecture the trainees on professionalism and demand efficiency, while staffing a case with them in five minutes. Afterall, nobody has the luxury of time in the real world.

References:
1. Khan M. A letter to my future self. Academic Psychiatry. 2023 Apr;47(2):217-8.
2. Ligibel JA, Goularte N, Berliner JI, Bird SB, Brazeau CM, Rowe SG, Stewart MT, Trockel MT. Well-being parameters and intention to leave current institution among academic physicians. JAMA Network Open. 2023 Dec 1;6(12):e2347894-.
3. Banerjee G, Mitchell JD, Brzezinski M, DePorre A, Ballard HA. Burnout in academic physicians. The Permanente Journal. 2023;27(2):142.

Figure 1: Cycle of Academic Labor Extraction

September Council Highlights

by Acting Secretary, Laura Halpin, MD

PRESIDENT’S REPORT                                     Dr. Rees

1. Introductions
2. Fellowship and Award Committee is looking for a new chair and members after years of leadership by Dr Larry Gross. Dr Gross shared more about the committee, their main role is to nominate the Distinguished Fellows of the APA and other awards of the District Branch.  If interested, please reach out to Ms Thelen and Dr Rees
3. Program Committee is still searching for a new chair, if interested, please reach out to Ms Thelen and Dr Rees
4. Academic Liaison: Dr Manal Khan is the new Academic Liaison Committee chair.
5. Alternatives to Incarceration Committee: Dr Reba Bindra is going to co-chair with Dr Wood.
6. APA CEO and Medical Director, Dr Marketa Wills will be joining Council meeting in October for the start of the meeting. Council is still planning the format of the meeting
7. Training program outreach: upcoming talks at Loma Linda, UCLA, Arrowhead, Ventura, Charles Drew University and Kaiser Permanente
8. APA Reception is scheduled for Monday 5/19 from 4-6 PM sponsored by PMRS at the Palm Restaurant. Dr Lin shared more details about the venue, close proximity to convention center and great options for food and drinks.

Motion Approved: Council ratified actions made on contracts with The Palm Restaurant and PMRS, previously approved by Executive Committee over summer hiatus.

1. Move Update: We have moved out of old physical office. Costs were less than expected, we received our security deposit back.
2. New workgroups: There are 3 new workgroups, the Stimulant issues Taskforce (Drs Wood and Halpin), APA Reception Task force (Drs Lin Goenjian and Kelly) APA representation taskforce (Drs Red and Silverman)
3. Action Papers for council approval: there was discussion of 3 action papers that were endorsed by council. Each was reviewed and available in Dropbox.  Titles are below:

Motion Approved: Endorsement of action paper titled APA to update position statement, provide guidance for providers and provider resources for caregivers to address social media use issues in children and adolescents

Motion Approved: Ratification of executive committee endorsement of action paper titled A secure application (app) to improve engagement and retention of APA members

Motion Approved: Ratification of executive committee endorsement of action paper titled Access to stimulant medication to treat ADHD

90034. SCPS Career Day will be Sunday December 8^th 2024 9:30 AM-3:00 PM Kaiser Permanente West LA 6041 Cadillac Ave Ste 503 Los Angeles CA 90034. Booths and speakers are coming together.  PMRS will be sponsoring lunch.

1. PRESIDENT-ELECT’S REPORT              Dr. Kelly
2. Newsletter Updates were provided. Dr Kelly recognized recent contributors and reviewed next month’s contributors.  New web based format was reviewed, interaction and clicks have increased with new format. October contributors were viewed.
3. Nominating Committee: Traditional roles is nominations for positions with SCPS. There was been some discussion about expanding role to promote SCPS members in external organizations engaging in advocacy with goals for organized psychiatry.  The committee may meet an additional time to do this.   Others interested can reach out to Dr Kelly.
4. SCSCAP Joint Meeting: Annual meeting in the Winter with topical focus. Plan is for the meeting to occur Nov-Dec, there was discussion of possible topics, those interested should reach out to Dr Kelly.

1. TREASURER’S REPORT                            Dr. Wood
2. August Financials and Cash on Hand Report

Dr. Wood reviewed various financial metrics, year-to-date. Overall, SCPS is in good fiscal health. A motion was made to approve the Treasurer’s Report and it was accepted by unanimous vote.

1. ASSEMBLY REPORT                                 Assembly Reps
2. Dr Silverman provided update about Area 6 meeting. Action Paper deadline is today (9/12/24) and discussion and endorsement of action papers occurred earlier in meeting.  There was also discussion about changing APA policy on inviting Executive Directors to Assembly.  This meeting used to be of great value for Executive Directors connecting and networking to better support members. Council members and Area 6 are concerned.   There was discussion about asking for this to be on next Area 6 Council meeting agenda.

VII.         GAC ACTION ITEMS                           Drs. Shaner and Wood

Report from monthly meeting was provided.  The CA legislative season is wrapping up, we are awaiting what will happen with the bills at the Governor’s office.  The GAC and CSAP GAC are working on legislative ideas for next year now (see more specific motions below).  There was also discussion about ongoing monitoring of the covid-exemptions to the Ryan Haight Act regarding prescribing controlled prescriptions via telehealth.  It is still unclear what will happen next, APA it advocating for an additional extension of covid-exemptions. Additional specific actions were presented:

1. Action 1: The Committee asked the SCPS CSAP GAC reps, pursuant to an SCPS Council action of June 13. 2024, to request a CSAP GAC August 15, 2024, agenda item to discuss crafting a request to the FDA to conduct a study to assess the risk of stimulants based on real-world data, and to determine from what entity (e.g.,, SCPS, CSAP) the letter should originate. It was also suggested that SCPS initiate an APA action paper to direct APA policy staff to make similar efforts.
2. Action 2: The Committee asked the SCPS CSAP GAC reps to request a CSAP GAC August 15, 2024, agenda item to discuss the extension of a CSAP invitation to the incoming APA CAGR chair to meet with CSAP to discuss opportunities for collaboration to support legislative advocacy, including psychostimulant shortages/reclassification.
3. Action 3: The committee voted to recommend to SCPS Council that it request its CSAP representatives to work with CSAP and other parties to seek appropriate congressional investigation to identify steps that the CSA and DEA should immediately take to lessen the continuing inability of patients with ADHD to obtain properly prescribed psychostimulant medication. (Dr. Wood)

Motion Approved: CSAP GAC representatives will bring this item to CSAP GAC for next steps

1. Action 3 (Motion) The committee voted to recommend to SCPS Council that it request its CSAP representatives to place on the CSAP policy agenda proposals developed by the SCPS Unhoused Workgroup to ameliorate the persistence of large numbers of unhoused mentally ill individuals in California. (Drs. Chang and Koldobskaya)

Motion approved: The following 3 items will be placed on the CSAP GAC agenda:

CARE Court: For patients who fail CARE court treatment, there is currently no court-mandated transition to a higher level of care. We would like to sponsor or support legislation to more clearly define and mandate the responsibility of the CARE court and the county to facilitate a transition to a higher level of care, such as LPS conservatorship, for patients who fail treatment through CARE court.

Conservatorship: There is currently no mandate for acceptance of tele-testimony from patients during LPS conservatorship proceedings. This creates limitations and delays in conservatorship proceedings for patients who are psychiatrically unstable or unable to attend court in person. We would like to sponsor or support legislation to correct that.

Board & care: Adult residential facilities, aka board and cares, are a significant housing resource for chronically mentally ill individuals who do not live with their families. Investment in board and care facilities could provide a highly cost-effective congregate living solution for chronically unhoused mentally ill individuals. We would like to advocate for rules of sponsored legislation to include meaningful investment in Adult Residential Facilities (aka board and cares) in Prop 1 funding.

1. Action 4: The Committee asked the SCPS CSAP GAC reps to request a CSAP GAC August 15, 2024, agenda item to discuss the extension of a CSAP invitation to the DMHC for a Follow-up meeting with DMHC (Department of Managed Health Care): (Dr. Rees et al.) Discussion of potential meeting with DMHC to determine out how DMHC intends to enforce new rules related to out of network access to care when the Health Plan network is inadequate.
2. Action 5: The Committee agreed to closely monitor the rollout of SB 43 and CARE Court in SCPS counties and seek ways to work with NAMI and other groups to develop CARE Act clean-up bill language to establish court responsibility to hold respondents and counties accountable for CARE plans, and to ensure proper use of Proposition 1 funding.

• COMMITTEE REPORTS                          Chairs

1. Alternatives to Incarceration –Drs. Wood and Bindra Committee is working on judges and psychiatrist liaison  The committee is looking at legislative ideas for the incompetent to stand trial system
2. Access to Care–The committee is developing a program on October 30^th at 7 pm to address working with managed care and then clozapine and LAIs. There was also discussion about how LA County DMH has been leasing private hospital beds. This is increasing challenges with access to some beds.  There was discussion about how the overall shortage of beds for any payer exacerbates this issue.  The unhoused workgroup is interested in coordinating on this issue.
3. APA Representation Workgroup–Drs Red and Silverman, the workgroup is forming to develop improved representation within the APA
4. Diversity and Culture – Dr. Malik. The committee continuing to review guidelines for diversity awards. They are also working on interacting with programs and figuring out next steps for the repudiation of Moynihan Report Action Paper
5. Private Practice: Dr Goldenberg October 7^th will be the first meeting, all are welcome
6. Stimulant Issues Workgroup: Drs Wood and Halpin provided updates about concerns about ADHD diagnosis and stimulant shortages.
7. Unhoused workgroup: presented initial proposals and continues to working on issues like shortage of subacute beds and reimbursement structures.

IX         MEMBERSHIP REPORT                         Dr. Ijeaku

1. Membership Report

The membership report was approved by unanimous vote.

1. NEW BUSINESS-                                        Dr. Rees

Volunteers for planning for meeting with Dr Wills next month, Drs. Shaner, Wood, Rees and  Ms. Thelen volunteers

OLD BUSINESS – none                                    Dr. Rees

ADJOURNMENT – 9:06 pm                             Dr. Rees

George L. Mallory Diversity, Culture and Social Justice Award Guidelines

Please see the following guidelines to apply for the George L Mallory Diversity, Culture and Social Justice Award.
Please send materials to socalpsychiatric@gmail.com

Award Description: The Diversity and Culture committee is very excited to announce the George L. Mallory Diversity, Culture and Social Justice Award. This award recognizes a Southern California psychiatrist for their exceptional contribution to advocacy, teaching, research and/or leadership aimed at countering structural racism and advancing our understanding of culture and diversity in psychiatry.

This memorial award is named in honor of Dr. George L. Mallory, a prominent educator, psychiatrist and civil rights activist who dedicated his life to treating the underserved in Los Angeles County. Dr. Mallory was one of the first staff members of Martin Luther King Jr./Drew Medical Center, a president of the Black Psychiatrists of Southern California, and the recipient of numerous awards. The purpose of the George L. Mallory Award is to honor current psychiatrists who are continuing this important work in reshaping public mental health to be more inclusive and equitable to all. The Committee encourages SCPS members to send in nominations (self-nominations accepted) for consideration for this award. For more information including past awardees please visit: https://www.socalpsych.org/about/diversity-culture-committee/

Application opens: November 1, 2024
Application closes: January 15, 2025
Nomination Process: Self-nominations and 2nd party nominations welcomed
Application Requirements: Description of the nature of your commitment to justice, equity, diversity and inclusion (1-2 pages). A copy of your CV (1-5 pages).

Selection Criteria:

● Award recipient should demonstrate a historical contribution and ongoing commitment to advocacy, teaching, research and/or leadership aimed at countering structural racism and advancing our understanding of culture and diversity in psychiatry
● Award recipient must be a psychiatrist serving in the SCPS regions
● Award recipient must submit their application materials by the published deadline in order to be considered

Award Recipient selected by: February 25, 2025

Awards Ceremony: Spring 2025. The award recipient is strongly encouraged to attend the SCPS Installation and Awards Ceremony to be recognized in person.

Los Angeles County’s HOME Team

The October 20, 2024 New York Times published an article highlighting Los Angeles County’s HOME Team.  The HOME Team is doing remarkable work treating and housing some of the most seriously ill unhoused people in Los Angeles.  The article highlights two SCPS members, Shayan Rab, M.D. and Yelena Koldobskaya, M.D.  SCPS member Danielle Chang, M.D. also works on the HOME Team.

https://www.nytimes.com/2024/10/20/health/los-angeles-homeless-psychiatry.html

SCPS

Dear Members,
Please remember that SCPS is here to help. If you have a question about your practice or a concern that may be applicable to the Government Affairs Committee, please reach out and let us know. We have several committees that may be able to assist with general resources.