Global and Rural Track

The Global and Rural Psychiatry Track is committed to producing culturally compassionate child and adolescent psychiatrists who are passionate about serving their community and a diverse set of patients in the U.S. and around the world.

El Paso, alongside Ciudad Juárez, the most populous city in the Mexican state of Chihuahua, and Las Cruces in the neighboring state of New Mexico, are sometimes referred to as the Paso del Norte. This region constitutes the largest bilingual and binational workforce in the Western hemisphere. Additionally, Ysleta del sur Pueblo, one of the three federally recognized Native American tribes in Texas, is located about 13 miles outside of El Paso, and there is a strong federal and military presence that is often host to refugees from around the globe.

• Continuity care at Ysleta del sur Pueblo Tigua Child and Adolescent Psychiatry Clinic.
• Border Health and Rural Medicine through Texas Child Mental Health Care Consortium (TCMHCC) projects: Rural Telemedicine for Youth (RTY) and Texas Child Health Access Through Telemedicine (TCHATT).
• Political asylum evaluation training under faculty supervision.
• Quarterly participation in a journal club or research seminar addressing a wide variety of global and cultural mental health topics.
• Attendance and participation at the annual TTUHSC El Paso Cultural Competency Conference.
• Completion of a scholarly or community project that can span the course of the fellowship to be presented at a conference or merit publication.
• Development of expertise about a selected ethnicity, country, or world region of interest to be presented at a conference or merit publication.

• Ethical consideration in global psychiatry.
• Mental and physical health concerns unique to the border region and rural Texas.
• Access to care and understanding the perpetuation of existing health disparities.
• Working with traditional healers, faith healers, and indigenous leaders.
• Immigration-related concerns.
• Public policy, advocacy, and activism.
• Practicing psychiatry, including assessment, diagnosing, and treatment, and providing psychoeducation to families within specific populations.
• Practical implementation in low-resource settings.
• Building sustainable, reciprocal relationships with global and community organizations.
• Psychiatrization of distress and lack of basic needs.
• Conscious social inclusion in common psychiatric diagnoses and treatment.

The application to the Global and Rural Psychiatry Track includes:

• A brief statement regarding your interest in the Global and Rural Psychiatry Track (maximum 250 words).
• Curriculum vitae.

Please email the requested materials and any questions to the contact below.

Dr. Cecilia De Vargas, M.D.
Child and Adolescent Psychiatrist
Associate Professor
Program Director, Child and Adolescent Psychiatry Fellowship
Texas Tech University Health Sciences Center

Office: 915-215-5857

Email: Cecilia.DeVargas@ttuhsc.edu

Texas Tech University Health Sciences Center El Paso
Department of Child and Adolescent Psychiatry

Child and Adolescent Psychiatry Fellowship
Global and Rural Psychiatry Track

Background:

Global health has become one of the most important areas of foreign, development, and security policy, paved and shaped by the rapid succession of endemic and epidemic outbreaks perceived as health crises. The concept has since expanded with the globalization of the twenty-first century, to include every health challenge or transnational determinant. Mental health is gaining traction as an important part of global health, difficult to disentangle from overall health. Global mental health has been defined as an area of study, research, training, and practice that places a priority on improving and achieving equity in mental health for all people worldwide.

Projects in global mental health, not only contribute to the advancement of psychiatry, but also provide opportunities for psychiatry residents and psychology trainees to build their cultural competency and compassion, diagnose and treat psychiatric disorders in a wide range of cultural groups, develop qualitative and quantitative research skills, and learn to address health disparities, including those that exist in a significant manner in the United States. There is also the opportunity to develop and build sustainable relationships with populations who differ in their practices and needs. 

While global mental health is gaining traction, it remains a very small portion of psychiatry training programs, with only a small percentage of programs having significant focus in global mental health or opportunities to further specialize in the field. These programs range from integration into the standard residency program to extra one to three year fellowships that provide the opportunity for specialization. Of note, of these programs, few have opportunities in global child mental health training.

Creating the track at TTUHSC El Paso:

Texas Tech University Health Sciences Center in El Paso (TTUHSC El Paso) is located in the far Southwestern portion of Texas, uniquely located just a few minutes from the borders of both New Mexico and Mexico. El Paso, alongside Ciudad Juarez, the most populous city in the Mexican state of Chihuahua, and Las Cruces in the neighboring state of New Mexico, are sometimes referred to as Paso del Norte. This region constitutes the largest bilingual and binational workforce in the Western hemisphere. Additionally, Ysleta del sur Pueblo, one of the three federally recognized Native American tribes in Texas, is located about 13 miles outside of El Paso. Another unique aspect includes a strong federal and military presence that is often host to refugees.

While several experiences with these communities already exist through the TTUHSC El Paso’s child and adolescent psychiatry fellowship, there are multiple advantages to create a focused track through which trainees can gain specialized experience and participate in projects with the goal of increasing their knowledge base and skills, as well as building TTUHSC El Paso’s presence within the community. Additionally, within the state of Texas, only UT Southwestern appears to have a portion of their curriculum officially dedicated towards global mental health. 

Advantages can include recruitment of trainees who are passionate about and interested in expanding their knowledge base and experience in global and rural psychiatry. Competencies that may differ from or have a stronger presence than the general fellowship may include conscious social inclusion, ethical approaches to mental health, culturally appropriate ways to speak about mental health, issues regarding access to care, public health policy affecting low resource populations, program development, the understanding of the psychiatrization of distress and lack of basic needs, and advanced psychiatric expertise in trauma-informed psychiatric care for immigrants, refugees, and Native American populations. Additionally, upon graduation, this expertise may be valuable in further serving the El Paso community, making advancements in global mental health and policy, or conducting ethical research with underserved populations that may change our understanding of current diagnoses and treatment modalities.

Competencies:

• Fellows will demonstrate the ability to establish rapport, attuned to dynamic issues, with families of different cultural, ethnic, and socio-economic backgrounds.
• Fellows will demonstrate the ability to assess, diagnose, and treat psychiatric illnesses in a culturally competent manner.
• Fellow will understand potential socio-economic and cultural stressors and strengths that are present in childhood and adolescence.
• Fellows will have proficient knowledge about the cultural and social-economic impact on the nature and extent of psychiatric morbidities and its treatments.
• Fellows will demonstrate culturally appropriate discussion and psychoeducation of stigmatized mental health topics.
• Fellows will demonstrate understanding of health disparities, including racial bias, in evidence-based medicine and practice.
• Fellows will demonstrate understanding of mental health concerns unique to the border region and rural Texas.
• Fellow will demonstrate understanding of mental health concerns unique to immigrants and refugees, including asylum-seekers.
• Fellows will demonstrate appropriate use of interpretive services.
• Fellows will learn about gender-affirming and trauma-based care within special populations.
• Fellows will develop expertise in a special population of their choice to present to the department of psychiatry.
• Fellows will develop effective teaching skills to build the capacity of community workers to care for the mentally ill using evidence-based protocols.
• Fellows will demonstrate the ability to use scientific literature, including the ability to perform effective literature reviews and apply findings in the clinical setting.
• Fellows will demonstrate understanding of ethical concerns in the field of global mental health, particularly in partnerships between high-resource and low-resource countries.
• Fellows will demonstrate skills necessary to build sustainable relationships with global partners.
• Fellows will build expertise in program development and logic models, along with qualitative and quantitative research skills, for low resource settings.

Didactic Topics

• Ethical considerations in practicing global psychiatry
• Mental and physical health concerns unique to the border region and rural Texas
• Concerns in access to care and health disparities present in psychiatry
• Values and unique aspects of cultures present in El Paso and the surrounding areas
• Values and unique aspects of cultures to Ghana
• Practicing psychiatry, including assessment, diagnosing, and treatment, and providing psychoeducation to families within special populations

Experiences and Expectations

• Half day elective rotation
  • Ysleta del Sur Pueblo Tigua Child and Adolescent Psychiatry Clinic 
  • TCHATT or CPAN with participation in outreach to schools and pediatricians in rural communities
• Development of educational opportunities for community members and schools
• Leading of quarterly journal club or presentation addressing a wide variety of global, rural, and cultural mental health topics
• Attendance at the annual TTUHSC El Paso Cultural Competency Conference
• Training to conduct asylum evaluations for children, adolescents, and adults through approved courses provided by Physicians for Human Rights
• Completion of a scholarly, quality improvement, or community project that can span the course of the fellowship to be presented at a conference or merit publication

Future goals:

• Look into strengthening relationships with external organizations such as the Consortium, Pecos Shelter, Las Americas Immigrant Advocacy Center.
• Develop rotations that provide opportunities to strengthen knowledge and skills in global and rural mental health.
• Expand network of guest speakers with expertise in the area of global and rural psychiatry to ensure a well-rounded and meaningful educational experience through the track and present on various career paths in this area of psychiatry

Deadline to Apply: September 15 of the second year of fellowship

Application Requirement: CV, paragraph on why you want to complete the track (maximum 250 words)