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Psychiatrist To Head State’s MH Commission

Elizabeth Childs, M.D., the first psychiatrist in two decades to head the Department of Mental Health in Massachusetts, brings multifaceted experience and broad support from mental health advocates to a difficult position.

Elizabeth Childs, M.D., takes a militant stance toward mental illness. She told Psychiatric News, "We’re in a fight with mental illness. We can’t let it deny people their lives."

With her appointment on June 30 as Commissioner of the Department of Mental Health in Massachusetts, Childs stepped into an arena in which many of the relevant battles will be waged.

Massachusetts, like most other states, faces budget shortfalls and has cut benefits for mental health services and fees to those providing them.

She is already familiar with some of the problems that come with her new job.

As chief and director of psychiatry at Carney Hospital in Dorchester, Mass., Childs learned firsthand of the problems for hospitals that treat large numbers of uninsured patients.

She testified to state officials earlier this year, "Providers. . .who continue to provide services to this population face pressure either to abandon their mission. . .or risk financial collapse and closure, further limiting access."

As immediate past president of the Massachusetts Psychiatric Society (MPS), Childs worked with a committee that advised the state on principles for a Medicaid drug formulary (Psychiatric News, May 16).

"Work within the system," she said. "You have to make the big changes from the ground up."

In applying those deceptively simple rules, organizational skills are a big help.

MPS President James Ellison, M.D., told Psychiatric News that Childs had helped bring about a reorganization in MPS’s committee and office structures.

"She’s excellent at reaching shared goals and capable of handling a huge amount of responsibility," he said.

Childs takes a broad view of who her constituencies are. "It’s not only patients and their families," she said. "It’s the communities in which they live, those who provide mental health services, and the legislature."

She is known for an inclusive approach toward advocacy and mental health issues.

Toby Fisher, executive director of the National Alliance for the Mentally Ill–Massachusetts, told Psychiatric News, "Beth was our first and only choice for the position. She spoke at our rallies, took time from her work to advocate for patients and their families, and at every turn talked about the needs of people with chronic mental illness."

In a letter of support, Fisher wrote, "We cannot say enough about the expertise and help she has given NAMI. . . .Her stature within the mental health community has grown even more over the past several years."

Childs takes a similarly broad view about the role of psychiatrists in advocacy. "Multiple disciplines are involved in the delivery of care in the mental health system," she said. "We should see ourselves as part of a big picture."

She has considerable experience in both the public and private sectors and in various aspects of psychiatry and administration.

Childs completed her residency in psychiatry at the Massachusetts Mental Health Center, where she was chief resident in adult psychiatry, and completed training in child psychiatry at that center and the Gaebler Children’s Center.

She has held academic appointments at the Massachusetts Institute of Technology, Harvard University, and the University of Cincinnati.

What about those areas of disagreement, such as mandatory treatment, that divide mental health advocates?

"It’s important to listen and to explain," she said. "I’ll be meeting with groups of all kinds in my new position."

Childs said she was impressed by the "desire to do things well" of the state employees. "Their commitment is quite something," she said.

Speaking for herself, Childs said, "I thought it would be the kind of job in which gratification is delayed, but I was pleasantly surprised. It’s such an immediate reward to be in a position in which I can help look out for people’s best interests and make decisions that help them."

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