Dr. Monika Thangada stands out as a compassionate and innovative leader in psychiatric care at Harry S. Truman Veterans’ Hospital. Educated at S.V.S. Medical College in India and further honed through a distinguished residency at St. Elizabeth’s Medical Center, associated with Tufts University, where she also served as Chief Resident, Dr. Thangada has deeply invested herself in the multifaceted field of mental health. Her expertise particularly shines in her work with veterans, where she leverages cutting-edge telepsychiatry to broaden access and enhance the effectiveness of mental health treatments.
In this enlightening interview, Dr. Thangada shares the milestones of her career, her passionate endeavors in the field of Psychiatry including telemedicine, and her ambitious vision for the future of mental health care.
What inspired you to specialize in psychiatry, particularly working with veterans?
My inspiration to specialize in psychiatry stemmed from a deep-seated interest in understanding human behavior and mental health. The decision to work specifically with veterans was influenced by the profound respect I have for their service and the unique challenges they face. Veterans often deal with complex mental health issues like PTSD, which require specialized care approaches. Every day, I have the honor of listening to their stories, understanding their struggles, and contributing to their journey toward healing. It’s more than a profession—it’s a privilege to serve those who have served us all.
What does a typical day look like for you as a psychiatrist at Harry S. Truman Veterans’ Hospital?
Every day at the Harry S. Truman Veterans’ Hospital presents a unique set of challenges and opportunities to make a difference. My mornings typically start with a thorough review of my patients’ progress and updates from our nursing staff. This preparation is crucial as it informs the treatment strategies we will discuss during our multidisciplinary team meetings.
Patient consultations form the core of my day. These sessions are intensive, as we treat veterans with severe mental illnesses, including but not limited to PTSD, schizophrenia and other psychotic disorders, unipolar and bipolar mood disorders, substance abuse-related disorders, and personality disorders. Each session is an opportunity to listen, assess, and evolve our treatment plans to better suit each veteran’s needs, often incorporating both medication management and psychotherapeutic techniques
Education and mentorship are also key components of my day. I spend time with residents and medical students, overseeing their clinical training and providing feedback on their handling of cases. This mentorship extends beyond formal education to instill a deep understanding of the empathy and respect required when treating our veterans.
Administrative tasks and documentation cap off my day, ensuring that all patient interactions and treatment decisions are meticulously recorded. This not only helps in continuity of care but also in ongoing research and quality improvement projects aimed at enhancing our service delivery.
Ultimately, my role is a blend of clinical practice, education, and continuous learning, driven by a commitment to providing the highest standard of care to those who have served our country.
How has telepsychiatry improved access to mental health services for veterans?
Telepsychiatry has revolutionized access to mental health services for veterans, particularly those living in remote or underserved areas. At Harry S. Truman Veterans’ Hospital, where I serve, we have implemented telepsychiatry as a core component of our mental health service delivery. This technology allows us to bridge the gap between the geographical barriers and the critical need for timely psychiatric care.
Through telepsychiatry, veterans can receive consultations, therapy sessions, and follow-up care without the need for long travel distances, which can be both time-consuming and costly. This is particularly beneficial for those who may be physically disabled or suffering from conditions that make travel difficult. Women veterans with post-partum depression faces unique challenges that make traditional, in-person therapy sessions difficult, including physical recovery after childbirth, childcare responsibilities, and the complexities of their mental health conditions. Telepsychiatry provides these veterans with critical access to psychiatric care from the comfort and privacy of their own homes, reducing the stress associated with arranging travel and childcare. Moreover, it ensures continuity of care, which is vital for effective management of chronic psychiatric conditions.
We have seen significant improvements in appointment adherence rates and a reduction in missed appointments since the introduction of telepsychiatry. Additionally, the flexibility of virtual appointments means that care can be provided in a timely and more frequent manner, which is often crucial in psychiatric care management.
Overall, telepsychiatry not only enhances access to mental health services but also contributes to the overall quality of care, enabling us to reach and treat more veterans effectively. It embodies our commitment to adapt and innovate in response to the needs of our veterans, ensuring that they receive the best possible mental health support, irrespective of their location.
How do you foster a clinical environment that encourages knowledge sharing and a passion for patient care?
We place a strong emphasis on creating a culture of open communication and continuous learning. We encourage knowledge sharing by regularly organizing patient presentations in interdisciplinary meetings where team members from different specialties share insights and innovative approaches to patient care. This not only broadens our collective knowledge but also enhances our ability to deliver comprehensive care to our patients.
Moreover, I believe in leading by example to inspire a passion for patient care. I strive to demonstrate empathy, diligence, and a commitment to patient-centered care in my daily interactions. This approach helps to cultivate a team atmosphere where each member feels valued and motivated to contribute their best. We also emphasize the importance of mental health advocacy and education, empowering our staff to not only treat but also educate and engage with our community about mental health awareness.
What recent advancement in psychiatric treatment are you most excited to explore further, and how do you foresee it changing psychiatric practice?
I am particularly excited about the potential of psychedelics in psychiatric treatment, which has shown promising results in controlled studies for conditions like PTSD and depression. PTSD can be particularly challenging to treat effectively with current methods. Many patients experience symptoms even after exhausting all available traditional treatments like psychopharmacological treatments and trauma focused therapies. This leaves a significant portion of patients struggling with persistent, debilitating symptoms that interfere with their daily lives and overall well-being.
We are at the initial stages of exploring how treatments like psilocybin or MDMA-assisted therapy could be integrated into our services. The introduction of psychedelic-assisted psychotherapy represents a breakthrough therapy in the treatment of PTSD. Early research has demonstrated that psychedelics, when used in controlled therapeutic settings, can facilitate profoundly transformative experiences that may lead to significant reductions in PTSD symptoms. These substances appear to act on neural pathways involved in fear and emotional regulation, offering patients a new way to process and overcome traumatic memories.
We are closely monitoring the progress of Phase 3 clinical trials examining the efficacy of psychedelic-assisted psychotherapy. If these trials demonstrate that treatments like psilocybin or MDMA can be effectively administered in a broader clinical setting, it will represent a critical advancement in the arsenal of PTSD treatments. The introduction of such therapies could significantly improve the mental health outcomes for PTSD patients who have not found relief through existing methods.
However, the promise of psychedelic-assisted psychotherapy also brings substantial challenges, particularly regarding the establishment of proper regulations and ensuring that these treatments are administered in controlled settings. Ensuring the safety and ethical management of these powerful substances is paramount, requiring careful oversight and rigorous protocols. As we consider integrating these treatments into practice, we must also develop comprehensive guidelines to manage the risks and maximize the therapeutic potential of psychedelics for treatment of mental health disorders.
How do you stay updated with the latest developments in psychiatric research and apply these insights to enhance your professional practice and do you do any research projects by yourself?
Incorporating the latest research into my daily practice is essential to providing comprehensive care to my patients. My commitment to continuous professional development includes actively participating in annual psychiatry conferences. These conferences are invaluable for staying updated on emerging trends and research findings that could impact our clinical approaches.
A key focus of my research has been suicide prevention, and I am currently working on a research project titled ‘Frontline Primary Care: Systematic Review of Strategies for Suicide Risk Management.’ This work is crucial in our ongoing efforts to refine and enhance strategies that effectively mitigate suicide risks among patients. By systematically reviewing and implementing best practices, we aim to significantly improve safety protocols and therapeutic interventions in our care settings.
Additionally, I am involved in another project researching the psychiatric side effects of GLP-1 agonists to have a thorough understanding of how emerging treatments can affect mental health. With the increasing use of GLP-1 agonists in medical treatments, it’s vital to anticipate and manage potential psychiatric reactions to ensure comprehensive patient care.
These research initiatives are integrated into our clinical practice by updating treatment protocols, training staff on new findings, and continuously monitoring treatment outcomes. This approach ensures that our veterans receive the most effective and informed care possible, reflecting the latest advancements in psychiatric research.
What role do you play in mentoring the next generation of psychiatrists, and why do you believe this is important?
As a residency supervisor and mentor, I actively engage with young psychiatrists and medical students, sharing insights not only into the science of psychiatry but also the art of compassionate care. I believe that mentoring is crucial because it prepares the next generation to face the evolving challenges in mental health with empathy, scientific rigor, and an innovative mindset. My role allows me to instill a deep commitment to veterans’ health, ensuring that the future of veteran care remains bright and informed.
June is recognized as PTSD Awareness Month, an important time to highlight the challenges faced by those living with PTSD. As a psychiatrist specializing in veteran care, how do you approach treatment during this month, and what initiatives do you believe are crucial for raising awareness and supporting recovery?
During PTSD Awareness Month, we focus intensively on educating our communities about the realities of PTSD, which affects an estimated 6 out of 100 Americans and 7 out of 100 veterans. Improving the awareness is crucial because people who experience or witness traumatic events often suffer a range of symptoms that can persist and disrupt daily life, such as feeling fearful, disturbed sleep, or feeling numb and detached. Unfortunately, despite the profound impact on daily routines—making simple activities like going to the grocery store or hugging a friend feel daunting—many with PTSD do not receive the treatment they need.
Throughout this month, I am dedicated to reducing the stigma surrounding mental health issues and encouraging individuals affected by PTSD, whether veterans or non-veteran survivors of trauma, to seek help. We enhance our outreach by holding workshops and seminars that provide education on symptoms, available treatments, and the importance of early intervention. We also emphasize the importance of community support and encourage everyone to learn more about how they can assist those in need.
It’s our duty to ensure that those suffering from PTSD know they are not alone and that there are effective treatments and supportive resources available. By raising awareness, we aim to empower individuals to get screened and seek treatment, fostering a community that supports recovery and resilience.
Is there anything else you would like to share about your work, your passion for psychiatry, or your vision for the future of mental health services?
Psychiatry, for me, is more than just a medical practice; it’s an opportunity to make a tangible difference in people’s lives through understanding, empathy, and science. Each day presents a new chance to help someone find peace or navigate their mental health challenges more effectively. Looking forward, I am particularly enthusiastic about the integration of new technologies and therapies that can enhance our understanding and treatment of mental health disorders. My vision for the future of mental health services is one where access is seamless, and stigma is non-existent. I hope to see a world where mental health care is as routine and unremarkable as physical health care, and where everyone has the support, they need to maintain mental wellness.
From the editor….
Dr. Monika Thangada’s work at Harry S. Truman Veterans’ Hospital exemplifies the integration of empathy, precision, and innovation in mental healthcare. Her commitment to telepsychiatry has significantly improved access to mental health services for veterans, ensuring timely and effective care.
Through her mentorship, she fosters a culture of continuous learning and compassionate patient care, preparing the next generation of psychiatrists to face future challenges. As Dr. Thangada looks forward to the advancements in psychiatric treatment and the seamless integration of mental health services, her vision remains clear: a world where mental health care is accessible to all, free of stigma, and as routine as physical healthcare.
Published: June 19, 2024
Nancy Cole has over 15 years experience as a educator and health practitioner. She has a B.S. from Brock, and a Ph.D. in biology from the University of Guelph . Nancy has worked as a special medical consultant for a major insurance provider before becoming a freelance health author and public speaker.
