Pine Rest grads are staying close to home

New psychiatrists help with overwhelming local demand for mental health care.
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In the wake of the COVID-19 pandemic, demand for mental health care nationwide is extremely high. Locally, graduates of Pine Rest Christian Mental Health Services’ psychiatry programs are working to fill that gap.

Pine Rest’s 2022 residency and fellowship graduates have overwhelmingly chosen to remain in Michigan, with 94% choosing to work in the state and 65% remaining at Pine Rest itself to continue offering care.

Pine Rest is a nonprofit organization offering psychiatric urgent care; inpatient and partial hospitalization; residential, outpatient and teletherapy services; addiction treatment and recovery; child and adolescent programs; senior care services; and specialized assessment and treatment clinics. It is the fourth-largest behavioral health provider in the United States and third-largest nonprofit behavioral health hospital in the country.

The hospital’s Grand Rapids location works in partnership with Michigan State University College of Human Medicine to educate and prepare the next generation of mental health care workers through residency and fellowship programs. Pine Rest offers fellowships in the areas of addiction psychiatry, child and adolescent psychiatry, geriatric psychiatry and a new program in forensic psychiatry.

Dr. Louis Nykamp. Courtesy Pine Rest Christian Mental Health Services

Dr. Louis Nykamp, psychiatry residency program director, and president of medical staff and outpatient psychiatrist at Pine Rest, credits the program’s top-notch guidance and resources for graduates as main reasons for them to stay, as well as relationships formed between graduates and their peers, mentors and patient groups.

“Continuing medical education that is specifically psychiatry related is robust at Pine Rest,” Nykamp said. “They (graduates) know that the faculty who are now their colleagues will have their back, that they can turn to those people and get good clinical advice. Learning (at Pine Rest) doesn’t stop because every week there are additional formal learning opportunities with grand rounds and case conferences and journal clubs. So, it’s a robust learning environment.”

Pine Rest currently has 51 residents and fellows. Seventeen of them are graduating from the facility’s program this year, with 65% having chosen to stay at Pine Rest to continue their careers, while another 29% are choosing to stay in-state to offer care to Michigan residents.

Dr. Kellen Stilwell. Courtesy Pine Rest Christian Mental Health Services

Dr. Kellen Stilwell, one of this year’s graduates, said he chose Pine Rest for his child and adolescent psychiatry fellowship based on the support and investment he felt from peers and mentors during his clinical rotations there. That same support is what is encouraging him to stay.

“I’ve been really pleased with the access we have; it’s been a really great learning opportunity. Just because I am done training doesn’t mean I am done learning,” Stilwell said. “I really feel a lot of opportunities to grow in my professional life here. They’ve been really good about creating space for what I am interested in.”

As a fellow, Stilwell works with adolescents to provide psychotherapy and psychiatric services. He helps children with mood disorders, anxiety, depression and attention deficit/hyperactivity disorder.

Stilwell, originally from Cadillac, also cited the sense of community in West Michigan and his partner, who lives in Grand Rapids, as contributing factors for him staying in the area.

As the after-effects of the COVID-19 pandemic become more clear, the need for mental health care providers has become more prominent as people struggling with anxiety and depression brought on by the isolation and stress of navigating the pandemic search for solutions.

According to Nykamp, patient volume during the past year has increased exponentially, leading to an overwhelming need for more doctors to offer care. Pine Rest’s graduates choosing to stay in the West Michigan area and in the hospital itself will contribute greatly to filling the gap between patient need and hospital’s ability to meet that need, he said.

“Initially, there was a little bit of drop (in patient volume) because people just weren’t going out,” he said. “And then about a year in we started to really see some repercussions of the social isolation and since that time the hospital has been often running at capacity. Our outpatient clinics have been extremely full, with record volumes. Pine Rest has really been trying to step into the gap to meet those needs and working with our resident trainees is a hugely important mechanism of doing that.

“We have a specific outpatient residency clinic, and that for the last few months also has been running at record volumes and the residents have been working exceptionally hard at meeting the patients’ needs and being able to squeeze in those extra appointments to get people seen. Demand has been really high.”

As the 2022 graduates go out into the community to serve, Nykamp said he has high hopes for the level of care they will offer to those in need. According to Nykamp, this class has had more hurdles than its predecessors, as students needed to adapt to the ongoing challenges that providing mental health care during the pandemic presented.

“They have faced a lot during residency due to the pandemic,” Nykamp said. “In March of 2020, for a time we were having to greatly restrict some inpatient services and then had to abruptly develop a specific COVID unit, which is very unique in the state.”

He also said that these graduates’ ability to offer telemedicine care is a new asset to the mental health care community.

Pine Rest, according to Nykamp, went from providing almost 100% in-person services to almost 100% telepsychiatry services in the space of two weeks, a challenge that the graduating residents met with resilience and adaptability. Those skills in telemedicine, Nykamp said, would continue to serve as an asset to their care in the years to come, as he predicts the ability to provide access to medical care in a virtual setting will continue to be utilized in offering services to those in rural settings or without the ability to travel for care.

“This group has learned by fire how to effectively deliver psychiatric care in a video conferencing type of environment,” he said. “It’s a skillset that gives them an adaptability that likely exceeds that of any other class before them who may have graduated.”

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