December 2017, Vol. 8, Issue 4
In This Issue
From the Newsletter Editor-in-Chief

Mona Amini, MD, MBA, FAPA

Season's Greetings, Fellow Readers!
2017 is coming to an end, and what a magnificent year it has been. Your contributions to our state legislative bodies have overturned some potentially devastating modifications to our healthcare, promoted active participation with other local interdisciplinary behavioral health organizations, continued our AZ Psychiatric Women's Group with fantastic turnout and events, and collaboratively connected with other professionals including our state Governor to tackle the Opioid epidemic significantly effecting our state.
These are just some of the state of affairs over the last 12 months that have made this a great year. Given the impending changes on the horizon with regard to healthcare and insurance, 2018 will likely serve as a challenging year. Despite this, in leveraging one another I am confident we will continue our strive for excellence in our profession.
How do we leverage one another? It is more important than ever to begin looking into your role and interests in politics and fundraising, not only on a local level but also national.  Advocacy within the American Psychiatric Association is easier than ever via the Association's online tools- try reaching out to your federal lawmakers today.
I share optimism for our future not only as an Arizonan, but also as a professional amongst all of you. Please join your colleagues in numerous events slated for January 2018 alone, including (and of transparent favoritism) the AZ Psychiatric Women's Group brunch on January 13th centering on physician wellness.
Happy Holidays and a Wonderful New Year to you all.

In November, members of the Arizona Psychiatric Society met with Representative Heather Carter for a campaign event and opportunity to discuss important issues affecting health care, physicians, and our community.   

Members Connecting with Representative Heather Carter


Dr. Wilson_ Lindsay_ and baby son_ Henry Aaron Wilson

Aaron Wilson, MD
President, Arizona Psychiatric Society, 2017-2018

As we reflect on 2017, on behalf of the Society, I thank the many members who lead the way in our community and our profession.  As you can see from the diversity of offerings in the month of January, these are made possible through our leadership and the collaborative partnerships in our behavioral health community.  From the Women in Psychiatry Wellness Brunch, the Opioid Use Disorders Essentials Workshop, to the Inter-Professional Behavioral Health Collaborative of Arizona Social and Advocacy Event, it is a month full of engaging and informative opportunities, and I hope you will sign-up to attend and share the invitations to the same with your peers.  

December 21, 2017 marked a cause for celebration in my home.  My wife, Lindsay and I welcomed the birth of our son, Henry Aaron Wilson (I am really hoping he is decent at baseball).  Together with my children, Tyler and Betty, we rejoiced in our family and its newest addition.  

January of 2018 marks another cause for celebration among our members and leadership, the 100th birthday of Arizona Distinguished Life Fellow, Dr. Martin Kassell.  Dr. Kassell inspires us all.  Speculated to be the most senior practicing psychiatrist in Arizona, he continues to serve our community by providing psychotherapy and has long served as a mentor to residents and early career psychiatrists.  The Society looks forward to a special opportunity to raise a glass together to Dr. Kassell at the Friday reception for the 2018 Annual Meeting on April 13, 2018.  

With thanks for your membership in the Society, I hope to see you at one or more of these great events.
Opioid Use Disorder Essentials on January 20_ 2018

Join the Arizona Psychiatric Society and Arizona Chapter of the Society for Addiction Medicine for Opioid Use Disorder Treatment Essentials - Medication Assisted Treatment and Coordination of Care; and Live Waiver Training.  Opt into the sessions of your choice featuring local experts in their fields on medication assisted treatment, coordination of care, the status of the opioid crisis in Arizona, and live waiver eligibility training.  Saturday, January 20, 2018, live at University of Arizona College of Medicine, Phoenix, and by live video to Flagstaff Medical Center or University of Arizona College of Medicine, Tucson.  CLICK HERE for a flyer with more information regarding the Agenda and CME.  $35 for Physicians; $20 for Residents; with an optional box lunch $10; the live waiver training on its own is free.  Register today.  ? contact 
PRMS_ Inc.

Brunch at University Club Image

Place:  University Club, Garden Room , 39 East Monte Vista, Phoenix
Time:  10:30 am to 12:30 pm on Saturday, January 13, 2018
Register:  CLICK HERE to register; CLICK HERE for a printable flyer

Plan to start 2018 on a positive note!  Join fellow Women in Psychiatry for collegial connection and socialization, brunch, and a presentation by Dr. Robin Reesal, with a discussion about happiness, stress, and positive lifestyle c hanges. Dr. Reesal's goal is to leave each attendee with more evidence-based choices for a quieter mind and healthier body.  

Share the invitation with your female peers.  Non-members are welcome!  
Medical issues forces sale:  Solo practice of well-respected doctor in Mesa, Arizona located in Mesa Office Suites complex.  Located 1 mile from US 60 with cross streets of Alma School and Baseline. Ample parking. Public transportation 500 ft away.  13 years in business at current location.  Patients were seen two and one-half days per week with gross profit of $450,000 in 2017.  Low overhead.  Tremendous opportunity for growth and expansion.  Current patients very stable and schedule full through February.  Turning away new patients daily.  1600 sq. ft. office also available for lease or purchase.  Three office spaces, waiting room/reception area, two bathrooms/handicapped accessible, large chart room/lunchroom/work space.  If interested please contact Darlene at 480-580-0608,

Monica Faria, MD
General Adult and Addiction Psychiatrist
2nd Chance Treatment Center
President, Arizona Society of Addiction Medicine
I think my passion for understanding and connecting with others began very early in life. I was born in Los Angeles into a family that had recently immigrated to the United States from Guatemala. I grew up quite sensitive and attentive to the events that surrounded me. I am very lucky that my mother spent time teaching me Spanish before I started school. From what I am told, I was head of the unofficial welcoming committee for my kindergarten class, often serving as a translator to the new children who weren't yet Bilingual. 

Many years later I continued to pursue an interest in helping others as I took an avid interest in psychology. In high school I became a peer mentor. Predictably, I studied psychology while attending college at Northern Arizona University, however I was not planning on becoming a pre-med student. Late in my junior year, my academic adviser noticed both my grades and interest in science. At this point I was only a few credits away from qualifying for a double major in Zoology. I remember feeling equally as perplexed as she did when she asked me why I wasn't a pre-med major. To this day I am incredibly grateful she encouraged me to apply to medical school. 

I attended the University of Arizona College of Medicine and spent time pursuing my medical studies on both the Tucson and Phoenix campuses. The College of Medicine was a very supportive environment despite the rigors of medical school training, and I was incredibly lucky to work with several outstanding clinicians. Once I became acclimated to medical student life I developed a strong interest in participating in professional medical societies. I fondly recall my first visit to the Phoenix capitol as a part of the Arizona Medical Association's "Doctor a Day" program. I represented our medical school in the University of Arizona Graduate and Professional Student Council. I also became involved with a community of women physicians through our school chapter for the American Medical Women's Association. 

The reason I bring up such experiences is because I strongly believe that my participation in organized medicine has supported me the most in my professional career. After a few years of heading down the path of general surgery training and working in a local Urgent Care, I was invited to a local Arizona Society of Addiction Medicine conference. At this event, I vividly recall feeling inspired by the collegial atmosphere and patient-centered advocacy. I solidified my plans to pursue training in general psychiatry and began my psychiatric residency at Banner University Medical Center. As a resident I continued to attend several events hosted by the Arizona Society of Addiction Medicine. Through my involvement in this chapter and with the support of my Banner Psychiatry attendings I sought out more opportunities to learn about the treatment of substance use disorders and other addictions. I completed a year of fellowship in Addiction Psychiatry at UCLA and returned to Arizona to give back to my community. 

I feel that organized medicine serves many purposes, one of which is to network and encourage one another, as well as to keep each other accountable to the highest standards of medical ethics. In this day of increased physician dissatisfaction and burnout, I believe professional societies provide the best platform for lifelong relationships and mentorships, two antidotes for disillusionment in medicine. I also believe the power of the physician voice is best communicated through professional societies. Over the years I have made it customary to attend local and national conferences to keep up to date with my clinical knowledge and connect with peers and mentors who keep me inspired. Now leading the Arizona Society of Addiction Medicine, I hope to help  clinicians share their knowledge and clinical expertise with one another, as well as their humanism and love of learning.  One of the more rewarding aspects of this position is witnessing the collective energy and enthusiasm generated from the collaboration between trainees and more established physicians. 

At this point in my early career I have worked in community mental health, inpatient residential treatment, intensive outpatient treatment, and outpatient treatment settings. My favorite part of being an Addiction Psychiatrist is helping patients discover their true strength and purpose. It thrills me to witness people transitioning from a state of detachment and pain to a state of connection and peace. Of course, there are always setbacks and people vary in their levels of commitment to change, however I feel particularly blessed as a psychiatrist to be able to partner with a patient to work on his or her own goals. This is the essence of Motivational Interviewing, a form of therapy used widely in Addiction Psychiatry and one that I continuously seek to improve on and implement in my day to day practice. 

My long-term career interests include treatment of substance use disorders, behavioral addictions such as gambling disorders and sex addiction, eating disorders, women's health, and physician's health. I recognize the high co-morbidity of trauma and mood and anxiety disorders in patients recovering from substance or behavioral addictions. Thus, I value the space and time that is required to create rapport and a therapeutic alliance to address these issues. As Hippocrates best sums it up, "Healing is a matter of time, but it is sometimes also a matter of opportunity."

I can be reached at  if you would like to share any questions, thoughts, and/or if you have an interest in becoming a part of the Arizona Society of Addiction Medicine.  
Photo of Dr. Kim

Edwin Kim, MD
APS Resident-Fellow Member
Chief Resident of Clinical Education
Maricopa Integrated Health System
Desert Vista Behavioral Health

I am a Phoenix transplant, originally from the Bay Area in California. I attended Bellarmine College Preparatory in San Jose, California then graduated with a degree in Psychobiology from the University of California, Los Angeles. I am the eldest of three children; my sister is a lawyer working for the Social Security Administration, and my brother is pursuing a degree in Mechanical Engineering. While the three of us pursue diverse careers, we all share a passion for travelling and experiencing new cultures, a trait passed unto us by our adventurous parents. One of my favorite memories was travelling the ultimate American road trip over the course of two summers. Yes, we passed through all 48 continental states!
I feel fortunate to continue my love of exploring throughout my medical career. I attended St. George's University School of Medicine.  I spent my first year of medical school in Newcastle, England in the Keith B. Taylor Global Scholars Program and my second year in Grenada, West Indies. It was during my clinical clerkships in New York where I became interested in psychiatry and addiction. I witnessed the impact of untreated substance abuse and mental illness on an individual and their loved ones. I realized psychiatrists, with a biopsychosocial focus, are best positioned to tackle problematic substance abuse. Thus, in a pivotal moment of my career, I pursued psychiatric training with the intention of sub-specializing in addiction.
Currently, I am in my fourth year of psychiatry residency, serving as Co-Chief Resident at Maricopa Integrated Health System in Phoenix. In training, I have learned the foundations of community psychiatry, treating the underserved and individuals with serious mental illness. Highlights of my residency training include winning best oral presentation at the University of Arizona's Academic Excellence Day, where I raised awareness of the dangers of smoking "wax" or "butane hash oil." Personally, I believe we have yet to see the aftermath associated with emerging forms of highly concentrated cannabis, particularly in adolescents. I also serve as Co-Chair of Arizona's Society of Addiction Medicine's Advocacy Committee. Most recently, we made recommendations to the Governor's Office regarding legislative changes needed to practice evidence-based medicine in the opioid epidemic.
I believe collaboration is fundamental in tackling the devastation caused by the opioid epidemic in Arizona. To answer the salient question, "what can I do to do my part?" we are organizing a one-day symposium. Please join us on Saturday January 20th, 2018 to learn more about clinicians' roles from an excellent panel of speakers from multiple disciplines including psychiatry, primary care (family medicine and internal medicine), and OB-GYN.
I am thankful for my family who provide unconditional support of my goals. In addition, I would like to thank my co-residents at MIHS who share a passion to better the lives of disenfranchised individuals. A special thank you to Dr. Chandrika Shankar, my program director, and our coordinator, Olivia Pearce, who ensure residents have an enriching learning environment. I am grateful for Drs. William James, Devnandini Rastogi and Carol Olson, who provided the opportunity to train in Phoenix. Thank you to Drs. Gwen Levitt, Aaron Riley, Gretchen Alexander, Payam Sadr and MIHS faculty who provide ongoing encouragement in my pursuit of addiction psychiatry. Thank you to Drs. Monica Faria, Michael Dekker, Matt Goldenberg, and Michel Sucher, for sharing their visions and helping develop my upcoming plans. Thank you to Drs. Carlos Carrera, Jose Vito and Michael Ascher, who are among my earliest mentors. Lastly, thank you to Teri Harnisch, who enthusiastically worked to make the upcoming Opioid Epidemic Essentials symposium possible.
Next year, I will pursue an addiction psychiatry fellowship at the University of Pennsylvania, with plans to return after training. I aspire to start an addiction fellowship here in Phoenix. I look forward to working closely with like-minded APS members to bring this dream to fruition. Please feel free to reach out for collaboration or to say hello at Connect @edwinkimmd 


Stephen P. Herman, MD, LFAPA, DFAACAP
Board Certified:  Pediatrics, Psychiatry, Child & Adolescent Psychiatry, Forensic Psychiatry
Darren (not his real name) is a 19-year-old freshman at an Ivy League School. He had attended private schools and was always a straight-A student. He was involved in extracurricular activities and had good friends. He stayed away from students using drugs and alcohol. He worked summers at a local newspaper.

There was a family history of Major Depressive and Bipolar I and II disorders. He had not known this.

Soon after he arrived at college, he became anxious: he thought everyone was smarter, and he struggled academically. Midway through the semester, his parents informed him they were getting divorced. Darren had no idea their marriage had been an unhappy one for years. He was devastated. His sadness grew and he became too preoccupied to do schoolwork.

Darren made friends with a few people who introduced him to kratom. He found peace and his emotional pain disappeared. He smoked it, drank its tea, chewed its leaves, and found where to purchase its extracts. He became addicted. He stopped going to classes.

Kratom is a Thai word referring to the evergreen tree, Mitragyna speciosa. It grows in Africa and Southeast Asia. Mitragyna has been used to reduce fatigue and for ceremonies prohibiting alcohol. In the U.S. it can be found in leaves, liquids, powder, capsules and gum. Although research has been scant, it is known that kratom has a stimulant and opiate-like effect. The opiate effect occurs at higher doses. Its active components are alkaloids related to yohimbine. In animals, it has been shown to have anti-inflammatory and analgesic properties. These alkaloids are thought to be partial agonists for the mu-opiate receptor. These receptors are found throughout the brain, spinal cord, peripheral sensory neurons and the intestine. In addition, the alkaloids probably affect neurotransmitters, especially adrenergic systems.

As of 2017, kratom had been banned in Wisconsin, Tennessee, Indiana, Arkansas and Alabama, New Hampshire, Vermont, Sarasota, Florida, Jerseyville, Illinois, and San Diego. In Oregon, a bill was in committee requiring the State Board of Pharmacy to study whether kratom should be classified as a Schedule I substance. In July, the bill failed. It sunsets January 2019.

What of Arizona? In 2014, HB2453 was introduced to add to the list of dangerous and narcotic drugs. Representative Eddie Farnsworth (R-District 12) proposed an amendment to strike kratom from the list. The bill is in the Rules Committee.

Kratom is legal in Arizona. It's available over-the-counter and in vending machines throughout the state. In Tucson, you can buy bags at sandwich shop, from $10 to $50, depending on the number of grams. An expert at the University of Arizona said there is no monitoring of how much kratom is in these bags. Customers have said kratom cures or mitigates the symptoms of lupus, PTSD, fibromyalgia and other disorders. Supporters of the substance claim it stops opiate addiction.

In 2017, Hamilton's Pharmacopeia, a show on Viceland, devoted two episodes to kratom. They featured interviews with people speaking of their positive experiences with the substance, and covered the pros and cons of its use.

In 2016, the FDA announced it would place kratom in the temporary Schedule I category. It cited increased calls to poison control centers, seizures, and deaths attributed to the substance. The public uproar against this plan was deafening. The White House received a petition with over 100,000 signatures. Thousands of people provided accounts of the curative effects of the substance. Advocates argued it is safer than opiates.
In late 2017, Representatives Marc Pocan (D-WI) and Matt Salmon (R-AZ) wrote to the FDA and the Office Management and the Budget, calling for a delay in implementing the FDA's plan. It was signed by more than 50 members of Congress. The FDA rescinded its proposal.

However, on November 14, 2017, FDA commissioner Scott Gottlieb issued a public health warning. It stated, "There is no reliable evidence to support the use of kratom as a treatment for opioid use disorder." The warning listed at least 36 deaths attributed to the substance. Further: "We have issued guidance on the proper development of botanical products that can help improve people's health . . . The agency also has a team of medical reviewers in the FDA's Center for Drug Evaluation and Research that's dedicated to the proper development of drug applications for botanicals. To date, no marketer has sought to properly develop a drug that includes kratom . . . we are working to actively prevent shipments of kratom from entering the U.S. At international mail facilities, the FDA has detained hundreds of shipments of kratom . . ."

On December 14, 2017, Representatives Marc Pocan (D-WI) and Frank Lo- Biondo (R-NJ) asked Congressional colleagues to join them in writing to the DEA. They criticized the DEA for beginning the process of listing kratom as a controlled substance. They cited studies supporting kratom's beneficial qualities and expressed concern about limiting research. However, much of this research comes from those working with the American Kratom Association, the Botanical Education Alliance and the United Kratom Association. 

Kratom is easy to buy on the Internet through many websites. It ships directly from Thailand. That's how Darren got his. He smoked it several times a day and drank its tea. One night he called his mother and talked about how he had found true spiritual awareness. He reported that he had made some extraordinary discoveries about time bending and the future of space travel. He said he didn't need any sleep. He admitted he had seen visions. Voices told him he was a genius and to keep making discoveries. His mother brought him home. He was hospitalized for a week on a psychiatry ward but refused to take antipsychotic medication. He agreed to take clonazepam. He was discharged, still in a manic state. 

The controversy over kratom will continue. If it is classified as a Schedule I substance, good research would be prohibited or severely limited. Nevertheless, psychiatrists need to ask their patients about kratom. Because right now, in Arizona, it's as easy to buy as a bottle of soda.  

The Society thanks Dr. Herman for this article on Kratom, an emerging substance on the youth scene.  Dr. Herman is recently relocated to Arizona.  His practice address is:   17470 N. Pacesetter Way, Scottsdale, AZ 85255, 480-579-3906.  
The Year in Reflection for Arizona Stepping Up
Maricopa County Stepping Up Peer Exchange
Dawn Noggle, PhD, CCHP
Mental Health Director
Maricopa County Correctional Health Services

2017 has been a busy year across Arizona for Stepping Up, the national initiative to reduce incarceration of the mentally ill (developed by NACO (National Association of Counties), Council of State Governments Justice Center and the American Psychiatric Association Foundation).  Largely due to the advocacy of David's Hope, Arizona is the first and only state with all counties having signed a Stepping Up Proclamation.  Nationwide 400 counties have done so to date. 

Maricopa County was selected by NACO for the first Stepping Up Peer Exchange.  November 30-December 1, we hosted this event (sponsored by Janssen Pharmaceutical Companies) that included high level and elected officials from 26 counties across the U.S.  County Board of Supervisor Chairman Denny Barney and Sheriff Paul Penzone opened our 2 day event that included AHCCCS Bureau Chief Kathy Bashor emphasizing the important role of peers and City of Phoenix Police Chief Michael Kurtenbach highlighting Crisis Intervention Training and Community Policing Practices. Mercy Maricopa Integrated Care leadership described their programs for their justice involved members, including the outcomes for their FACT Teams, which received a 2017 Medicaid Best Practices award. Various Maricopa County Smart Justice leaders presented our work over the past 5 years which has culminated in a 5% recidivism reduction for individuals designated Seriously Mentally Ill along with significant declines in days spent in jail.  Although Maricopa and Phoenix were the County and City of greatest population growth for 2016, our jail population is down from 10,000 just a few years ago to an average of 8,000. 

One of the highlights of the Peer Exchange was the tour of Connections AZ Psychiatric Urgent Care which receives over 600 individuals dropped off, monthly, by local arresting agencies. Clearly many of these individuals would be booked into jail if it weren't for a strong CIT training presence in our community and for the efficiency of the urgent care center in accepting these referrals.  Our visitors marveled at the smoothness of the process, the professionalism and compassion of the staff, including peers on the "floor", and the calmness of the units.  "Where are the people in crisis?" one person asked.  "Right here!" was the answer.
The federal government Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) last week released a report, "The Way Forward" It is worth a look.  The report lists recommended areas for improvement for the mentally ill involved in the criminal justice system.  Our Peer Exchange presentations touched on our progress in these areas including interventions and programs along every "intercept" from arresting and booking practices, to universal screening, to diversion and specialty courts, and community transition.  We were proud to present our progress and collaborative partnerships and happy to see that we are leading the way on best practices. 
The report also calls for greater effort to address homelessness for these vulnerable individuals.  With Phoenix falling in the top 10 communities last year for growth in homelessness, this is a high priority, especially for individuals with mental health concerns and substance use disorders.  Maricopa County Correctional Health Services (CHS) and Human Services along with the Housing Authority of Maricopa County, Arizona Behavioral Health Corporation (ABC), Lode Star, Native American Connections, and Community Bridges have developed a collaboration, Hand in Hand, to address just these issues.  We are targeting homeless individuals booking into jail 10 or more times per year, most of whom have a behavioral health or substance use disorder to effect a housing strategy.  By identifying these individuals we engage them upon incarceration, connect them with navigation services and a potential housing strategy (rapid rehousing, supportive housing) through housing provider agencies.  As our research showed, for 2015, 59 of these "familiar faces" accounted for over 1,000 arrests. The arrests were almost exclusively for low level misdemeanors.  93% of those 59 familiar faces reported homelessness in the past year during assessment in the first 24 hours with CHS.  Cities are paying $20,000 or more per person for jail costs alone (much greater than the $14,000 it costs to house individuals including appropriate support services).  While our community indeed likely needs more psychiatric beds, housing should be seen as a priority.  For justice involved homeless individuals we know that housing is healthcare and a necessary strategy to stop the revolving door leading back to jail.

Most recently for Maricopa County Jails (MCSO), Sheriff Paul Penzone announced his decision that the closed "Tents" jail would have its facility building dedicated to our Mosaic Program, a 7 week intensive evidence based substance use program developed for the moderate to high recidivism risk population.  This trauma informed care program offers treatment from a holistic perspective addressing underlying problems to substance use such as high exposure to traumatic events, multigenerational issues, and lack of effective coping skills.  Through evidence based curriculum developed specifically for incarcerated individuals, we are helping people "put the pieces back together".  While we (the staff) think it's a great program, the comments and success of the participants is a far better measure of the program.  With a 90% graduation/retention rate and plenty of tears and smiles during individual testimonies at each graduation ceremony, we can see the impact for our participants.  Most importantly, the preliminary data for participants in the 2015 Mosaic forerunner program shows a significant drop in recidivism.  By mid 2018, we will have recidivism for the program in its current iteration.  With the Sheriff dedicating this space to Mosaic, we have gone from initially serving 150 people in 2015 to 500 people in 2017, expanding now to 750 people for 2018.  I look forward to providing more updates on this program and our increasing collaboration with community partners to address the opioid epidemic in the next edition.  

For more information, click to read each part of the recent Republic series on THE NEW HOUSING CRISIS:

The Arizona Psychiatric Society thanks Dr. Noggle for her comprehensive updates that keep our community informed about the progress made by Maricopa County, counties across Arizona, and community organizations, including David's Hope, NAMI Arizona, Mental Health America Arizona, and many others, to advance Stepping Up initiatives to reduce people with mental illness in our jails.  We greatly value and hope you enjoy Dr. Noggle's updates and the additional linked resources provided for your benefit.  We look forward to continued updates on progress made in Arizona and hope you will be a part of this important initiative.

Invitation for Comments or Questions

The Arizona Court system initiated the Task Force for Justice for All which was intended to look at current laws and criminal justice policies in Arizona with the goal to minimize disparate consequences for offenders who are poor.  A subcommittee of this task force was named to focus specifically on issues relating to mental health and the criminal justice system; the subcommittee is chaired by Mr. Kent Batty, the Court Administrator of the Superior Court in Pima County, and members include representatives from the criminal and defense bar, the judicial system, the police, the jails and the mental health treatment system.  The group has met three times, with a focus on improving:

1)       The process for competency determination in limited jurisdiction courts
2)       The process for compliance with SB1157, passed in the last legislative session, which involved some ongoing involvement of the criminal court after individuals have been found incompetent to stand trial and referred for civil commitment under Title 36.

In addition, the task force is considering whether the current standards for ordering mental health treatment should be revised in any way, in order to allow for earlier intervention. 

APS Executive Council member, Carol K. Olson, MD, is a member of the Subcommittee on Mental Health and the Criminal Justice System; feel free to email your comments or questions to

Thank you to Janssen_Johnson _ Johnson Health Care Systems_ Inc. and Meadows Behavioral Healthcare for sponsoring
6:30 to 8:30 pm, Meadows Outpatient Center
A Hosted Behavioral Health Networking Opportunity

Join the Inter-Professional Behavioral Healthcare Collaborative of Arizona for a Networking Social and Advocacy Presentation on Thursday, January 25, 2018, from 6:30 pm to 8:30 pm, at The Meadows Outpatient Center, 19120 North Pima Road, Suite 125, Scottsdale, Arizona.  Light dinner hosted.  For more information, CLICK HERE for a flyer about IBHC of AZ and the event.  Spots are limited.  Register today!  

PRIVATE PRACTICE OPPORTUNITY IN TUCSON, AZ.  Take over practice of retiring psychiatrist,  in an overhead sharing arrangement with  two other psychiatrists, a psychologist  and a master's level therapist.  Contact Shari at 520-795-0309.

TUCSON OPPORTUNITY:  TWO CLASS A PSYCHOTHERAPY OR PSYCHIATRIC OFFICE SPACES ARE AVAILABLE ON OR BEFORE AUGUST 1, 2018.  Share space and expenses with three other collegial independent psychologists, psychiatrists, and therapists in an attractive spacious quiet leased setting in midtown Tucson, Arizona conveniently located two miles from UA/UMC. Five large first floor offices share front office, reception area, kitchenette, storage for medical records and small supplies, two restrooms, ample patient/client parking, front and back entry/exits, and covered parking for the clinicians. Additional office expenses such as phone, janitor, utilities, supplies, and receptionist/office manager payroll are shared by the 5 clinicians. Billing services are inexpensively available thanks to the computerized scheduling and billing program. Vacancy or part time space available by late 2017 or early 2018 to allow sooner transition, if you wish. For questions and to express interest please contact Kevin Leehey MD at 520-296-4280.  

NORTH SCOTTSDALE OPPORTUNITY.  Seeking Board Certified Psychiatrist to rent unique office space in North Scottsdale part-time.  There will be an opportunity early next year to expand practice there.  This is a very desirable location in The Citadel at intersection of Pima and Pinnacle Peak Road.  Call 602-349-0025  John Liebert, MD, Psychiatrist.  

Congress authorized a temporary extension of funding for the Children's Health Insurance Program (CHIP), which expired on Sept. 30. This stopgap measure only funds the program through the end of March. The American Psychiatric Association (APA) has  previously urged Congress, and will continue to urge Congress, to pass long-term funding for CHIP.  
CLICK HERE to read the letter sent jointly by APA and the American Association of Child and Adolescent Psychiatry (AACAP) which outlines the essential nature of funding for the program.  

SUBSCRIBE TO the APA Engage alerts or visit the Engage website for periodic updates on messages to share with your elected representatives on key mental health.
Washington, DC - November 2017   

Payam Sadr, MD, FAPA, Arizona Assembly Representative
Mona Amini, MD, MBA, FAPA, Arizona Assembly Representative

The APA November Assembly was held November 4-6, 2017 in Washington, DC.   

Arizona was well-represented by Dr. Sadr and Dr. Amini.  Key updates from APA Staff included news of the move-in details for the new offices of the APA.  APA Staff will be in place and working from those new offices on January 2, 2018.  

Due to budgetary concerns, the Spring Area 7 Meeting, slated to occur in Alaska, has been changed to a teleconference option meeting, with some representatives self-funding to attend in person.  Regular meeting set-up will return with the August 2018 Area 7 Meeting, to happen in Las Vegas, Nevada.  

Dr. Amini and Dr. Sadr had the opportunity to meet in person candidates for the APA Elections.  Voting bgins on January 2, 2018, and ends on January 31 at 11:59 p.m. ET.  There are  three great candidates for APA President in Drs Martin, Schwartz, and Strakowski, each of whom bring unique qualifications to their respective candidacies, and Area 7 members will also have the opportunity to vote for Area Trustee to the Board.  The Board of Trustees is the most important decision making body in the APA, and Area 7 has three capable leaders to consider in Drs. Mathews, Polo, and Sonkiss.   CLICK HERE for more information about the APA 2018 Elections.  Also be sure to check out the ECP Trustee bios included in this Newsletter, which were voluntarily submitted by those candidates for consideration by Arizona members.  

For a full report on the APA Assembly November 2017 Meeting, please CLICK HERE.


Dr. Mark Haygood
Vote Mark 4 ECP Trustee Button

Mark A. Haygood, DO, MS
Greetings Arizona! I visited your great state in February of this year during an APA Assembly Executive Meeting. You have a beautiful state and extremely friendly people! I have been very active in the APA Assembly as this has afforded me the opportunity to learn what drives medical students and RFMs to be involved in the profession including advocacy for patients, colleagues, and psychiatry. Being in the APA has also stimulated my participation in the local district branch and the AMA. I believe it is more important than ever that the APA continue to take the lead for our profession and patients and help us avoid stagnation in the changing world of medicine, particularly in technology. RFMs and ECPs are the lifeblood of the APA and I will work to improve retention. Please call me anytime with questions at 256-490-7318 or visit  for more detailed information about my platform.

Dr. Ayana Jordan for ECP Trustee
Ayana Jordan, MD, PhD  
Dr. Jordan has been involved in the APA since residency, initially as an APA Leadership Fellow, then as a APA/SAMHSA Substance Abuse Fellow, serving on the communications council for two years, where she helped with rebranding efforts and web design. Currently, Dr. Jordan is Secretary for the Black caucus and Mentor for the APA Mentorship program. She finished her MD/PhD training at Albert Einstein College of Medicine in NYC and went on to complete an adult psychiatry residency at Yale University, where she served as Program-Wide Chief Resident and completed an Addiction Psychiatry Fellowship.  Dr. Jordan is currently an assistant professor at Yale, an attending physician at Connecticut Mental Health Center, and director of the Yale Global Mental Health program.  She believes increasing involvement by ECPs with varied interests is crucial in understanding Psychiatry and will help APA become a more vibrant organization, representing a diverse group of constituents.   Twitter: @DrAyanaJordan 

Dr. Hector Colon-Rivera
Hector Colon-Rivera, MD
I am a proud Puerto Rican and Indian by marriage psychiatrist. I completed my medical studies in Puerto Rico, my residency at Boston University, and my addiction psychiatry fellowship at Yale University where I treated adults and adolescents with comorbid substance use and mental health disorders. Currently, I am an attending at both the PHL VA Medical Center/ University of Pennsylvania and in the University of Pittsburgh/Telemedicine.
In my community, I started a weekly radio program called Salud A Flote where high school students would interview my physician's colleagues and discuss health topics that affect us all. 
Several APA fellows and I formed a nonprofit organization,
I believe that my dedication to mental health, my passion for diversity, and my advocacy for psychiatrists as leaders in the complex healthcare system make me the ideal candidate to represent psychiatrists from all cultural background across our nation.
Follow me at:  @colonriveramd

If you would like to contribute to the leadership of the Arizona Psychiatric Society through serving as a member of a Committee on a topic of personal interest (i.e. Legislative, Membership, Ethics, ECP, etc.), or if you would like to get involved as an officer of the Society, we welcome you!  Please contact with your area of interest.  Members are welcome to attend meetings of the Executive Council to learn more about the leadership and how to contribute.    
CME AND EVENTS:  APA Free Course of the Month; PCCS-O and PCSS-MAT Free Opioid Education; Essentials of Primary Care Psychiatry - Las Vegas, NV; Banner Grand Rounds for January; Southwest Psychoanalytic Workshop

Each month APA makes available a free CME course exclusive to members only through its Learning Center. CLICK HERE for more information.


PCSS-O and PCSS-MAT have trained more than 100,000 clinicians in preventing, identifying, and treating opioid use disorder, but did you know that these free resources are available to you through these two federal grant projects. VIEW THE FLYER for more information on the training (including podcasts) and mentoring, all by experts in the field.  

Banner UMC Phoenix Logo

CLICK HERE for the detailed flyer regarding January 2018 Banner University Medical Center Phoenix Grand Rounds for the Department of Psychiatry, held from 12:00 to 1:00 pm, Medical Education Amphitheater, with presentations on January 12, 2018,  The Evaluation and Treatment of Toxidromes,  Daniel E. Brooks, MD; and January 19, 2018,  Physician, Heal Thyself:  Looking into the Mental Health  of Medical Providers,  Tanida Brown, MD.  February Grand Rounds resume  starting Feb 2, 2018.

Flamingo Hotel
Register Now for Friday, January 26th to Saturday, January 27th, 2018 at the Flamingo Resort Hotel, Las Vegas, Nevada, "Essentials of Primary Care Psychiatry Conference," sponsored by the California Psychiatric Association.  CLICK HERE for the flyer.  For conference and hotel registration/information, please visit or call 800-772-4271.  
Eroticism: In the Maternal Matrix  and Analytic Dyad,  Dianne Elise, PhD,  January 13, 2018, 9:00 am to 3:30 pm.  For more information, view the Flyer.  

Fellow definition

American Psychiatric Association has elected the following Arizona Psychiatric Society members to the status of Distinguished Fellow of the APA.

Gwen A. Levitt, DO, DFAPA
Carol Kline Olson, MD, DFAPA
Randall K. Ricardi, DO, DFAPA
Payam Sadr, MD, DFAPA
Richard Spiegel, MD, DLFAPA
Shabnam Sood, MD, DFAPA

These newest Arizona Distinguished Fellows will be honored at the APA Annual Meeting in May with a President's Reception and a Convocation of Distinguished Fellows.

In addition, the following members of the Arizona Psychiatric Society were approved for Fellow status by the APA, and these Fellows will be honored during the Convocation ceremony in May:

Gretchen B. Alexander, MD, FAPA
Christina J. Arredondo, MD, FAPA
Lee Ann Kelley, MD, FAPA
Gurjot K. Marwah, MD, FAPA

On behalf of the entire membership of the Arizona Psychiatric Society, we congratulate these newest Distinguished Fellow and Fellows of the APA on their distinguished careers and thank them for their continued support and membership in the APA and our Society. We would also like to recognize and thank the many Distinguished Fellow members in the Society who provided letters of support.


Nominations for Distinguished Fellow must be submitted through the District Branch. If you are interested in more in formation on the requirements, please visit or contact the APS administrative office (, 602-347-6903). Distinguished Fellow nominations for recognition at the 2016 APA Annual Meeting are due to be submitted to the APA on or before July 1, 2018; Fellow nominations are due on or before September 1, 2018.


The following members of the Arizona Psychiatric Society will be recognized by the APA for reaching the following Life membership status (at the May 2018 APA Annual Meeting):

Eric Benjamin, MD, LAPA
Emerson B. Bueno, MD, DLFAPA
William J. Burke, MD, LFAPA
Donald Curran, DO, LAPA
Patricia A. Fangohr, MD, LAPA
Gary Grove, MD, DLFAPA
Richard D. Lane, MD, PhD, DLFAPA
Kevin R. Wandler, MD, LFAPA
Karen L. Weihs, MD, DLFAPA

Of special note, we recognize the following members who achieved the pinnacle of 50-Year Members in the APA as of January 2018:

Raman N. Bhavsar, MD, LAPA
Robert F. Meyer, MD, LAPA

These members will be acknowledged in the Convocation at the 2018 APA Annual Meeting.  We recognize these fellow members for their years of dedicated service to the APA and the Society and to their contributions to the field of psychiatry and the enrichment of our mental health community.

Thanks to Drs. Heck, Cochrane, and Yates for their efforts in planning the Fall Mixer at TopGolf Scottsdale, a fun afternoon of connecting was enjoyed by all.  

Take note of the opportunity to poster present at the APS Annual Meeting on April 14, 2018 described in this Newsletter.  

About APA/APAF Fellowships:   The APA and APAF award up to 77 fellowships each year across eight different fellowship programs. Areas of focus include policy, research, substance abuse, child psychiatry and more.   Each fellowship has unique  application requirements program responsibilities and  eligibility requirements  - all detailed on each fellowship's page.  The deadline for all APA and APAF Fellowship applications is January 30, 2018.  For more information, visit    
Faculty from Neuroscience of Enduring Change
Faculty from the Neuroscience of Enduring Change:  
September 2017 - Tucson, Arizona

Robin Reesal, MD, FAPA

The Neuroscience of Enduring Change: Applications to Psychotherapy Conference in Tucson was a success. The meeting, hosted by the University of Arizona Psychology and Psychiatry Departments was on September 15 and 16, 2017 in Tucson.

The conference theme connected neuroscience to psychotherapy techniques. The sessions were based on the research article,  Lane RD, Ryan L, Nadel L, Greenberg L., Memory reconsolidation, emotional arousal and the process of change in psychotherapy: New insights from brain science. Behavioral and Brain Sciences 2015; 38:1-19.   The authors' active participation in the meeting enhanced the exchange of ideas.  

A cast of expert and skilled scientists, researchers, educators, innovators and psychotherapists with international reputations, spoke about the importance of memory consolidation and emotional arousal in psychotherapy. On Day 1 talks covered basic science topics such as memory, emotion, emotion-memory interactions and the effects of sleep on reconsolidation of emotional memories. On Day 2 expert psychotherapists discussed their perspectives on common and distinct change processes in different modalities.  The conference participants have agreed to summarize their presentations in a book to be published by Oxford University Press in late 2018.

The audience listened to cutting edge and clinically relevant information. The meeting advanced the following concepts, as stated in the key article identified above. Therapeutic change results from updating prior emotional memories through a process of reconsolidation that incorporates new emotional experiences. Therapies share an integrated model for change that revolves around autobiographical memories, semantic structures, and emotional responses. The essential ingredients for therapeutic change are reactivating old memories, reconsolidating memories, and using the reformulated memories in the future.
Thanks and congratulations to the organizers for having a well-run meeting! 

Dr. Reesal is an internationally experienced psychiatrist with a background in psychopharmacology, behavior therapy, and mental health education. He is starting an evidence-based prevention and education focused telehealth practice for working professionals. This is an added service to standard healthcare. 


RFM and Medical Student Invitation.  The Arizona Psychiatric Society invites all Arizona psychiatric residents or Arizona medical students to submit an abstract for consideration for a judged and scholarshipped poster presentation at the Arizona Psychiatric Society Annual Meeting, to be held on Saturday, April 14, 2018 at the Wild Horse Pass Hotel & Casino Conference Center, 5040 Wild Horse Pass Blvd, Chandler, AZ 85226.  Please review the APS Resident-Fellow and Medical Student Poster Guidelines for complete information regarding participation and prizes. 
Physician Invitation.  The Arizona Psychiatric Society invites all Arizona psychiatric physicians to submit an abstract for consideration for a peer juried poster presentation at the Arizona Psychiatric Society Annual Meeting, to be held on Saturday, April 14, 2018 at the Wild Horse Pass Hotel & Casino Conference Center, 5040 Wild Horse Pass Blvd, Chandler, AZ 85226.    Please review the APS Psychiatric Physician Peer Poster Guidelines for complete information regarding participation. 
Visit the submission link at: and provide the requested authorship information and submit your abstract of 3000 characters or less (including spaces).
We welcome all to present their best work from recent meetings or preview new work.  The submission deadline is midnight on April 1, 2018.  View the full Call for Abstracts here.  
Arizona Psychiatric Society Newsletter Committee
Mona Amini, MD, MBA, FAPA, Editor-in-Chief
Brian Espinoza, MD, FAPA, CME Features
Robin Reesal, MD, FAPA,Global Psychiatry Features
Gagandeep Singh, MD, Assistant Editor

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