Area Health Education Centers (AHEC)

The Division of Social and Community Psychiatry has a three-fold purpose:  train physicians for work in population-based mental health systems; foster research regarding social and organizational aspects of severe mental illness, and support public mental health programs in the State of North Carolina through continuing education, consultation, academic linkage and assistance with resource development.

UNC psychiatry residents receive one of the best introductions to community-based psychiatric treatment available anywhere.  The statewide system of Mental Health Area Programs has been ranked among the top ten state systems nationally in terms of its organization and effectiveness.  The NC AHEC program, one of the earliest and best established programs of its type in the nation, links the UNC Department of Psychiatry with more than half of the State Area Programs, covering all geographical regions, both urban and rural populations.  Our training in community psychiatry is unique not only by the diversity and depth of the experience offered, but also by its design, which includes two seperate one-year exposures: one in the PGY2 year and one in the PGY4 year.  This allows the progressive development of first basic (clinical) and then advanced (administrative) skills.

Undergraduate and graduate medical education is conducted through curriculums in public mental health.  Approximately 20 psychiatric residents and a dozen medical students are placed in community area programs throughout the state each year.  Through partnership with AHEC.  Psychiatry faculty are available to provide training within their areas of expertise in a variety of formats at minimal cost to state public mental health programs.  Clinical education programs by other Department faculty are also arranged through the Division of AHEC.  Please see departmental faculty directory for information on individual faculty background, interests and specialties.

Division members actively conduct social and service delivery research in partnership with a variety of state public mental health programs.  The Division also assists those programs in location and maintaining professional staff, as well as in developing model service delivery approaches through consultaion, and technical and program development assistance.  The Division provides consultation for public mental health programs at minimal costs, as well as arranges for consulation by other UNC Psychiatry faculty.

Core Division faculty include: Jack Naftel, MD, Division Director; Joseph Morrisey, PHD (Director of the UNC Sheps Center for Health Services Research), and Linda Mundle, MD (Director of the Center for Mental Health, Charlotte).

Community Training Sites

Undergraduate Training - The task of developing community-oriented psychiatrists begins in medical school.  UNC Psychiatry AHEC offers undergraduate training rotations in community psychiatry at the MS III level at the Charlotte Area Programs, and at the MSIV level at the Charlotte and Alamance/Caswell Area Programs.

First year- PGY1 residents spend 50% of their first year at Central Regional Hospital and 50% on the inpatient units of UNC Hospitals.  The main training thrust of the state hospital experience is to establish early competence and comfort working with patients who have chronic, multiple and severe disabilities.  At the UNC inpatient site, there is an additional training goal providing early and intimate exposure to the programs of our local Mental Health Area Programs.

Second year - The community-oriented goal of the second training year is for the resident to become comfortable and competent providing direct and continuous clinical care to severely disabled patients in a community-based setting.  A secondary goal is to give the resident a ''first look'' at non-office-based mental health center programs.  The centerpiece of the PGY2 introduction to community psychiatry is a year long AHEC rotation (one day/week) in one of the mental health area programs across the state, offering training opportunities not available at the University (e.g., working with PACT teams, community-based substance use disorder teams, jail psychiatry, and outreach to Latino populations). 

Fourth year- Residents return to community training sites for a required second year of AHEC placement.  The focus of this second placement shifts to the development of the resident as leader, planner, and consultant.  The PGY4 resident is expected to take a relatively more active role in exploring the system and negotiating the terms of his or her employment.  Time is invested in one or more non-direct service activities, including working on an administrative team, developing a consultative role, helping to plan new services, or researching an issue related to the operation of the area program or a treatment need of the community.  PGY4 residents join PGY2 residents in the group process workshops.

Additional Resources

The Sheps Center Program for Services to the Severely Mentally Ill sponsors bi-weekly seminars dealing with mental health services research.  This program also offers post-doctoral research fellowships.  The UNC School of Public Health offers training toward an MPH degree, and residents in their latter years of training can enroll prior to completion of residency training.  Through our commitment to the continuing education arm of the AHEC Mental Health Initiative, faculty in all Psychiatry divisions teach and consult in area programs across the state.