A new grant is helping Indiana University School of Medicine Department of Psychiatry strengthen its position as a national leader in addiction psychiatry training and patient care through expansion of the addiction psychiatry program and nationwide implementation of a model of care developed at IU School of Medicine.
Indiana Health

IU School of Medicine awarded $4 million grant for expansion of Addiction Psychiatry Program

Jul 01, 2020
R. A. Chambers, MD

R. A. Chambers, MD

A new grant is helping Indiana University School of Medicine Department of Psychiatry strengthen its position as a national leader in addiction psychiatry training and patient care through expansion of the addiction psychiatry program and nationwide implementation of a model of care developed at IU School of Medicine.

“We’re training a workforce of physicians who can lead the integration of treating both mental illness and drug addiction together,” said R. A. Chambers, MD, associate professor of psychiatry for IU School of Medicine Department of Psychiatry.

The $4 million grant comes from the United States Department of Health and Human Services (HHS) through the Health Resources and Services Administration (HRSA) and will support the Indiana University-Addiction Psychiatry Expansion Project (IU-APE). The grant will help the school train more fellows through its addiction psychiatry fellowship, expand the Division of Addiction Psychiatry through hiring more faculty and implement a new model of patient care developed and designed by Chambers.

“Addiction psychiatry is the only physician specialty where doctors are trained to diagnose and treat both mental illness and drug addiction,” Chambers said. “Most patients with mental illness also have drug addiction and vice versa, and it’s really hard to get expert treatment for both conditions.”

Over the last couple of decades, IU School of Medicine has done basic science research to study the relationship between mental illness and drug addiction. They discovered the top risk factors for drug addiction are having mental illness and being exposed to drugs early in adolescent development. Chambers said the research that has already been done illustrates the link between drug addiction and mental illness. But despite those findings, the two are often treated as separate conditions by separate health care providers, and having to see multiple doctors in multiple locations can make it difficult for patients to get comprehensive care.

“We train specialists to treat both addiction and mental illness, because if you ignore the addiction, but only treat the mental illness, you’re not going to get very far,” Chambers said. “The addiction will fuel the mental illness, despite what you do to treat it. The same is true the other way around.”

The IU School of Medicine fellowship in addiction psychiatry is one of about 40 addiction psychiatry fellowship programs in the country and is the only addiction psychiatry fellowship in the state of Indiana. The HRSA funding for IU-APE will allow the department to train up to four fellows per year, greatly increasing the number of trained addiction care specialists in the state. It will also provide funding for more addiction psychiatry faculty, leading to more opportunities for medical students and residents to complete rotations in addiction psychiatry.

“The hope is that it will help addiction psychiatry become a much bigger part of general psychiatry instead of this narrow margin on the side,” Chambers said. “Almost half of all of our psychiatrists trained here in Indiana will now have the opportunity to train in addiction psychiatry.”

The HRSA grant also funds expanded use of “The 2 x 4 Model” of treatment, which Chambers developed and designed at Sidney & Lois Eskenazi Hospital.

“The 2 x 4 Model is a blueprint for treatment focused on building clinics that treat both mental illness and addiction, rather than having a separate bipolar clinic, PTSD clinic, suboxone clinic, etc.,” Chambers said. “We need to be paying attention to addiction and mental illness together as one team under one roof, with certain types of psychotherapies and medications available in the same place.”

An illustration of the 2x4 Model of Addiction Psychiatry care

HRSA awarded similar addiction psychiatry grants to other universities across the nation. The IU-APE project will allow IU School of Medicine to work collaboratively with many of these centers to help build a national network of 2 x 4 Model clinics that provide expert integrated treatment of mental illness and addiction comorbidities. Here in Indiana, the IU School of Medicine grant will allow for expanded use of the model at Indiana University Health, the Richard L. Roudebush Veterans Administration Medical Center, Adult and Child Health Center and other community mental health centers state wide.

“The expansion of our fellowship and faculty in the Division of Addiction Psychiatry via the IU-APE will help us make impactful strides for addiction psychiatry care in Indiana and beyond,” said Thomas McAllister, MD, chair of the Department of Psychiatry.

“This grant will help us integrate partnerships to expand and strengthen training and clinical services in the field of addiction psychiatry for patients spanning the entire life cycle from adolescence, to pregnancy, to young parents and older adults. IU School of Medicine is committed to being a national leader in the field of addiction psychiatry and I am hopeful that this grant will have a national impact on treating those suffering from addiction and mental illness.”

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IU School of Medicine is the largest medical school in the U.S. and is annually ranked among the top medical schools in the nation by U.S. News & World Report. The school offers high-quality medial education, access to leading medical research and rich campus life in nine Indiana cities, including rural and urban locations consistently recognized for livability.

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