Rajesh Tampi, MD, MS, DFAPA, DFAAGP: Recipient of the 2024 AAGP Diversity Award

CLINICAL CONVERSATIONS

Psychiatric Times Editorial Board member, Rajesh Tampi, MD, MS, DFAPA, DFAAGP, received the American Association for Geriatric Psychiatry’s (AAGP) Diversity Award at the 2024 AAGP Annual Meeting on March 15-18 in Atlanta, GA.¹ This award recognizes an individual or organization involved in geriatric mental health care who demonstrates sensitivity to issues of diversity in aging, or who has an innovative approach or track record of service to elderly minority or underserved populations. We sat down with Tampi to learn more.

PT: You were recently chosen to receive the AAGP Diversity Award Congratulations! What does this win mean to you?

Rajesh Tampi, MD, MS, DFAPA, DFAAGP: I am truly honored and humbled to receive this award. This is not just an award for me, but a celebration of all the work that is being done by my colleagues to improve the life of all older adults with mental health disorders, especially minoritized older adults.

PT: What advice do you have for other clinicians who want to provide culturally sensitive care?

Tampi: The most important skill that a clinician can bring to the table while caring for patients is the ability to actively listen and understand the individual’s situation or problems. Actively listening to your patient means that you respect them and the concerns that they bring forward to your attention. This will lead to the development of trust between you and the patient. Once that mutual trust is established, you and the patient can collaborate to find appropriate solutions for each situation or problem.

PT: What advice would you give clinicians and colleagues who are from diverse backgrounds to achieve success?

Tampi: My advice to them is to develop a clear plan to move forward with their goals, stay true to those goals, work hard, do not cut corners, see every adversity as an opportunity to learn something new, build partnerships, and always be humble.

PT: What issues stand out to you as the most critical in geriatric psychiatry?

Tampi: In my opinion, the most critical issues in geriatric psychiatry at present are as follows: the serious shortage of trained geriatric mental health professionals to care for our aging population with mental health disorders; lack of funding to develop sustainable models of care for older adults with mental health disorders; and apathy towards the welfare of our senior citizens who have contributed so much to our society.

PT: You recently initiated a new column with Psychiatric Times, “Translating Research Into Practice.” Can you share more with readers why you started this column and what information you hope to share?

Tampi: There is a lot of conflicting information that is available in the media on the care of individuals with mental health disorders. My goal for this column is to use a standardized process to evaluate the evidence for the assessment and management of mental health disorders, and to share the best possible evidence with my colleagues for their review and reference.

PT: Research has indicated disparities in health care, especially mental health care. How do you use your platform to make a positive impact? How can other clinicians do the same?

Tampi: Social determinants of health are vitally important factors to consider when planning the care of an individual and to also improve the health of our communities. Disparities in health care are highly prevalent, especially in mental health care. These disparities worsen health care outcomes, not only for the individual but also for society in general. As mental health care providers, we must be aware of the social determinants of health and include them in the assessment and management of mental health disorders. Additionally, we must educate our patients and our colleagues about these factors and the disparities in health care, so that they too can pay close attention to these factors. By forging collaborations and improving the disparities, we can contribute to the improved overall health of our patients and the communities we live in.

PT: Approximately 20% of US older adults have a diagnosable psychiatric disorder.²

Tampi: Approximately 20% of individuals aged 55 years or older experience some type of mental health problems. The most common psychiatric problems include anxiety, severe cognitive impairment, and mood disorders (depression or bipolar disorder). The rate of suicide among men ≥ 85 years is 4 times the overall rate of a suicide for all ages (45.23/100,000 vs 11.01/100,000).

PT: Biogen recently announced its decision to discontinue all development and sales of aducanumab (Aduhelm) for Alzheimer disease,³ and now the FDA will convene an advisory committee to discuss donanemab.⁴ What are your thoughts on pipeline treatments for Alzheimer disease at this time?

Tampi: These are bumps in the road, and not the end of the road for the development of new treatments for Alzheimer disease. As expected with any new treatment, these treatments have limited efficacy, and significant adverse effect profiles. Additionally, the need for close monitoring of adverse effects and the high cost of these drugs add to the burden of caring for these individuals. Additionally, there are issues with equity as many individuals with Alzheimer disease will not have access to these treatments. However, the lessons learnt from the development and marketing of these drugs will help the pharmaceutical industry develop drugs with better efficacy and adverse effect profiles. 

PT: What do you see as the top challenges facing psychiatrists today? What are you most excited about in the field of psychiatry? Are there any new treatment modalities in which you are interested?

Tampi: In my opinion, issues with limited work life balance and greater risk for burnout are the current biggest challenges facing any mental health provider. The need to see more patients, navigate complicated electronic medical records, and deal with administrative tasks are major barriers to developing a good work-life balance. I am most excited about collaborative care, where evaluation and evidence-based treatments are provided to individuals with mental health disorders at their primary care providers offices. This will reduce stigma and improve access to care for so many individuals with these disorders. I am most excited about the use of neuromodulation, electroconvulsive therapy, transcranial magnetic stimulation, transcranial direct current stimulation, and ketamine among individuals with neurocognitive disorders.

PT: Thank you!

Dr Tampi is professor and chairman of the Department of Psychiatry at Creighton University School of Medicine and Catholic Health Initiatives (CHI) Health Behavioral Health Services. He is also an adjunct professor of psychiatry at Yale School of Medicine in New Haven, Connecticut, and he is a member of the Psychiatric Times editorial board.

References

1. Tampi chosen to receive AAGP Diversity Award. Yale School of Medicine. February 15, 2024. Accessed March 12, 2024. https://medicine.yale.edu/news-article/tampi-chosen-to-receive-aagp-diversity-award/

2. The state of mental health and aging in America. Centers for Disease Control and Prevention. 2008. Accessed March 12, 2024. https://www.cdc.gov/aging/pdf/mental_health.pdf

3. Kuntz L. Biogen discontinues aducanumab for Alzheimer disease. Psychiatric Times. January 31, 2024. https://www.psychiatrictimes.com/view/biogen-discontinues-aducanumab-for-alzheimer-disease

4. Kuntz L. Donanemab delay: FDA calls for last-minute meeting to discuss safety and efficacy. Psychiatric Times. March 8, 2024. https://www.psychiatrictimes.com/view/donanemab-delay-fda-calls-for-last-minute-meeting-to-discuss-safety-and-efficacy