More than a number

The statistics are staggering. One in five adults will struggle with a behavioral disorder during their lifetime, and the ripple effects reverberate throughout the community, straining hospitals and public institutions. Behavioral disorders are responsible for one out of every eight visits to the emergency department, and more than eight million Americans care for an adult family member with a behavioral disorder, averaging 32 hours a week in unpaid care.

With only 10 state psychiatric hospitals across Texas to serve its 29 million residents, the waiting list for treatment can easily amount to months, and private facilities may not be covered by insurance, resulting in thousands of dollars in out-of-pocket expenses.

Yet the real story lies beyond what the numbers tell us; it lies in the lives disrupted, the dreams dashed, and the anguish lived through every day.

“We need to emphasize behavioral health now and address those issues because of how important they are, how prevalent,” explains Jair C. Soares, MD, PhD, Professor and Pat R. Rutherford, Jr. Chair in Psychiatry at McGovern Medical School at UTHealth Houston. “It's a major cause of disability worldwide. These are very common conditions that need to be better addressed so that people can live fuller, happier lives.”

For years, behavioral health experts like Soares in the Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School have dedicated themselves to pursuing discovery, clinical, and translational research and offering individuals and their families access to the latest treatments and therapies.

In spring 2022, UTHealth Houston strengthened its commitment to behavioral health when it opened the doors of a new facility that, combined with the UTHealth Houston Harris County Psychiatric Center (HCPC), has created the largest academic psychiatric hospital in the nation. A collaboration with the Texas Health and Human Services Commission, the new facility, which carries the name of the John S. Dunn Behavioral Sciences Center, adds 264 beds to the existing 274 beds at UTHealth Houston HCPC.

“The new hospital improves access to inpatient psychiatric care for our community,” says Lokesh Shahani, MD, Associate Professor. “It provides us an opportunity to develop innovative and personalized ways of caring for individuals suffering with mental illness.”

Shahani says the goal is to create a more complete continuum of care by providing step-down beds for those patients who need more time in the hospital, something the region previously lacked. In the future, patients could transition from acute to subacute care in the hospital, to a partial hospitalization program, to an intensive outpatient program, and finally to outpatient-only care. This is critical to easing and reintegrating patients back into the community.

The Dunn Center Building will also allow the university to double the number of psychiatric residents. “When this happens, we will have the largest psychiatric residency program in the nation,” says Shahani.

“We are building a massive footprint in behavioral health at UTHealth Houston,” says Soares. “We now have the Behavioral Sciences Campus in addition to close to 20 sites in the community and partnerships with hospitals throughout the Texas Medical Center.”

More patients translates into more research. “The Dunn Behavioral Sciences Center will help us grow exponentially at the same proportion on the research side,” says João de Quevedo, MD, PhD, Professor and Director of the Translational Psychiatry Program. “With longer treatment programs, patients can be enrolled in more comprehensive research.”

De Quevedo balances seeing approximately 40 patients a week for mood disorders with leading the Translational Psychiatry Program in the Faillace Department of Psychiatry and Behavioral Sciences. The Translational Psychiatry Program sits at the center of four overlapping focus areas—the Center of Excellence on Mood Disorders, the Center for Neurobehavioral Research on Addiction, the Brain Collection for Research in Psychiatry Disorders, and the Trauma and Resilience Center.

“In translational research, we work on the basis of the disease to discover how it develops and why. From there, we propose new therapies,” explains de Quevedo. To do that, researchers work in tandem with clinicians to obtain patient data, neuroimaging, and blood samples and to employ genomic, behavioral, epidemiological, and bioinformatics approaches.

For example, researchers are investigating the accelerated aging that happens in people with bipolar disorder.

“There is the chronological age that is on your driver’s license, and then there is biological aging,” says de Quevedo. This biological aging is associated with non-psychiatric conditions like cardiometabolic disease and cancer. “The data show that patients with behavioral disorders age quicker biologically versus chronologically. We are trying to understand why and how to prevent that.”

The team has a large focus on treatment-resistant behavioral disorders. Patients who do not respond to traditional treatment are more likely to be on disability, attempt suicide, and have increased health expenditures.

“These patients have been sick most of their lives. They give up their dreams. They drop out of college. Their relationships suffer, and they are unable to hold a job,” explains de Quevedo. “When you treat them, and you are able to bring them back to normalcy, it’s life-changing. These are the people we would really like to help because the others are already served by traditional treatments.”

Building on evidence that bipolar disorder is linked to the loss of neurons and increased inflammation in the brain, Soares and de Quevedo are initiating the first pilot study to determine whether stem cells—which have been shown to stimulate neuron growth after a stroke—can effectively treat complex behavioral disorders like treatment-resistant bipolar depression.

Part of the Dunn Foundation’s transformational gift—which the Dunn Behavioral Sciences Center was named in honor of—is designated for research like this, an endeavor they have supported since their giving began in 1986. Similarly, Anthony Faillace made a significant commitment in honor of his father and founding chair of psychiatry at UTHealth Houston, Louis A. Faillace, MD, which created faculty chairs that provide resources for behavioral research and educational programs.

Understanding the importance innovation plays in ending suffering, Elizabeth and Drew Kanaly created a research endowment to help find answers, and Yvonne and Walter Johnson made a substantial estate commitment to ensure work like this continues long into the future. They join a growing list of individuals and foundations committed to advancing behavioral health.

“The impact of philanthropy goes beyond what is seen through a donor’s initial gift. It impacts other researchers, who produce preliminary data to apply for grants to keep programs going,” de Quevedo says. “Without our donors, we would not be competitive.”

But there is still work to be done.

“I really believe that we are now where the field of oncology was 30 years ago, before major investments created a much better understanding of the pathways and mechanisms involved in causation,” says Soares. “This is in many ways still the last frontier in medicine.”