Daniel P. Dickstein, MD, FAAP, newly minted chief of McLean’s Nancy and Richard Simches Division of Child and Adolescent Psychiatry, has a big vision. His enthusiasm and passion are contagious.
Dickstein, a physician-scientist who is uniquely triple board-certified in pediatrics, adult psychiatry, and child/adolescent psychiatry, was recruited from Brown University. He brought his well-regarded PEDIMind lab with him, to become McLean’s first director of child and adolescent research and associate director of the Simches Division in 2020.
Last fall, Dickstein stepped into the top spot, taking over from Joseph Gold, MD, who led the division for 22 years and will now focus on his role as McLean’s chief medical officer.
We caught up with Dickstein in his office—a space adorned with hand-drawn pictures from former young patients.
Horizons: You’re stepping into big shoes. Dr. Gold is a beloved and well-respected clinician and leader. Can you talk a little about his legacy?
Dickstein: I have enormous admiration for Joe; the breadth of what he has done in this field is inspiring. He built a division that is internationally recognized for providing top-notch care, with a uniquely multifaceted collection of services.
For example, the partnership we have with Franciscan Children’s Hospital and the establishment of the 3East continuum, arguably the best DBT services in the world, are the result of Joe’s leadership. I am thrilled to build on his legacy, working with our talented and collaborative team.
Horizons: What are some of the most pressing issues you’re seeing in the child and adolescent mental health arena today?
Dickstein: The biggest issue is providing access to care in an efficient, affordable, and equitable way. The pandemic has focused a great deal of attention on mental health, but it has also dramatically increased the need for care.
I’m proud that McLean opened the Oak Street inpatient program at McLean SouthEast in record time last year, but it’s not enough. Consider the fact that more than 1 million Americans died of COVID-19, with more than 250,000 children losing a parent or primary caregiver.
Add to that the impact of economic insecurity, social isolation, and interruption in learning. Kids are struggling and presenting sicker than ever.
Horizons: What can you do about that? How do you tackle such an ocean of need?
Dickstein: It is a daunting issue and one of the contributing problems is the workforce shortage. So, it’s a perfect storm of increased need and dwindling numbers of trained staff. There are simply not enough clinicians.
And it takes a long time to “grow” a child psychiatrist, researcher, social worker, or nurse. We have to create a pipeline and encourage the best and the brightest to choose this field and come to McLean.
This means investing in recruiting interns, funding fellowships, and attracting early career clinician-researchers. It also means sparking joy in the workplace for our vibrant teams.
Dr. Daniel Dickstein
Horizons: Can you be more specific about your plans on this front?
Dickstein: Yes, we have so many exciting initiatives in the works. We’ve already had success bringing some incredible talent to McLean. I am committed to growing our child and adolescent research capacity.
For instance, Dr. Alex De Nadai recently joined us as our first director of Data Science and Computational Medicine. His unique expertise is leading us down innovative paths as we search for more efficient ways to diagnose illnesses.
Dr. Julianne Tirpak is the first recipient of a new post-doctoral fellowship at 3East, funded by philanthropy. It’s what we call an 80/20 fellowship: Julianne spends 80% of her time on research and 20% on clinical care. In the past we’ve had 50/50 fellows, but they didn’t have the time they need to spend on research—work that will ultimately improve clinical outcomes.
We’ve also created three new internships for psychology trainees; one at 3East focusing on emotion dysregulation and self-harm; one concentrating on anxiety and mood disorders involving the McLean Anxiety Mastery Program (MAMP), our Child and Adolescent Obsessive Compulsive Disorder Institute (OCDI Jr), and the Belmont Adolescent Partial Hospital Program; and a third focused on depression, psychosis, and suicide at McLean SouthEast’s inpatient, residential, and partial hospital units. And we’re currently recruiting additional 80/20 post-docs for these three tracks.
These new positions are designed to jumpstart a pipeline of early career clinician-researchers who can help find solutions to some of the most pressing and significant mental health issues of our generation.
Another major emphasis is to recruit scientists and clinicians from underrepresented communities. A diverse workforce helps everyone innovate, learn, and perform better. It also helps us understand a wider range of patient and family cultures.
Horizons: How is McLean unique in the way it serves adolescents and children?
Dickstein: McLean has tremendously broad expertise. Our specialty programs are unparalleled.
MAMP, the 3East DBT continuum, our School Consultation Service, our youth OCD program, and of course both schools—Pathways Academy and the Arlington School—are all gold-standard programs. It’s astonishing to have all of these at one institution, and now a burgeoning child and adolescent research enterprise.
We have extraordinary talent across the board—in trauma, depression, anxiety, suicidality, family dysfunction … I could go on and on. The collaborative possibilities are endless and our ability to locate researchers right next to clinicians makes everyone a winner, particularly our patients and families.
Learn more about all of McLean’s child and adolescent mental health efforts
Horizons: One of your new projects is the CARE initiative, can you talk a little about what that is and why it is so important?
Dickstein: CARE stands for child and adolescent routine evaluation. It’s a simple, but critical, idea. CARE ensures all patients in every program receive a comprehensive, research-grade evaluation at the beginning of their care.
This kind of assessment provides the information our clinicians need to make the right diagnoses, offers more information to fuel research, and helps us provide the best individualized care.
CARE was driven by clinicians who wanted to learn more about their patients and their programs. Only a place like McLean could pull this off—where collaboration between clinicians and researchers is front-and-center to our mission and big dreams can become reality.
Horizons: What is the role of philanthropy in all of this?
Dickstein: Philanthropy is absolutely critical. Our division has benefited from long relationships with people who believe in and support what we do every day.
Those relationships provide the resources and validation to help us tackle the most difficult problems, develop better diagnostic tools, hire the best clinicians and researchers, and—most importantly—get our young patients back on track to live healthy, productive lives.
Every one of those positions I mentioned are philanthropically funded. Philanthropy also helps our researchers do the preliminary work needed to attract larger, multi-year government grants.
We simply couldn’t do what we do without the donor community. And our donors will help us realize the dream of building a new, comprehensive child and adolescent facility in the near future. One that our patients need and deserve, where they can work with our clinicians to do the really hard work of healing and recovery.
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