Alexander S. Young, MD, MSHS

Interviewed Spring 2002

Archived Profiles

Dr. Alexander S. Young is Director of the Health Services Unit of the Desert Pacific Healthcare Network MIRECC, Assistant Clinical Professor in the UCLA Department of Psychiatry, and Associate Director of the Vulnerable Populations Core of the NIMH UCLA RAND Research Center on Managed Care for Psychiatric Disorders. Born and raised in Brookline, Massachusetts, Dr. Young received a B.S. in biology from Yale College and graduated with honors from Harvard Medical School. He has received Young Investigator Awards from the National Alliance for Research on Schizophrenia and Depression, and an AMA Burroughs-Wellcome Award for Outstanding Community Service. Dr. Young actively leads research in the area of quality measurement and improvement and is widely published in this field. When he can find time for recreation, he enjoys sports and activities with his wife and two young children.

What experiences led you to focus on quality of care and what impact has your work had on treatment provision?

My work in both innovative and traditional treatment programs for people with severe mental illness led me to be concerned about the prevailing level of treatment quality in this population. While it is important to develop new approaches to treatment and ensure that clinicians are trained in these approaches, it appears that organizational changes must also be made so individuals with severe mental illness actually receive these treatments. Often, persons with disorders such as schizophrenia are not provided treatments that we know to be effective. Outcomes such as improved quality of life and role functioning could be a reality if we implemented methods for improving access to state-of-the-art care. During my residency training at UCLA, I founded novel medication treatment programs at two mental health centers and played an active role in developing an academic affiliation for what is now known as the Edelman Westside Mental Health Center. I also realized that the UCLA Neuropsychiatric Hospital did not have a cohesive program for the treatment of schizophrenia, and this was an ideal opportunity to create one. I collaborated with faculty clinicians to develop and direct the Schizophrenia Clinic, which has become an active clinical service for the university with residents, faculty, and multidisciplinary staff collaborating on the care of the SMI.

With a clinical medical background, how did you prepare yourself for research in the area of quality of care?

A three-year program of research training at UCLA followed the clinical and administrative experience I gained during my residency training. I gained skills in health services research through a fellowship in the Department of Sociology, the Robert Wood Johnson Clinical Scholars program in the Departments of Medicine and Psychiatry, and a masters degree program at the UCLA School of Public Health.

In your role as teacher and researcher, how might your work have its greatest impact on the treatment of individuals with severe mental illness?

There is increasing interest in the organizations that provide healthcare, and especially in managed care in the private and public sectors. Clinicians and consumers both are concerned about the potential effect of managed care on quality. It is possible to use health services methods to monitor and improve the performance of clinicians and managed care organizations. Performance measurement and quality improvement are areas that are often poorly understood. I see teaching in these areas as a way to improve clinicians' and consumers' understanding of the importance of performance monitoring, and to provide them with information that can help ensure that people with mental health disorders receive effective care. Also, I hope that my teaching informs the research of others in the health services and clinical research communities, and demonstrates the value of health services research to a wide variety of audiences.

What is your hope for the impact your work on the future of people with serious mental illness?

I hope to create a knowledge base that can be used by policy-makers and family members to improve the services that people with serious mental illness actually receive. The overall goal is to see to it that the average person with schizophrenia, who is out there somewhere, gets into the best treatment program possible, and is able to make the most of their life. We will need to substantially improve healthcare for this to happen. Improving the average level of treatment quality for mental illness will be a challenging, but hopefully worthwhile undertaking.