Meet Dr. Willing
Laura, Willing, MD, is an attending in the Division of Psychiatry and Behavioral Sciences at Children’s National. Dr. Willing got her Bachelor’s Degree at the College of William & Mary and her Medical Degree at the University of Virginia School of Medicine. She completed her residency program in Psychiatry and her fellowship training in Child and Adolescent Psychiatry both at the University of North Carolina Hospital. Dr. Willing has long been interested in global health, first travelling to Guatemala during medical school to provide pediatric primary care for six weeks at a local hospital. Later in her training, Dr. Willing travelled to an orphanage in Williamson, Haiti through Mount Sinai. There, she worked on providing psychiatric training for teachers and caretakers as well as clinical care for the children in the orphanage. In 2018, as an attending, Dr. Willing returned to Williamson with Mount Sinai to check on the children she had worked with previously, as well as to make some recommendations regarding psychiatric health for the caretakers at the school.
On her first trip to Williamson, Dr. Willing spent four weeks providing primary care to an orphanage, the school is was affiliates with, and the surrounding community. The need at this site was large, “at this particular orphanage about fifty percent of the kids had a physical or mental disability,” estimates Dr. Willing. She worked with pediatricians and caretakers at the orphanage, teaching them how to identify signs of mental illness, including characteristic emotions, behaviors, coping mechanisms, and the best ways to react in different mental health crises. “Just providing behavioral and parenting information for them was really critical,” says Dr. Willing, “how to identify different red flags for anxiety, depression, trauma, and ADHD both in the schools and in the orphanage.” Working together, they were able to develop group therapy sessions for the kids. The community is very lucky, says Dr. Willing, to have a social worker, a school psychologist, and pediatricians.
On her second trip to Williamson, after she had acclimated to the community, Dr. Willing was able to meet with kids the local providers had identified as potentially suffering from mental health issues, based on the diagnostic guidelines Dr. Willing provided on her first trip. She also did more case by case training, for example, if a child in class is hyperactive, “(teachers) can have them stand at the front of the classroom to calm down,” says Dr. Willing. In addition, as the orphanage is so integrated into the surrounding community, they held clinics for local families, as well as educational sessions where parents could ask questions about their child’s health. While there were some community members who brought up the point “you want to talk about trauma when we don’t even have food to eat,” remembers Dr. Willing, most parents “were just happy to talk to you about healthcare at all.”
There is a lack of mental healthcare, and mental healthcare providers, all over the world, not just in low and middle resource countries. Luckily, points out Dr. Willing, a lot of her psychiatric skills are very transferable, enabling her to spread her knowledge and expertise without expensive equipment or machinery. “A lot of mental health is behavioral, educational, and social interventions,” says Dr. Willing, and to make an impact, “you just need people who are interested, willing, and motivated to make things better.” While simply being enthusiastic isn’t going to solve everything, “it can really get you started,” she adds.
However, there are undeniable challenges to providing care. Most notable, is a lack of access to necessary medications. “One day I just went to Port-au-Prince and drove around to several pharmacies and they just didn’t have psychiatric medications, there really isn’t access,” says Dr. Willing. In addition, she recalls the difficulty of getting things done which, in the US, would be simple errands. “Logistically it is very difficult,” adds Dr. Willing, “and you just have to be flexible and go with what you can get done.”
Despite the difficulties, meeting the children and their families, and visiting their community is very compelling for Dr. Willing. “Once you go and you meet the community and you get to know the people…and you know their goals and how they want to grow up and what they want to do, what are you going to do? You have to keep going, you can’t just abandon them.” While it is physically hard for Dr. Willing to travel to Williamson for more than the periodic visit, the majority of her work for this community is now done remotely via telemedicine, providing consultation to the local providers. She is currently looking to get more residents, fellows, and trainees involved in this project, as well as global health in general, adding, “it’s important that mental health not be forgotten!”