Child and adolescent psychiatrist Mark DeAntonio, MD, has always been drawn to matters of mental health. As a 17-year-old undergraduate, he volunteered at UCLA's Peer Helpline, offering a sympathetic ear to his fellow students. Inspired by his experience, he went on to work in substance abuse programs and psychiatric units. By the time Dr. DeAntonio entered medical school, he knew he had found his calling. "It seemed to me that adolescents were poorly understood by the psychiatric profession," he says. "I went to medical school with the goal of helping [to] change that."
Anything but typical
As director of the Inpatient Child and Adolescent Psychiatric Service at the David Geffen School of Medicine at UCLA, Dr. DeAntonio wears many hats. While his days are anything but "typical," they usually include some combination of administrative tasks, clinical care and teaching.
Running a 25-bed inpatient psychiatric unit requires management skills. On his way to work, Dr. DeAntonio calls the unit to discuss recent and upcoming admissions with the psychiatric nurses, assigns case coordinators to patients, and interfaces with the emergency department regarding possible new admissions.
Once he arrives at UCLA, he visits the unit and speaks with the nursing team leaders for the unit's three inpatient subsets, which house children, teens and those with eating disorders. It's a busy morning, filled with grand rounds, meetings with other clinicians, and—most important—visits with patients on the ward. These young patients have been hospitalized due to behaviors that cannot be managed at home or who are a potential danger to themselves or others.
Throughout the day, Dr. DeAntonio coordinates care with his trainees: Because the Inpatient Child and Adolescent Psychiatric Service is part of a teaching hospital, patients are usually assigned to a resident or other trainee, who Dr. DeAntonio supervises. "It's a very positive experience to mentor trainees," he says. "They learn by doing, and when they have the opportunity to evaluate and treat patients, they gain more confidence."
Helping patients and their families
Later, Dr. DeAntonio may see outpatients in his private practice. It's a 12-hour workday that's often filled with challenges and surprises. The children and adolescents he sees can have a wide range of concerns, including bipolar disorder, major depression, anxiety, anorexia, bulimia, autism, obsessive-compulsive disorder, post-traumatic stress disorder, or a combination of these and other issues. Determining the right diagnosis and treatment for young patients can be difficult, says the child and adolescent psychiatrist. "Because they're still growing, and because many problems don't fully develop until adulthood, children and adolescents often don't present with typical symptoms," he explains. "We form long-term relationships with many patients and their families to see how a condition might evolve and crystalize over time."
An adventure every day
Being a child and adolescent psychiatrist may not be right for everyone, but it can be the perfect fit for those who are intellectually curious, patient, and able to tolerate ambiguity, says Dr. DeAntonio. "If you're someone who needs things to be clear cut and black-or-white, this may not be the right field for you," he says. And be prepared to work with both kids and adults—many trainees don't realize that they'll need to forge close relationships with parents and families as well as patients.
Dr. DeAntonio advises that medical students approach all specialties with an open mind. "When I was in medical school, I explored different specialties but asked myself what wouldn't bore me in 30 years," says Dr. DeAntonio. As he approaches his third decade in practice at UCLA, the answer is clear: "Every patient is different and brings new challenges for me to address," he says. "Coming to work is a new adventure every day."
By Jessica Cerretani