When Jessica Goren worked at a Philadelphia psychiatric hospital after graduating from URI, she found she really liked the patients. She was saddened, however, to see how some portions of the population were treated. “I tend to root for the underdog, and people with schizophrenia are the ultimate underdog,” she said. “They’re also poorly served by the medical community.”
That’s why she did a residency in psychiatry and focuses her research on improving medication treatments for patients with severe mental illness, who often do not receive evidence-based medical care. “Instead, they get treated with things that haven’t even been proven to be beneficial,” Professor Goren said. “A lot of research is trying to understand why clinicians don’t follow evidence-based guidelines for these patients.”
Professor Goren also believes that when patients with mental illness go to a medical clinic with general health problems, they are less likely to be diagnosed appropriately and to receive adequate treatment. So she conducts research on the “prescribing behaviors” of health care professionals who treat the mentally ill. For instance, she is evaluating why doctors may choose to prescribe new expensive medications over older inexpensive options that work equally well. She recently demonstrated that if more veterans with treatment-resistant schizophrenia were treated with clozapine—the only effective treatment but one considered the last resort by many doctors because of its unique side effects—they would have better outcomes and the Veterans Administration health care system would save money.
“Even though clozapine is a challenge to manage, it can dramatically improve patients’ lives,” said Professor Goren, who also serves as senior psychiatric pharmacist at Cambridge Health Alliance and an instructor in psychiatry at Harvard Medical School.
“It breaks my heart to see how poorly these patients are treated in all phases of their lives, she added. “This is my population. There are evidence-based treatments that work.”