Dr. David Hodson (left): Department of Behavioral Health, Fort Jackson and Camp Ederle (Vicenza, Italy) and Dr. Melinda Thiam (right): PSI Support Coordinator for military families; Staff Psychiatrist, Lexington County Community Mental Health Center; Psychiatrist, Future Psych Solutions, Columbia, South Carolina
Tell us about your path and your interest in perinatal/postpartum mental health.
Dr. Thiam: I grew up in the twin Cities, MN and joined the MN Army National Guard (ARNG) as a medic on my 17th birthday. My unit was an aviation unit and we did physicals on pilot. At the same time, I spent a concurrent senior year of HS /first year of college. I initially assumed I wanted to become a physical therapist, but became interested in medicine after working with the unit Flight Surgeon (physician who specializes in requirements for aviation medicine). I decided to switch career goals to pursue medicine—and I wanted to be a military doc full time. I ended up switching to Army ROTC and went to Pacific Lutheran University located in Tacoma Washington. During my time in college, 9-11 occurred and everything shifted in the military. I was granted permission to delay my service commitment (from ROTC) in order to attend Uniform Services University of the Health Sciences—a school we commonly referred to as “the best medical school never heard of”. At USUHS, we were trained to be military physicians—not just physicians who wore the uniform. I first started in pediatrics due to love of working with babies, children and parents. I completed my internship in Pediatrics at Madigan Army Medical Center at Ft. Lewis, Washington, where I switched to Psychiatry and went into psychiatry residency at Walter Reed. During residency I developed mother-infant dyadic group therapy. From that point forward, I specialized in the field. After residency I was stationed at Ft. Jackson, working as a staff psychiatrist where I worked with military initial entry trainees, commands, permanent party staff and, on occasional, military family members and retirees.
Dr. Hodson: I was originally born and raised in London, Ontario, Canada and obtained my diploma in nursing from Georgian College in Owen Sound, Ontario. I initially moved to the state of Texas where I worked for 18 years, married, and began our family. We now have four adult children and four grandchildren. I also continued to expand my educational background, obtaining my baccalaureate degree from Texas Christian University, my graduate degree from Texas Women’s University as a psychiatric mental health clinical nurse specialist, then becoming board certified through ANCC. My wife and I moved to the state of Florida where we resided for approximately 12 years and I worked in private practice providing behavioral health services and taught nursing students. We then had the opportunity through my wife’s work to move and reside in Colombia, South Carolina where I was a part of the faculty and ultimately Assistant Dean in the College of Nursing at University of South Carolina, teaching both undergraduate and graduate students primarily in psychiatric mental health. I also maintained my practice working with chronically ill psychiatric patients. While in South Carolina, I became an active member in the South Carolina Nurses Association and served as the president of the psychiatric mental health committee, and in addition was president of the peer assistance program in nursing for the state of South Carolina. I also served on the South Carolina Board of Nursing representing baccalaureate education. While in South Carolina I had the opportunity to join the federal sector and work with the United States Army providing behavioral health services to soldiers and their families at Fort Jackson. It was during this period of time that I met and worked with Dr. Melinda Thiam who was serving as clinical chief at the rank of Major.
Being a long time provider of behavioral health services I was drawn to the vulnerability that psychiatric patients have for suicidality, this resulted in an increased desire to attempt to understand various aspects of suicidality. This was extremely heightened when our daughter, who was 5 months pregnant with her first child lost her husband to suicide. While working with Dr. Melinda Thiam we had many discussions on the vulnerability for suicidality within the military and an area of science that was under served and not much written about in our observation was the vulnerability for emotional disequilibrium and the potential for suicide within the perinatal and postnatal population.
Outside of your profession, what do you enjoy?
Dr. Thiam: I love spending time with my family and playing with my 3 girls.
Dr. Hodson: Having been born and raised in Canada I have maintained a love for the game of hockey and continue to not only enjoy watching the game but participate in the game. I may also be considered “a car guy” and have a love for automobiles, and have resurrected a 1963-1/2 Ford Galaxy. I love all kinds of music and am a “wanna be” guitar player.
Dr. Thiam, please tell us about your volunteering for PSI as a Support Coordinator for military families.
Dr. Thiam: I first connected with PSI in 2013. I was active duty military (a 3rd year psychiatry resident), and the military was very strict about “off duty employment” out of concern of possible conflict of interest, so my involvement was informal at that time. When I retired from military in 2017, I was able to become more actively involved and actually list my contact info on the PSI website. I have received requests from active duty moms and spouses. I have had challenges such as setting up resources for spouses in OCONUS (outside continental US) that are challenging due to restrictions.
In helping military spouses who reach out to us, at times I have been able to contact my prior military comrades at the local base where the service member/spouse is located, to coordinate resources. Part of it is also informing active duty/military spouses about resources such as the Army’s Child and Family Behavioral Health Service (CAFBHS) as well as Primary Care Behavioral Health (PCBH) where primary care at local military facility has coordination with BH providers.
I have also had a few more urgent cases where I can coordinate with the spouse or active duty service member to connect to resources. In some cases, the individual voiced suicidal thoughts or a suicide attempt; this IS NOT typical, as we are not a crisis line. But with my military background, especially as a psychiatrist, I did not want to relegate this to local EMS only, because often EMS/emergent resources are oblivious to perinatal mental health.
Please describe your collaboration with each other.
Dr. Thiam: When I arrived at Ft. Jackson, I was a new staff psychiatrist, fresh out or residency, and with a contract to write a book on perinatal mental health. I always love research and getting others involved. Dr. Hodson was one of main providers with whom I worked at Ft. Jackson. I had discussed my passion for perinatal mental health and we soon started more in depth with the topic. Dr. Hodson was graciously able to help author two different chapters in the book, and was a huge source of encouragement.
Dr. Hodson: Dr. Melinda Thiam and I have a professional relationship in that she is my professional preceptor and continues to remain as such. Both of us are licensed in the State of South Carolina with our respective Boards.
Please describe the work you do in the field outside of your collaboration.
Dr. Thiam: I am a general psychiatrist at this time. Upon retirement from the military in 2017, I started working in private practice with Dr. Don DuBose at Future Psych Solutions (www.futurepsychsolutions.com) where we specialize in perinatal mental health as well as depression/ADHD/Trauma/integrated medicine, and interventional psychiatry (such as TMS…ketamine/neurofeedback, microcurrent stimulation…) I also work in community mental health, including perinatal mental health aspects. I am transitioning to a combination of the VA and private practice with the hope to also specialize/work with military veterans—an even more under-reached population as they don’t have the services/support of military families, but have the military cultural challenges that impact pregnancy and parenting.
Dr. Hodson: I currently serve as a government service employee with the United States Army and I am stationed in Vicenza, Italy at the United States Army Health Clinic, Vicenza. A good number of my patients either serve active duty and/or are dependent family members. They are generally a younger population approximately 20-35 years of age and oftentimes first time parents. With the vulnerability of not only being stationed abroad they are also vulnerable to either or both being deployed at a moment’s notice and this results in increased emotional behavioral health stressors and potentially compromises the readiness of our military.
What advice do you have for military parents?
Dr. Thiam: You can’t be 100% in both roles. However, being a good parent doesn’t mean you are not a good service member and that you are not dedicated to serving the country. It is HARD being an active duty parent. However, there are countless others who have been there and can be supportive. Never forsake your own health for “the sake of your career”– it is not worth it. Emotionally, put your family first. There will obviously be parts of mission when you have to answer call of duty, but consider parenthood when it comes to career shifts. Reach out to military resources. Like much in mental health, often the worse stigma is within yourself. There are places to help so you can continue in the military and be a parent. For spouses—seek our resources. Don’t be afraid to seek help due to fear of your spouse’s career. If you are not doing well, it WILL affect the active duty member and your health directly affects his/her readiness. Thus don’t delay seeking treatment—your wellness is essential to military mission as well as essential to be a parent. It is hard. But the military also is tight knit community. Reach out to your local family readiness group, spouses group, CDC (daycare center), or service specific community resource center.
What advice would you give to care providers who work with military parents?
Dr. Thiam: PLEASE, there are many free training programs out there to learn more about the military family. We also provide guidance in our book Perinatal Mental Health and the Military Family: Identifying and Treating Mood and Anxiety Disorders. https://www.routledge.com/Perinatal-Mental-Health-and-the-Military-Family-Identifying-and-Treating/Thiam/p/book/9781138924789
In addition, the following websites have free educational webinars, modules, learning tools, etc.
Dr. Hodson: For any of our members who may be working with the military and/or former military personnel you may recognize that this is a special population of individuals with some but not all of the challenges of being a military family such as, a young age, isolation from traditional support network, geographic separation and possible single parenting, economic concerns, active duty parenting, and last but not least frequent relocations.
Anything else you’d like to share?
Dr. Thiam: I want to reach out to active duty mothers, military spouses, active duty fathers… You are NOT alone. There is help. The military is coming to understand that strong families are essential to military readiness. There is a birth of a parent also when a baby is born, and this has unique challenges when babies are born into military families or born to parents who have served.
For the active duty parent… You can’t be 100% in both roles. However, being a good parent doesn’t mean you are not a good service member and that you are not dedicated to serving the country. You are not a bad parent for deploying when duty calls, you are not abandoning your child. Instead, you are role modeling that freedom is not free and our freedom has a cost. Children are resilient and will grow to appreciate this. You are not abandoning your duty by shifting career plans that are family friendly. You are not a bad soldier for not being hard pressed for next promotion and instead putting your family first ahead of career advancement.
It is HARD being an active duty parent. However, there are countless others whom have been there and can be supportive. Never forsake your own health for “the sake of your career”—it is not worth it. Emotionally, put your family first. There will obviously be parts of mission when you have to answer call of duty, but consider parenthood when it comes to career shifts. Reach out to military resources. Like much in mental health, often the worse stigma is within yourself. There are places to help so you can continue in the military and be a parent. For spouses—seek our resources. Don’t be afraid to seek help due to fear of your spouse’s career. If you are not doing well, it WILL affect the active duty member and your health directly affects his/her readiness. Thus don’t delay seeking treatment—your wellness is essential to military mission as well as essential to be a parent. It is hard. But, the military also is tight knit community. Reach out to your local family readiness group, spouses group, CDC (Daycare center) or service specific community resource center.
Dr. Hodson: Last but not least for any of our members who are non-providers who have experienced perinatal and/or postnatal issues and/or who have watched your family members suffer remember, that not only is there a birth of a child but also the birth of a mother and father. The costs of untreated perinatal mental illness may result in suicidality. One of the four leading external causes of maternal mortality is a result of perinatal disorders
Military Culture Training Fact Sheet
This is part of a series of profiles featuring members of PSI. If you know of a PSI member you think we should feature, please contact firstname.lastname@example.org