Managing Mental Health

A positive aspect of overcoming the challenges of 2020 is the prioritization of mental health and self-care. In the pre-COVID-19 world, there was still an element of shame and judgment that those experiencing mental health issues faced. During the  heightened pandemic, it seems there are very few people who are not facing at least mild forms of depression and anxiety, and more people than ever  are seeking out formal therapeutic solutions.

Brook Mehregany Choulet ’11 was one of the many mental health professionals called upon to treat an increasing number of patients—particularly children—who were experiencing mental health issues due to the COVID-19 crisis. Choulet, who specializes in child psychiatry, was responsible for admitting acute cases to multiple psychiatric hospitals in the Phoenix area and getting those patients stabilized, through medication management, individual therapy and family therapy sessions. The good news, according to Choulet, is that people generally responded well to therapy, “especially when we get them in the hospital, and they are removed from the acute stressors that brought them in,” she shares. 

After returning to their current environments, however, patients may still face challenges. “In many cases, especially with children, patients are going back to a home environment that isn’t conducive to healing or calm,” explains Choulet. “There might  be a house filled with people who are trapped together and not getting along, or the children might have working parents who have to leave them alone. There are also children who are struggling with the ‘new normal.’” 

For Choulet, the pandemic didn’t change what she was already doing in her practice. But the work has grown and heightened, including the added challenges of treating patients who are alone and restricted from having visitors. Family and outpatient  meetings are done over the phone. The inability to have in-person follow-up lessens the guarantee that recovery will be long-term, but, as with many other jobs, connecting virtually is the safest option.

The trials of this unprecedented time have only increased Choulet’s steadfast commitment to child psychiatry. “Seeing the state of children when they arrive at the hospital and the progress they make by the time of discharge is really rewarding,” she says. “Children who are manic or psychotic on admission often show significant improvement after medication initiation. We’ve noticed a decrease in symptoms in teens who came to us depressed and anxious, as well as resolution of suicidal thoughts. It’s nice to see that in a time of turmoil, we can still provide the kind of care we were providing before and help people get through these tough times.” 

Choulet learned much about her vocation from her mother, Donna Kashani, M.D., who is a child psychiatrist. After her own time at LJCDS, Choulet went on to an accelerated six-year program where she earned both her bachelor’s and medical degrees in six years. After her residency at Banner was completed in summer 2020, she started her Child and Adolescent Psychiatry Fellowship through Creighton University School of Medicine in Phoenix. There, Choulet works with teens who are psychiatrically hospitalized as well as school-age children and teens on an outpatient basis.

After she completes her training, she intends to establish a private practice dedicated to working with children and their parents. And she has no doubt that, down the road, she will follow in her mother’s footsteps and return to San Diego to serve the local community. “The sense of community there [at LJCDS] fosters a good, cohesive unit that makes you feel supported through tough times,” explains Choulet. “I believe that’s what all people should strive to maintain in their own futures. And I want to be part of that.”