Nearly 1.5 million adults in North Carolina have a mental health condition. That’s more than three times the population of Raleigh, yet many still feel ashamed to bring up conditions like depression and anxiety. Openly talking about mental health is an important part of improving it. Another key component is making sure everyone has access to health care.

Presently, more than 150 million Americans, nearly half of the country’s population, live in federally designated mental health professional shortage areas, the Association of American Medical Colleges reports. The shortage is even more pronounced for military service members and those who live in rural areas.

To address this need, Novant Health is working to bring more psychiatric doctors to Eastern North Carolina through a program led by psychiatrist Dr. Julia Triggs. Triggs is the director of a new civilian/military residency program that will train psychiatrists at Novant Health New Hanover Regional Medical Center in Wilmington, and at Naval Medical Center Camp Lejeune on the Marine Corps base, a program that will increase access to mental health services for all people of Eastern North Carolina, whether civilian or military.

Psychiatry residents in the program will provide mental health care services at Naval Medical Center Camp Lejeune for veterans and active-duty family members, and active-duty Marines will also benefit. After completing their residency training, the military residents can help their military colleagues wherever needed, as active-duty psychiatrists are embedded within Marine battalions to ensure service members receive needed support while deployed and once they return.

Each year, the residency will accept three military residents and four civilian residents. The hope is that many will remain in the area after completing their training or their military service to “provide high-quality care that all people in our communities deserve and really, truly need,” Triggs said.

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Following her dream

As a child, Triggs knew she wanted to work in either law or medicine. She was born on Joint Base Andrews in Maryland, and her father was in the U.S. Navy until her birth. Growing up, she was inspired by a friend of her father who was a physician and had served in the military.

As an adult living in the eastern panhandle of West Virginia, near Washington, Triggs began her professional life as a freelance court reporter, recording word-for-word courtroom proceedings. It gave her a fascinating view of the legal system as she captured multi-person conversations using her stenography machine – conversations that frequently surpassed 250 words per minute.

Triggs and her husband, James, had two kids, and she maintained her court reporting business for 12 years. And then she hit a wall.

“My husband said, ‘You know, you don't really enjoy what you're doing anymore. Why don't you quit and go do what you've always really wanted to do?’” Triggs agreed; it was time to pursue her dreams of a medical career. At 34, she enrolled at nearby Shepherd University as a college freshman.

Of course, being a mom and a full-time college student had its challenges. “At age 8 or so, my daughter actually went to some of my organic chemistry classes from time to time, when she wasn't in school,” Triggs said.

When Triggs was accepted to the West Virginia University School of Medicine, she and her middle-school-aged kids relocated to Morgantown, while her husband stayed behind at their home in the D.C. region to keep his job. For four years, he drove five hours every week so the family could be together. The sacrifices that her family made to support her dream, Triggs acknowledges, were huge.

After completing her residency at the University of Maryland Sheppard Pratt Psychiatry Residency Program, she joined the faculty and served as the residency program's associate program director for two years before transitioning to becoming the medical director for a county mental health clinic. Triggs relocated to Wilmington in 2012 to join the team at New Hanover Regional Medical Center. Even then, the psychiatric residency program was a dream of some long-time New Hanover physicians, she said, so it’s rewarding to see it become reality more than a decade later.

Meeting a need

The program, scheduled to begin in June 2024, is only the fourth of its kind in the U.S., Triggs said. She and a team of collaborators from Novant Health, Naval Medical Center Camp Lejeune, UNC Health and the UNC School of Medicine worked together to design the program.

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Lt. Cmdr. Devon Johnston

“The end goal of the residency is to develop strong psychiatrists and leaders in both military and rural psychiatry to improve access to care in the local community,” said Lt. Cmdr. Devon Johnston, of Naval Medical Center Camp Lejeune, associate program director and director of the military leg of the program.

Triggs said that while lack of access to mental health care is a long-standing problem, the worsening opioid crisis and fallout from COVID-19 isolation are really shining a light on the issue. Triggs and Johnston see a clear demand for a program that will bring more mental health practitioners to the region.

“It is really just out of sheer need in the area, just as it's needed everywhere in the country,” Triggs said.

Recent studies illustrate Triggs’ point. With the nationwide high demand for mental health care professionals, health care teams must use targeted strategies to ensure military families get the care they need. North Carolina has the fourth-largest military presence in the country with Camp Lejeune, located 60 miles northwest of Wilmington in Onslow County, accounting for nearly 40,000 active-duty members of this community. These service members and their families face unique health care challenges under the stress of frequent moves, deployments and separation from loved ones.

“Residents will be working with patients who have PTSD, or who have traumatic brain injuries. They'll also be getting to work with the families of the soldiers as well,” Triggs explained. “There will be a large focus on substance use disorders and detox treatment, which is a very big need everywhere.”

Increasing care in the community

The psychiatric residency program will be the fifth accredited graduate medical program at New Hanover Regional, joining residency programs for internal medicine, general surgery, OB/GYN and family medicine. Additionally, the family medicine residency program is increasing its reach with a new rural family medicine track, also slated to begin during summer 2024.

While laying the foundation for the program, Triggs’ past life as a lightning-fast typist came in handy. She and Laura Solt, New Hanover Regional Medical Center’s psychiatry residency program coordinator, wrote out every detail of the four-year training program’s curriculum. They sometimes worked late into the evenings and on weekends, accepting offerings of encouragement and sandwiches from their husbands. The result was a 189-page document that the duo had poured their hearts into. They submitted it and received the stamp of approval from the Accreditation Council for Graduate Medical Education, and now it’s the program’s official roadmap.

“I think this will be a huge boon to the community,” Triggs said. “It really will be providing a large service and additional resources to everybody.”