Shashank V. Joshi, MD, FAAP, DFAACAP

All Publications

• Increasing Access to Mental Health Services Through Reduction of Stigma. Pediatrics Beers, N., Joshi, S. V. 2020

  View details for DOI 10.1542/peds.2020-0127

  View details for PubMedID 32434762

• An Exploratory Survey of Career Choice, Training, and Practice Trends in Early Career Child and Adolescent Psychiatrists and Fellows. Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry Mann, A., Tarshis, T., Joshi, S. V. 2020

  Abstract

  A pilot survey was created to sample early career child and adolescent psychiatrists (CAPs) and fellows to identify factors contributing to recruitment, satisfaction, and general practice trends.A 44-item survey was developed based on a previous study of early career CAPs and discussion at an early career forum. Participants were recruited at a professional meeting and through emails sent to all 125 US training program directors.Only 184 out of 2209 responses were received. Approximately two-thirds were female and one-third had completed fellowship. Most decided to pursue a career in child psychiatry during medical school and expected full time salaries between $175,000 and $250,000 after fellowship. Forty-five percent owed more than $150,000 in educational debt. The top reasons for pursuing a career in child psychiatry included the following: working with children, working in an interesting field, and helping society. Males (x?=?85.7, SD 22.9) compared with females (x?=?77.5, SD 25.3) were more interested in pursuing full time work. A higher proportion of participants were confident in prescribing medications (x?=?79.9, SD 17.1) compared with providing psychotherapy (X?=?63.3, SD 23.9).The vast majority of early career CAPs were recruited during medical school, motivated by altruistic reasons, and rated high confidence in their career choice despite significant student loan debt. Training directors should consider increasing competency in psychotherapeutic skills. Early child psychiatry exposure and a means of addressing physician debt are needed to improve recruitment to this specialty.

  View details for DOI 10.1007/s40596-019-01167-y

  View details for PubMedID 31900876

• Clinical Update for the Role of Child & Adolescent Psychiatrists in Schools Kataoka, S., Joshi, S. V., in press, A. American Acad of Child & Adol Psychiatry. Wash DC. 2020
• MEETING CHILDREN "WHERE THEY ARE AT": MODELS FOR THE 21ST CENTURY SCHOOL-BASED MENTAL HEALTH CLINIC Alleyne, S., Biel, M. G., Joshi, S. V. ELSEVIER SCIENCE INC. 2019: S31

  View details for DOI 10.1016/j.jaac.2019.07.134

  View details for Web of Science ID 000518857300109

• Low-Resource Project-Based Interprofessional Development with Psychiatry Faculty. The Psychiatric clinics of North America Shoemaker, E. Z., Myint, M. T., Joshi, S. V., Hilty, D. M. 2019; 42 (3): 413?23

  Abstract

  Projects done in interprofessional groups can foster faculty development with minimal resources beyond what is already available at the university or medical center. Each project can yield multiple "wins" in individual faculty growth while meeting the needs of academic medical centers. These projects can build collaborative skills and a sense of community among faculty, trainees, and staff. The combination of low costs, high yields, and improvements in team skills make these approaches appealing and sustainable in resource-constrained medical centers. The authors describe 4 sample projects and their teams, needed resources, and outcomes.

  View details for DOI 10.1016/j.psc.2019.05.011

  View details for PubMedID 31358121

• Teaching Well-Being: From Kindergarten to Child Psychiatry Fellowship Programs. Child and adolescent psychiatric clinics of North America Rettew, D. C., Satz, I., Joshi, S. V. 2019; 28 (2): 267?80

  Abstract

  Psychiatric training for medical students, residents, and fellows can integrate well-being principles to improve mental health. From preschool to college, principles of wellness and health promotion are increasingly prevalent and are showing promising results. Courses on happiness and well-being have been embraced at colleges and universities. Well-being is now a required component of child and adolescent psychiatry training. Training residents and fellows in emotional and behavioral well-being requires incorporation into clinical supervision and the overall culture and infrastructure of the training program.

  View details for PubMedID 30832957

• The Use of Technology by Youth: Implications for Psychiatric Educators ACADEMIC PSYCHIATRY Joshi, S. V., Stubbe, D., Li, S. T., Hilty, D. M. 2019; 43 (1): 101?9

  View details for DOI 10.1007/s40596-018-1007-2

  View details for Web of Science ID 000459533100019

• Youth Depression in School Settings: Assessment, Interventions, and Prevention. Child and adolescent psychiatric clinics of North America Joshi, S. V., Jassim, N., Mani, N. 2019; 28 (3): 349?62

  Abstract

  In this article, the authors make a compelling case that all clinicians who treat youth with depressive disorders should embrace strategies to engage with school staff to best serve their patients in the classroom. Because these disorders have a high incidence in the school population (13% of US teens experienced at least 1 major depressive episode in 2016), this can affect learning, social interactions, and classroom engagement. Several approaches are highlighted for assessment of depressive symptoms, intervention and treatment in school settings, and prevention strategies, including depression education curricula and programs promoting subjective well-being, such as positive psychology and mindfulness.

  View details for PubMedID 31076113

• SAN MATEO AREA TEEN MENTAL HEALTH STUDY Geiser, K., Fehrer, K., Pyne, J., Gerstein , A., Harrison, V., Joshi, S. V. John W. Gardner Center for Youth and their Communities, Stanford University . 2019

  Abstract

  Adolescence is a time of remarkable growth and development. It is also a time of great vulnerability. According to national indicators of adolescent health and well-being, the most significant health issues young people face are related to mental health. When a young person is supported to develop the skills and habits associated with robust mental health and their mental health needs are effectively diagnosed and treated, they are more likely to experience positive outcomes associated with their physical, social, emotional, and cognitive development as well as overall quality of life. Conversely, when a young person is not supported to develop the skills and habits associated with robust mental health and their mental health needs are left undiagnosed or untreated, they are more likely to experience a wide range of negative outcomes including, but not limited to, an acute mental health crisis. The Center for Disease Control and Prevention and The National Institute of Mental Health have reported that suicide, often considered to be an indicator of acute mental health distress, was the second leading cause of death for American youth ages 10-24 in 2017. In San Mateo County, a recent report on adolescent health frames the prevalence of mental health needs among public school students as ?staggering.? Both locally and nationally, To address these challenges in Northern California?s San Mateo County, San Mateo Union High School District, Peninsula Health Care District, and Stanford?s Department of Psychiatry & Behavioral Sciences? Center for Youth Mental Health and Wellbeing have been collaborating to strengthen mental health supports for youth in both the high school district and its K-8 partner districts. To better understand which efforts have the greatest potential for impact, we joined their collaborative to conduct a mixed methods study to examine three questions: 1. How do students, parents, teachers, and providers perceive mental health needs and student supports throughout middle and high school? 2. What predictive factors appear to be related to positive transitions, high school readiness, or risk indicators of later mental health challenges? 3. What are the opportunities for intervention and support to improve teen mental health? schools are grappling with the challenges of students? mental health needs, and the resulting demand it places on them not only to respond to students experiencing acute mental health distress, but to more effectively promote the mental health and well-being of all students. Key Findings ? Schools are experiencing earlier onset, increased prevalence, and greater complexity of student mental health needs across all ages (K-12) and across the socio-economic spectrum. ? Student mental health is affected by a wide range of school and non-school factors. ? Student mental health needs are often difficult to detect until they manifest as crisis. ? Resources to address student mental health needs vary across schools and districts, primarily focus on crisis management, and rest heavily on individual responses rather than a comprehensive or integrated system of support. ? Most students and families navigate transitions between grades, schools, and districts with relatively little guidance, leaving them vulnerable to gaps in services and support. ? Information regularly collected by public school districts provides little insight into students? mental health strengths/challenges and the effectiveness of mental health supports; available data do not yield any predictive factors related to mental health challenges. ? There are many opportunities with high potential for transforming how participating schools and districts support student mental health and well-being. Opportunities The research findings point toward four opportunities for schools and districts to transform their approach to supporting mental health and well-being: 1. Situate student mental health in the broader context of comprehensive development and well-being that is cultivated over the course of a lifetime 2. Shift from an individual view of the problem and solution to a systems view 3. Strengthen continuity of care across grades, schools, and districts 4. Expand data systems to include meaningful measures of well-being These opportunities are accompanied by a tri-level framework for comprehensive change which emphasizes an integrated approach to innovation that simultaneously addresses the system (district/cross-district), setting (school site), and the individual (student/family). The Research Brief includes concrete examples of strategies that can be used to address each of the opportunities at each of these levels, across the K-12 continuum. In so doing, it offers multiple entry points for activating a more comprehensive and coordinated approach to supporting student mental health and well-being.

• Guest Editors' Introduction to Special Issue on Advancing our Understanding of Suicide among Asian Americans Asian American Journal of Psychology Leong, F. T., Chu, J., Joshi, S. V. 2019; 9 (4): 247-251
• Developmental approaches to professional development. Psychiatric Clinics of North America Teshima, J., Seritan, A., Joshi, S. V., Hilty, D. 2019; in press

  View details for DOI 10.1016/j.psc.2019.05.008

• Summer support in SBHC?s for students with mental health need needs AAP Council on School Health Joshi, S. V., Ladegard, K. 2019; in press
• School-based Interventions for Pediatric Mood Disorders A Clinical Handbook for the Diagnosis and Treatment of Pediatric Onset Mood Disorders Joshi, S. V., Jassim, N. edited by Singh, M. K. American Psychiatric Association Press, Incorporated. 2019; in press
• Hidden Suicidal Ideation or Intent Among Asian American Pacific Islanders: A Cultural Phenomenon Associated With Greater Suicide Severity ASIAN AMERICAN JOURNAL OF PSYCHOLOGY Chu, J., Lin, M., Akutsu, P. D., Joshi, S. V., Yang, L. H. 2018; 9 (4): 262?69

  View details for DOI 10.1037/aap0000134

  View details for Web of Science ID 000453232100003

• Recognizing and Referring Children with Posttraumatic Stress Disorder: Guidelines for Pediatric Providers. Pediatrics in review Wilson, H. W., Joshi, S. V. 2018; 39 (2): 68?77

  View details for PubMedID 29437126

• Mental health issues among 1st generation college students. College Student Mental Health Wang, R., Joshi, S. V. edited by Roberts, L. Springer. 2018: 389?398
• Cultural Child & Adolescent Psychiatry Lewis? Child & Adolescent Psychiatry Sholevar, P., Joshi, S. V. edited by Martin, A., et al Wolters Kluwer. 2018; 5
• After a Suicide: A Toolkit for Schools, 2nd ed. Joshi_Contributor, S. V. Suicide Prevention Resource Center / AFSP. NYC. 2018
• Maintaining the Therapeutic Alliance in Modern Pharmacology Practice Joshi, S. V. American Society of Clinical Psychopharmacology (ASCPP). Brentwood TN. 2018 ; Model Psychopharmacology Curriculum, 8th edition. I. Glick (ed.) 501.1?501.22

  Abstract

  (2018). , in , . : American Society of Clinical Psychopharmacology.

• Social media/networking as part of e-behavioral health and psychiatric education: competencies, teaching methods, and implications. J Technology in Behav Sci Hilty, D. M., Zalpuri, I., Snowdy, C. E., Shoemaker, E. Z., Joshi, S. V., Mint, M. T., Liu, H. 2018

  View details for DOI 10.1007/s41347-018-0061-7

• K12 Mental Health Promotion and Suicide Prevention Toolkit Joshi, S. V., Ojakian, M., Lenoir, L., Lopez, J. Heard Alliance / Student Mental Health Policy Workgroup, California Dept. of Education. 2017 300
• Statement Regarding the National Resident Matching Program Child and Adolescent Psychiatry Match: A Call to Uphold the Gentlepersons' Agreement ACADEMIC PSYCHIATRY Joshi, S. V., Stock, S., Adams, A., Gleason, M. M., Varley, C. K. 2016; 40 (3): 552-554

  View details for DOI 10.1007/s40596-015-0484-9

  View details for Web of Science ID 000376248800036

  View details for PubMedID 27020935

• School-based Suicide Prevention: Content, Process, and the Role of Trusted Adults and Peers Child and Adolescent Psychiatric Clinics of North America Joshi, S. V., Hartley, S. N., Kessler, M., Barstead, M. 2015; 24 (2): 353-370

  View details for DOI 10.1016/j.chc.2014.12.003

• Shared Learning in Community-Academic Partnerships: Addressing the Needs of Schools Partnerships for Mental Health: Narratives of Community and Academic Collaboration Joshi, S. V., Ijadi-Maghsoodi, R., Merrell, S. E., Dunlap, P., Hartley, S. N., Kataoka, S. Springer. 2015: 163?178
• Partnerships for Mental Health: Narratives of Community and Academic Collaboration edited by Roberts, L. W., Reicherter, D., Adelsheim, S., Joshi , S. V. Springer. 2015
• Multicultural and Ethical Considerations in American Medicine Professionalism and Ethics in Medicine Joshi, S. V., Reicherter, D., Pumariega, A. J., Roberts, L. W. Springer. 2015; 1: 39?56

  View details for DOI 10.1007/978-1-4939-1686-3_3

• A Guide to Student Mental Health and Wellness in California Joshi_Contributor, S., et al Minnesota Association for Children?s Health. St. Paul , MN. 2014 90

  Abstract

  Joshi SV (Contibutor, 2014). California Dept of Education, Placer Co. Office of Education and Minnesota Association for Children?s Health: A Guide to Student Mental Health and Wellness in California. 2014 (90 pages): St. Paul, (I contributed as part of the California School Mental Health Policy Workgroup, appointed by State Superintendent of Schools Tom Torlikson)

• Does Early Mentorship in Child and Adolescent Psychiatry Make Difference? The Klingenstein Third-Generation Foundation Medical Student Fellowship Program ACADEMIC PSYCHIATRY Stein, J. A., Althoff, R., Anders, T., Davison, Y., Edwards, S., Frosch, E., Horst, R., Hudziak, J. J., Hunt, J., Josh, S. V., Kitts, R. L., Larson, J., Leckman, J., O'Brien, J., Lowenhaupt, E., Pruitt, D., Malloy, E., Martin, A., Partner, A., Sarles, R., Sikich, L., Wells, L., Kolevzon, A. 2013; 37 (5): 321-324

  Abstract

  OBJECTIVE There is a critical shortage of child and adolescent psychiatrists in the United States. Increased exposure, through mentorship, clinical experiences, and research opportunities, may increase the number of medical students selecting child and adolescent psychiatry (CAP) as a career choice. METHOD Between 2008 and 2011, 241 first-year participants of a program to increase exposure to CAP, funded by the Klingenstein Third-Generation Foundation (KTGF) at 10 medical schools completed baseline surveys assessing their opinions of and experiences in CAP, and 115 second-year participants completed follow-up surveys to reflect 1 year of experience in the KTGF Program. RESULTS Students reported significantly increased positive perception of mentorship for career and research guidance, along with perceived increased knowledge and understanding of CAP. CONCLUSIONS Results suggest that the KTGF Program positively influenced participating medical students, although future studies are needed to determine whether these changes will translate into more medical students entering the field of CAP.

  View details for Web of Science ID 000323916200007

  View details for PubMedID 24026370

• Ethical issues in child & adolescent psychiatry Focus: The Journal of Lifelong Learning in Psychiatry Goldsmith MD, Joshi SV 2012; X (3): 315-320
• Suicide Prevention Initiative, 2nd Annual Report. Ojakian, V., Joshi, S. V., et al County of Santa Clara Behavioral Health Board. San Jose. 2012 24

  Abstract

  Ojakian V, Joshi SV, et al. (2012). Suicide Prevention Initiative, 2nd Annual Report. (24 pages); San Jose: County of Santa Clara.

• Culture and Development in Children and Youth Child & Adolescent Psychiatric Clinics of North America Pumariega AJ, Joshi SV 2010; 19 (4): 661-680
• Thinking About Prescribing:The Psychology of Psychopharmacology Pediatric Psychopharmacology: Principles and Practice Pruett, K., Joshi, S. V., Martin, A. Oxford Univ Press. 2010; 2nd: 422?433
• Cultural issues in pediatric mental health (Collected volume of papers) Child & Adolescent Psychiatric Clinics of North America Joshi SV, Pumariega AJ (eds.) 2010; 19 (4; October)
• Culturally adapted pharmacotherapy and the integrative formulation Child & Adolescent Psychiatric Clinics of North America Malik M, Lake J, Lawson W, Joshi SV 2010; 19 (4): 791-814
• The supporting alliance in child and adolescent treatment: enhancing collaboration among therapists, parents, and teachers. American journal of psychotherapy Feinstein, N. R., Fielding, K., Udvari-Solner, A., Joshi, S. V. 2009; 63 (4): 319-344

  Abstract

  Research indicates that the therapeutic alliance between therapist and pediatric patient is most effective in the context of a productive supporting alliance--an alliance encompassing the network of relationships among therapists, parents and teachers. In this essay, we develop a model of the supporting alliance, arguing that the child's primary relationships with various parties (therapists, teachers, and parents) imply a set of secondary relationships among those parties (parent-therapist, therapist-teacher, parent-teacher). We review the literature on these secondary relationships, focusing on their nature and discussing the benefits of and obstacles to establishing productive collaborations in each case. We also describe three sorts of pathology that can afflict the supporting alliance as a whole, and discuss the importance of patient autonomy and therapist-patient confidentiality relative to the supporting alliance. Finally, we identify directions for future research and highlight implications for practice.

  View details for PubMedID 20131741

• Subtypes of pediatric delirium: A treatment algorithm PSYCHOSOMATICS Karnik, N. S., Joshi, S. V., Paterno, C., Shaw, R. 2007; 48 (3): 253-257

  Abstract

  Delirium in adult populations of hospitalized patients has been well characterized into hyperactive, hypoactive, and mixed subtypes. The degree to which these subtypes apply to pediatric populations has yet to be fully demonstrated. In this case report, the authors present two cases of delirium that serve as examples of the hyperactive and hypoactive/mixed types and then discuss treatment. They find marked differences in the response of different delirium subtypes to haloperidol and risperidone and theorize as to the neurochemical pathways by which these pharmacological agents might work. This framework provides an algorithm for the treatment of pediatric delirium.

  View details for Web of Science ID 000246210400010

  View details for PubMedID 17478595

• Teaching evidence-based psychotherapies CHILD AND ADOLESCENT PSYCHIATRIC CLINICS OF NORTH AMERICA Thienemann, M., Joshi, S. V. 2007; 16 (1): 183-?

  Abstract

  Currently our field is actively involved in developing new ways to characterize and treat children and adolescents with psychiatric disorders and in evaluating the effects of our therapies. We also are beginning to examine the effectiveness of our teaching methods. This article presents evidence for, ideas about, and a philosophy to guide individuals who are privileged to train child psychiatrists in psychotherapies. Specifically, it discusses the issues of the evidence base for diagnosis and for nonspecific and specific active elements of child psychotherapy. Evidence for methods of training is presented. The article addressed the need for supervising psychiatrists to keep abreast of developments in teaching methods so that we can best train competent, curious, and compassionate child psychiatrists.

  View details for DOI 10.1016/j.chc.2006.09.004

  View details for Web of Science ID 000243016300012

  View details for PubMedID 17141124

• Psychiatric Medications for the Treatment of Pruritus Psychosomatic Medicine Shaw, R. J., Dayal, S., Good, J., Bruckner, A. L., Joshi, S. V. 2007; 69 (9)
• Teamwork: The therapeutic alliance in pediatric pharmacotherapy CHILD AND ADOLESCENT PSYCHIATRIC CLINICS OF NORTH AMERICA Joshi, S. V. 2006; 15 (1): 239-?

  Abstract

  All child psychiatrists' interactions with patients and families have important potential meanings, and the act of prescribing medication is no exception. As psychopharmacologic practice has increased in child psychiatry, facility with psychotherapeutic skills, such as establishing an alliance, identifying and treating symptoms, and promoting adherence must follow to enhance clinical outcomes. This article addresses the role of the therapeutic alliance in pediatric work, the psychologic implications of administering medications, developmental issues altering psychopharmacologic efforts, the role of the dual alliance (allying both patients and parents), and recommendations for clinical practice and further research.

  View details for DOI 10.1016/j.chc.2005.08.004

  View details for Web of Science ID 000234522400013

  View details for PubMedID 16321733

• ADHD: Assessment and Treatment across the Lifespan American Society of Clinical Psychopharmacology (ASCPP) Model Psychopharmacology Curriculum, 4th ed., Glick I (ed.) Joshi SV 2006: 504.1-504.22
• School Consultation and Intervention Handbook of Mental Health Interventions in Children and Adolescents: An Integrated Developmental Approach, Joshi SV 2004: 885-916
• Psychostimulants, atomoxetine, and alpha-agonists in the treatment of ADHD Handbook of Mental Health Interventions in Children and Adolescents: An Integrated Developmental Approach, Joshi SV 2004: 258-287
• Psychological aspects of pediatric medication management Handbook of Mental Health Interventions in Children and Adolescents: An Integrated Developmental Approach Joshi SV, Khanzode LA , Steiner H 2004: 465-481
• Characteristics and perceived. needs of mothers with serious mental illness PSYCHIATRIC SERVICES Joseph, J. G., Joshi, S. V., Lewin, A. B., Abrams, M. 1999; 50 (10): 1357-1359

  Abstract

  This cross-sectional survey determined the prevalence of motherhood among severely mentally ill women hospitalized in an inner-city facility and examined the demographic characteristics and perceived needs of the 32 mothers who were identified. Slightly less than one-quarter of these mothers had seen their children within the last week, and only about 20 percent maintained full custody of their children. However, none of the respondents reported feeling that it was unimportant whether they continued mothering their children. Approximately half described needing help in dealing with their sadness about their children. The pilot data presented in this paper suggest that motherhood is common among severely mentally ill and hospitalized women and that issues relevant to mothering remain important to them.

  View details for Web of Science ID 000082941600017

  View details for PubMedID 10506308

• The Berman Award Lecture: Cultural Considerations in School Mental Health-Lessons Learned From Diverse Settings American Academy of Child & Adolescent Psychiatry Annual Meeting 2016 Joshi, S. V. 2016

  View details for DOI 10.1016/j.jaac.2016.09.488

• Children?s Participation in Live Crisis Drills and Exercises. Pediatrics Pediatrics Lerner, M., Committee on School Health, T. 2019; in press
• School-based Health Centers and Pediatric Practice. Pediatrics Lerner and the Committee on School Health, M., et al 2019; in press
• ADHD and Other Disorders of Attention Regulation Steiner H (ed.), Handbook of Developmental Psychiatry Steiner H, Stemmle P, Joshi SV, Patel P 2011: 271-315
• America's New Kids Preface CHILD AND ADOLESCENT PSYCHIATRIC CLINICS OF NORTH AMERICA Joshi, S. V., Pumariega, A. J. 2010; 19 (4): XV-XVII

  View details for DOI 10.1016/j.chc.2010.08.001

  View details for Web of Science ID 000284507200002

  View details for PubMedID 21056339

• Medical assessment and laboratory testing in child and adolescent psychiatry Poustka F, Lehmkuhl D, Steiner H , eds: Lehrbuch der Kinder - und Jugendpsychiatrie. Traver D, Joshi SV 2008
• Teaching about School Psychiatry American Academy of Child & Adolescent Psychiatry News Bostic JQ, Joshi SV 2007; February
• The Resident as Teacher and Learner: Utilizing Principles of Adult Learning Theory American Academy of Child & Adolescent Psychiatry News Joshi SV, Hunt J 2007; December
• Attention Deficit Hyperactivity Disorder Ferri's Clinical Advisor: Instant Diagnosis and Treatment Misakian AM, Louie A, McBurnett K, Joshi SV 2006
• ADHD, growth deficits, and relationships to psychostimulant use. Pediatrics in review Joshi, S. V. 2002; 23 (2): 67-68

  View details for PubMedID 11826259

• Fever and Acute Foot Pain in an 8-year Old Boy Emergency and Office Pediatrics Joshi SV 1996; 9: 92-94