Dr. Héctor Colón-Rivera, a former MFP Fellow with the American Psychiatric Association (ApA), had been working to address the mental health needs of the residents of Puerto Rico long before the island was devastated by two hurricanes this past September. Shortly before the hurricanes struck, he and several other Puerto Rican psychiatrists formed a nonprofit, Crear Con Salud, Inc. (Create with Health), which is dedicated to serving the mental health needs of Puerto Ricans. The Crear Con Salud
team had been making regular visits to the island, but increased the frequency of their visits after the storms. Their current mission is to train community leaders on the effects of trauma and PTSD and on how and where to get help for island residents, especially those living in rural areas. Because Puerto Rico has experienced an exodus of psychiatrists in recent years, decreasing from about 397 in 2012 to about half of that in 2016, many Puerto Ricans, particularly those in rural areas, have often been left without adequate mental health services.
The lack of mental health services was compounded after Hurricane Irma and then Hurricane Maria left thousands homeless and most of the island without electricity. Dr. Colón-Rivera estimates the death toll to be in the 400s, but said no one really knows. “People are dying from lack of food and water,” he said, “and we’ve seen instances where people may have committed suicide because they gave up hope.” He is more committed than ever to make a difference in the lives of American citizens who were born and live in Puerto Rico.
Dr. Colón-Rivera’s interest in mental health issues emanated from his experiences as a child watching his mother, a special education teacher, work with children and families coping with mental illness. When visiting the island of Vieques, where his mother grew up—a 3-hour trip from San Juan by car and ferry—he understood how isolation often exacerbates the effects of mental illness. He went on to get his medical degree from Puerto Rico’s Ponce School of Medicine and Health Science, completed a 4-year psychiatric residency at Boston University Medical Center, and earned an M.D. in addiction medicine at Yale University Medical Center.
While in residency at Boston University, he made semiannual trips to Puerto Rico, and started a weekly radio program called Salud A Flote (Health Afloat), during which high school students interviewed his colleagues. Dr. Colón-Rivera became an MFP Fellow during his residency and was selected by his colleagues to be Chair of the ApA’s MFP program during 2016–2017. The ApA and ApA Foundation have been supportive of his work and have made assistance available to the Puerto Rico Psychiatric Society through the ApA’s Erich Lindemann Disaster Support Grant and the ApA Foundation’s Disaster Relief Fund.
Dr. Colón-Rivera is currently a Clinical Associate Professor at the University of Pennsylvania and the Philadelphia VA Medical Center where he specializes in the acute care of patients with a wide variety of mental and substance use disorders. He is also an attending physician in telepsychiatry at the University of Pittsburgh Medical Center (UPMC) for an inpatient psychiatric unit in northwestern Pennsylvania, where he attends to a dozen patients daily providing virtual psychiatric services.
“I work with a nurse who is on site at the clinic,” he explained. “I am able to meet patient’s needs by using my phone and a computer.”
UPMC recently received a grant to provide services to rural outpatient clinics with the goal of expanding medication-assisted treatment and services for people with opioid use and related disorders. Dr. Colón-Rivera believes that this technology can also be used in Puerto Rico—to provide much needed services to isolated residents on the island.
For news about the work of Crear Con Salud, see the following articles: