For the Better

This detailed data collection has helped the team identify several valuable insights. One key finding, published in the prestigious JAMA Network Open, identified tobacco smoking as a leading predictor of natural-cause mortality among people with schizophrenia. Although smoking is known to shorten life expectancy in the general population, its impact is magnified among those with serious mental illness, where the prevalence of tobacco smoking can exceed 50%.

“The reasons why people with schizophrenia and other serious mental illnesses smoke so much are still not fully understood,” said Dr. Dickerson. “There’s a long-standing—and incorrect—myth that smoking helps alleviate stress or improves thinking. It doesn’t. But the social environment, stigma, and historical attitudes toward smoking have made it a difficult issue to tackle.”

Other factors associated with early mortality include lower cognitive functioning, obesity, chronic medical conditions like COPD and cardiac arrhythmias, and social circumstances such as being divorced or separated. These factors create a web of vulnerability that can erode both physical health and the ability to seek and maintain medical care.

The implications of these findings are profound. As general healthcare continues to improve across the population, the mortality gap between those with and without SMI has actually widened—a reminder that mental health and physical health are intrinsically linked.

This research goes beyond theory and leads to real steps that can be taken. Dr. Dickerson strongly advocates for expanded smoking cessation efforts targeted at people with SMI. She cites previous programs at Sheppard Pratt, funded through the Maryland Department of Health, which provided brief behavioral counseling to all inpatients who smoked. “We know how to help people quit smoking,” she said. “It’s not just about telling people to stop. It requires skilled behavioral counseling and medication. But the resources have to be there.”

Beyond smoking, Dr. Dickerson hopes to see better integration of psychiatric and primary care services, reducing gaps that leave physical health needs unaddressed in people with SMI. 

“We’ve seen that people with serious mental illness sometimes receive subpar medical care because their physical symptoms are too quickly dismissed as psychiatric,” she explained. “Improving collaboration and reducing stigma are critical.” This is one of the drivers of Sheppard Pratt’s Collaborative Care program in partnership with Greater Baltimore Medical Center (GBMC); Sheppard Pratt therapists are embedded in GBMC primary care offices, ensuring that mental healthcare is accessible—just a short walk down the hall. 

Sheppard Pratt’s research also focuses on exploring new possibilities. Studies on probiotics, linked with a growing understanding of the microbiome, suggest they may help reduce hospital readmissions for people with acute bipolar disorder. Although more research is needed, these areas offer hope for improving both mental and physical health.

Michael Hann, MD, MBA, MS, chief of medical staff at Sheppard Pratt, highlights how this research matters in everyday life. “This work is a bridge between research and advocacy,” he said. “The insights not only inform how we care for individuals but also highlight the urgent need for policies and funding that support comprehensive, integrated care for this underserved population.”

Dr. Dickerson remains committed to continuing and expanding this work, driven by the belief that people with SMI deserve the same chance at a full, healthy life as anyone else. “It’s unacceptable that they should lose decades of life to conditions we can help manage or prevent,” said Dr. Dickerson.

At Sheppard Pratt, this research is a testament to hope and progress, and it also calls for action. Community support, partnerships, and continued investment are crucial to putting research into action to help people with serious mental illness live longer, healthier lives.

Meeting Complex Needs

In the past, people in Maryland and nearby areas often had to seek specialized OCD treatment elsewhere. To fill this gap, Sheppard Pratt built in-house services that now serve local patients and position the organization as a national leader in OCD care.

What sets Sheppard Pratt’s Center for OCD and Anxiety apart is its philosophy that no case is too complex. Many patients have multiple diagnoses—like trauma, substance use, mood disorders, or autism—that complicate OCD treatment. Thanks to the multidisciplinary team at Sheppard Pratt, patients have access to expert OCD treatment and expertise in other diagnoses, meaning they can receive holistic, comprehensive care. “At Sheppard Pratt, we don’t have to say ‘no’ to people with co-occurring issues,” Jon Hershfield, MFT, director of The Center for OCD and Anxiety, explained. “We work collaboratively, making sure we’re coming at the person with a multifaceted approach at all the right times.”

This collaborative model extends into Sheppard Pratt’s residential offerings, particularly at The Retreat by Sheppard Pratt, which integrates Hershfield’s team directly into the care environment. Their expertise has become a cornerstone of The Retreat’s programming, making it a sought-after destination for residential OCD care. Working closely with psychiatrists and other specialists, the OCD team ensures continuity of care and a highly tailored experience for each resident.

Beyond traditional cognitive behavioral therapy (CBT) and exposure with response prevention (ERP)—the gold standards for OCD treatment—the Center for OCD and Anxiety embraces a flexible, patient-centered approach. With institutional support for continuous learning, the team is empowered to pursue a variety of evidence-based modalities to meet the diverse needs of patients, including acceptance and commitment therapy (ACT), which helps individuals build psychological flexibility and resilience in the face of distressing thoughts, and radically open dialectical behavior therapy (RO-DBT), a treatment designed for individuals with perfectionistic and emotionally overcontrolled coping styles, traits often seen in OCD and obsessive-compulsive personality disorder (OCPD). 

Sharing Expertise

Recognizing the need for better education in OCD treatment, Hershfield launched a monthly lecture series through Sheppard Pratt’s Center for Professional Education. This free series invites leading voices in OCD research and treatment to share insights with clinicians worldwide. The team has built a library of more than 50 talks, providing free continuing education credits online.

The Center for Professional Education also partners with the International OCD Foundation to cohost free public workshops that combine expert insights with personal stories, helping to raise awareness and reduce stigma.

Changing Lives, One Story at a Time

At the heart of Sheppard Pratt’s OCD services are stories of those whose lives have been impacted by the care they received for OCD at Sheppard Pratt. Hershfield recalls a young woman whose OCD rituals had become so consuming that she couldn’t even send a simple text message without elaborate mental routines, driven by fears that a mistake might harm someone she loved. At The Retreat, she gradually built the courage to face her fears, resist compulsions, and reconnect with life beyond OCD. Central to her treatment was using a team-based approach to help her identify her values and how OCD was getting in the way of connecting with them.

Another patient—a mother plagued by fears of harming her children—worked with Hershfield for years. Despite setbacks, she eventually found the confidence to step back from therapy, carrying forward the skills she had built to manage OCD on her own. A year later, Hershfield received a joyful email and a photo of her child, a testament to the life she reclaimed. The key was persistently applying ERP principles to daily life and working through the shame and self-stigma that held her back.

These stories illustrate The Retreat’s ultimate mission: not simply to reduce symptoms but to help people achieve mastery over their OCD and live fully. As Hershfield said, “We’re in the business of getting people back to themselves.”

The Center for OCD and Anxiety is preparing to expand its services for younger children with OCD, since research shows that 50% of cases of OCD begin in childhood or adolescence. Clinicians have already started receiving specialized training to meet this growing need.

Sheppard Pratt’s commitment to OCD care offers hope for individuals and families facing this complex condition. Through innovative treatment, collaboration, and education, the Center for OCD and Anxiety is transforming lives and ensuring no one faces OCD alone.

Education: Taking a Holistic Approach

Sheppard Pratt’s nonpublic special education schools serve students from kindergarten through age 21, addressing a diverse range of diagnoses, including autism, emotional disabilities, multiple disabilities, other health impairments, specific learning disabilities, and speech-language impairments. Class sizes are small, averaging six to eight students, with a remarkably high staff-to-student ratio. This individualized environment enables teachers, behavioral specialists, and related service providers to deliver personalized instruction and therapeutic interventions, either in groups or one-on-one based on a student’s Individualized Education Program (IEP). These interventions impact academic progress and, more importantly, a child’s future. “That’s what really sets us apart. We’re able to intervene early and provide prevention services that can change the trajectory of a student’s future,” Flannery said.

This level of tailored support often keeps students out of more restrictive settings, like inpatient hospitalization or residential programs. The schools cultivate not only academic knowledge but also social and emotional development. Bullying rates, for instance, are significantly lower than in public schools, creating safe spaces where students can truly belong. “It’s not uncommon for us to hear a family say, ‘I’ve never had people accept my child for who they are,’” said Flannery.

Learning for Life: Beyond the Classroom

At Sheppard Pratt, education is about more than academics—it’s about preparing students for life. Through Community-Based Instruction (CBI), students build real-world skills in everyday settings. Whether grocery shopping, navigating public transit, or volunteering at local businesses, students practice independence, self-advocacy, and emotional regulation in environments beyond the classroom.

CBI also teaches workplace readiness—from understanding break times to interacting with nonschool supervisors—helping students transition successfully into adult life. For some, that path includes college. Through dual enrollment with the Community College of Baltimore County and Montgomery College, eligible students can earn credits while finishing high school. Students in Montgomery County also have the opportunity for dual enrollment at Thomas Edison High School of Technology, where they can participate in career opportunities, earn professional certifications, and get hands-on application of technical skills in several different specialized programs.

Others gain hands-on experience through internships, volunteer roles, and life-skills training in financial literacy, time management, and community safety. For students with more intensive needs, the focus is on managing routines, building leisure skills, and engaging with the world around them—safely and with confidence.

Path to Employment

Another one of Sheppard Pratt’s impactful programs is Project SEARCH, an international initiative providing immersive work experiences for students in their final year of school. Instead of spending their days in classrooms, participants go to business sites—like hospitals or hotels—where they rotate through internships, learning real job skills and building confidence.

“The ultimate goal is that every student graduates with some type of paying job,” Flannery said about the Project SEARCH program. 

Beyond Project SEARCH, several Sheppard Pratt schools operate hands-on vocational programs on campus and in the community. At Sheppard Pratt School in Rockville, for instance, students manage landscaping across expansive school grounds, gaining skills in teamwork, leadership, and practical trades. “They’re learning how to work together toward a goal, how to give and receive feedback, and how to take pride in their work,” said Claire Cohen, LCSW-C, senior director of schools. “These skills can be transferred to interest-based internship opportunities at sites like the Croyden Creek Nature Center.”

Meanwhile, students at Sheppard Pratt School in Gaithersburg venture off campus to work at businesses such as the Salvation Army, Burlington Coat Factory, and Mama Lucia’s. These partnerships provide essential opportunities to practice workplace behavior, navigate public transportation, and engage in the community.

“Students who struggle in traditional academic settings can shine in other ways,” said Cohen. “They find success, confidence, and a sense of belonging.”

One shining example of this success is Marcus Moore, a proud graduate of our program and the inspiring founder of Moore Crunch. Moore, a young entrepreneur with autism from Annapolis, turned his love of pretzels into a thriving business. What began in his apartment kitchen quickly grew into a retail and farmers market success, with over 600 bags sold in just months.

Moore now hopes to expand and hire others with disabilities, proving that with support and opportunity, anything is possible. “I could hire those that are like me just to show that you can do anything,” Moore said.

The Sheppard Pratt Continuum of Care

Sheppard Pratt’s nonpublic schools don’t operate in isolation. They are part of the broader Sheppard Pratt continuum of care, giving students seamless access to specialty services, more intensive levels of care, and post-school programs when needed. “We have the luxury of being part of something bigger,” Cohen said. “If a student needs more support, we can connect them quickly.”

While Sheppard Pratt schools focus on students, the benefits reach entire families. Many students who once struggled with everyday activities now manage transitions more easily and engage in family life.

“It changes the lifestyle the family can lead,” said Flannery. “It changes relationships with siblings and extended family. The impact is enormous.” For families who once felt alone, Sheppard Pratt offers hope and real progress, making graduation a powerful celebration of how far everyone has come.

As Sheppard Pratt looks ahead, community support remains vital to keep these life-changing programs thriving. Here, education is about more than school—it’s about preparing students for a future full of possibilities.

A key part of Sheppard Pratt’s approach is its commitment to a harm reduction model. Instead of requiring immediate abstinence, harm reduction focuses on gradual progress. 

“If someone isn’t ready to stop using, they’re not going to talk to a counselor about anything,” Hackey explained. “So we start with engagement, education, and practical support.” This compassionate approach helps people make safer choices and find their own path toward recovery, ensuring no one is turned away for not being ready to quit entirely.

Today, six of our seven outpatient centers across Maryland provide SUD services, with plans to expand further. This colocation model means individuals can receive mental health and substance use treatment under one roof, strengthening coordination and removing the burden of juggling multiple providers. As Marshall Henson, MPP, vice president and chief operating officer, community services, explained, “We are committed to a continuum of care that is responsive to the impact of substance abuse disorder on mental well-being for individuals seeking care. Integrating SUD services ensures that people seeking behavioral health support get the right care at the right level, all in one place.”

Many clients seeking care arrive with both mental health and substance use challenges—nearly 28% of our outpatient clients have co-occurring diagnoses. For some, addressing trauma is the first step; for others, harm reduction strategies pave the way toward deeper engagement. “It’s about treating the whole person, not compartmentalizing problems,” added Sandra Smith, LCPC, NCC, senior director, outpatient services. “When services are integrated, people are more likely to stay connected to care and achieve lasting recovery.”

Sheppard Pratt remains steadfast in its mission to expand access and remove barriers. This integration reflects a shared belief: that comprehensive, compassionate care should be available close to home, empowering every individual to pursue a healthier, brighter future.

Real-World Readiness

While academic medicine often leans heavily into theory and research, Sheppard Pratt emphasizes something equally essential: day-one readiness. Residents are trained to write clear, legally sound documentation, navigate interdisciplinary teams, and manage real-world workplace challenges.

“Fellows tell us they feel truly prepared to step into leadership roles,” said Vittoria DeLucia, MD, medical director, Sheppard Pratt Schools and Residential Treatment Center, who helps lead the child and adolescent fellowship program. “They’re learning how to make decisions in non-textbook situations, how to advocate for patients, and how to balance work and life in a field where burnout is very real.”

Andrew van der Vaart, MD, PhD, a former resident, credits the program’s breadth and depth for preparing him to practice independently—and confidently—on day one.

“I never felt like there was anything I was unprepared for,” he said. “Several rotations at Sheppard Pratt were key to going from observing psychiatrists to becoming one.”

Today, van der Vaart serves as the program’s associate director of residency training, helping shape the experience of new residents—proof of a training model that nurtures not only excellence but longevity and leadership.

Unmatched Clinical Breadth

What makes Sheppard Pratt’s training uniquely powerful is that it is part of one of the nation’s largest behavioral health systems, offering exposure to a wide range of specialty settings that few other programs can replicate.

Trainees rotate through inpatient units and outpatient centers, specialized neurodevelopmental programs, and day hospitals. They have access to advanced treatment options like neuromodulation, The Retreat by Sheppard Pratt, and even psychedelic therapy trials. These settings offer real-time lessons in the best practices of psychiatry and cutting-edge, novel interventions.

“Our child and adolescent fellows train in an inpatient unit for kids under 12 with autism and intellectual disabilities—one of only seven like it in North America,” said Dr. DeLucia. “We also offer experience in treating eating disorders, mood disorders, behavioral issues, and more—all within the same continuum of care.”

That continuum of care is key to Sheppard Pratt’s mission. It ensures that patients can move between levels of care—whether inpatient, residential, or outpatient—without gaps. And it gives trainees a front-row seat to integrated, holistic behavioral healthcare delivery.

Investing in the Future

Training a psychiatrist takes a minimum of four years, not including any subsequent specialty fellowships. That’s why Sheppard Pratt sees its residency program as a long-term investment in the future of mental healthcare—not just for Maryland but also for the nation.

“There’s no quick fix to the psychiatrist shortage. But we’re doing the work now to ensure that patients in five, 10, or 15 years will still have access to the care they need,” said Dr. Hann.

In doing so, Sheppard Pratt is preparing clinicians to meet the needs of today while building the infrastructure for the care every community deserves tomorrow.