Dear Doctor: Sonali Sharma M.D. M.Sc.
The passionate psychiatrist who’s working toward improving the mental health gap in NYC and abroad.
Throughout her career, Dr. Sonali Sharma has had the opportunity to work in multiple different communities, cultures, and countries. In each place, mental health care was approached differently, yet there was an underlying issue that connected them all — a gap in care. Dr. Sharma’s global perspective has given her insight into the complexities behind this problem, and she has become a leader in her field, training physicians and developing programs to help create solutions. Read on to learn more about this amazing psychiatrist’s time abroad and how her work there has informed her approach to care in her private practice here in NYC.
“I always had a feeling that I would become a doctor, but it wasn’t until I worked in healthcare consulting my first two years out of college that I realized that I wanted to be a direct service provider. I was working in health care policy, and yet I wanted to fully understand how to take care of the individual before I could learn how to take care of the system. At that time, I was working with paper, ideas, and concepts instead of with people, which is really what I love to do.”
Combining Medicine and Social Development
I went to medical school at Weill Cornell. I did my first three years there and then took a year off to go to the London School of Economics, where I completed a Master’s degree in Social Policy and Planning. During my time in medical school, I loved working with people and learning the human systems, but I knew that I wanted to combine that knowledge with the work I had been doing prior in the larger context of social development. Ultimately, I wanted to be able to take care of people at an individual level, but I also wanted to dig into how society supports that. Both my degrees were important in shaping my perspective and informing my training for the rest of my career.
When I was working on my Master’s in London, I learned about a field called post-conflict reconstruction, which looks at how countries transition to democracy post-war and I was particularly interested in thinking about mental health and social development in this context and what public health issues come with that change. While working on my thesis in South Africa, I began to realize that my interests in working with behavioral health issues, mental health, substance abuse and conflict mediation fit well with psychiatry. So my thesis really drove me into my specialty as a psychiatrist.
Global Mental Health Work
After residency, I started my own practice, which I felt really trained to do. Being in psychiatry is very flexible, because I can also work on other healthcare projects in public policy at the same time. It really fit what I wanted at that time.
I began working with an emergency psychiatrist at Columbia and pursued global health projects on the side. After two years of that, I got my dream job to do global humanitarian work full-time. I worked for a Dutch NGO, as mental health technical advisor. My main focus was to integrate mental health into primary care in two different post conflict countries, Burundi and Afghanistan. In my two years working there, I travelled back and forth from Amsterdam.
The World Health Organization (WHO) developed a methodology called mhGAP, which refers to the mental health treatment gap around the world. I became proficient in their methodology, and used it to inform my work at the Dutch NGO, and over time trained nurses, doctors, and non-mental health specialists across a variety of settings.
Understanding how mental health can be expressed across cultures is really crucial because not everyone speaks the same language about it.
We had an anthropologist on our team at the NGO, and the first dive we’d do was an anthropological study to understand cultural idioms of distress across cultures.
Local Mental Health Work
When I came back to New York, I started working back at my practice in Flatiron and also worked in the Bronx for a few years in public psychiatry. First, I was the Deputy Director of the Department of Psychiatry and Director of the Psychiatric Emergency Services (aka, the psychiatric ER) at a city hospital in the Bronx called Lincoln Hospital. I was in that role for under two years until I switched to working in a primary care setting for a collaborative care program where I was the Chief of Psychiatry. I was responsible for the integration of mental health care into the primary care service delivery model, similar to the work I had been doing globally. I loved this job, it really brought together everything that I had trained for and learned.
Thrive NYC’s Mental Health Service Corps
During my maternity leave, I took on the role of Director of a Thrive NYC program called the Mental Health Service Corps. The program is focused on service delivery and workforce development. The idea was modeled on the concept of taskshifting, which refers to the process of training and empowering other healthcare staff who are more available and accessible to address the bottlenecks of healthcare. For example, social workers, psychologists, and licensed mental health counselors can be trained and empowered to provide evidence-based mental health care (instead of relying solely on psychiatrists or traditional mental health models of care) under structured supervision system to be able to expand the reach of mental health care and make it a more scalable model. The clinicians in training were placed in high need communities across the city.
The program was very ambitious with now over 300 social workers, psychologists, mental health counselors, and other supervising clinicians. It was an incredible opportunity for me to work with the mayor’s office and the department of health and mental hygiene, and to work toward addressing the gap in mental health care. It’s truly changing and expanding the workforce.
Building a Private Practice
I kept my private practice going throughout my time on all these different programs. Even when I was abroad, I kept some patients through telepsychiatry. I’d come back once every three months to see people in person. It was important for me to keep it going; I’m really committed and proud of what I’ve built.
I love working at my practice. I have a practice in Flatiron, and see patients one day a week in Williamsburg, Brooklyn. I offer psychopharmacology, therapy or a combination of both. I see a lot of people who are struggling with anxiety disorders and mood disorders, such as depression and bipolar disorder. I help quite a few women who are pregnant, postpartum, or who are struggling with parenthood. My focus is naturally evolving to that now that I’m a parent myself. I still see a lot of people impacted by exposure to trauma given my previous work in global mental health, and those needing crisis intervention because of my work as an emergency psychiatrist.
Because I have worked with so many primary care providers throughout my career, I view my patients holistically. I conduct a comprehensive psychiatric and psychological evaluation for everyone that comes in, which also includes a thorough medical inventory. For example, if they’re presenting with anxiety or depression, I’d check to see if they’ve had their thyroid checked. I make sure that my patients’ physical health and mental health are integrated into one.
As the owner of my own practice, I have the autonomy to design and structure the look and feel of the practice. I’ve thought about everything from how I welcome people to the digital tools used. I love that I can design a workflow and system that is easy for my patients and at the standard I want.
My goal is not to keep people in my care forever. I want to help them make their lives better, and to be a catalyst for change so they can go and live their fullest life. I want people to get better.
Innovations in Psychiatry
One of the reasons I went into psychiatry was because of the opportunity for innovation and technology that could impact the field over time. For example, our understanding of genetics has changed so much, there’s now testing available to look at genetic variability to see if you’d be better on a certain medication. I offer this in my practice; it’s called Genesight. I’m starting to use this test to inform my decisions. Having more data available is so helpful in helping patients get better faster. Before the test, it would take time to find the right medication that worked for them in terms of efficacy and side effects. This test has been critical in reducing time and side effects.
Lightning Round
If I weren’t a doctor, I’d be…a painter.
New York’s best kept secret is…the coffee bars in Williamsburg. I love Cafe Oslo, Grade Coffee, and Devocion coffee.
Everybody needs some…space to process their emotions and experiences sometimes.
Favorites
Meal to cook: A gnocchi mushroom risotto with salmon.
Family activity: My son is in a trapeze studio class at Streb, and my family and I went to one of their shows — it was fantastic!
Spring activity: Domino Park
Museum: Stedelijk in Amsterdam.
Artist: Picasso
You can learn more about Dr. Sonali Sharma here.
Know a great female doctor in NYC? We’d love to meet her, introduce us here!
