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Professional News
Army Psychiatrist Specializes In Disaster, Trauma Response
Psychiatric News
Volume 39 Number 13 page 20-20

APA distinguished fellow E. Cameron Ritchie, M.D., was promoted to full colonel in the Army Medical Corps last month. This milestone caps 18 years of active-duty service and numerous other accomplishments.

Highly regarded by her military colleagues, Ritchie recently became president-elect of the Society of Uniformed Services Psychiatrists, an APA district branch.

A psychiatrist colleague at Walter Reed Army Medical Center described Ritchie recently as a "Type A personality with an adventurous side." Her resume reflects both traits.FIG1

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Col. E. Cameron Ritchie, M.C., stands in front of the Tigris River in Medical City, Baghdad. Shortly after this picture was taken, red spots from a sniper scope were observed on her back by her colleagues. The group decided to leave the area and return to the Green Zone, the area in Baghdad where the coalition headquarters is located. 

Last month, Ritchie received her master of public health degree after completing her first year of the new Disaster Psychiatry Fellowship at the Uniformed Services University of the Health Sciences (USUHS) (Psychiatric News, July 18, 2003). Ritchie is an associate professor of psychiatry at USUHS.

Ritchie will spend her second fellowship year doing research at the USUHS Center for the Study of Traumatic Stress. She plans to use her recently acquired epidemiological and biostatistical skills to survey the approximately 88 members of the Iraqi Society of Psychiatrists (ISP). She will collect information to help determine what mental health services the Iraqis need in light of 30 years of conflict, sanctions, and limited resources, said Ritchie. This information will be provided to individual and organizational stakeholders as Iraq reconstructs its medical and mental health systems.

She has met with leaders of the ISP several times and attended and presented at a joint U.S./Iraqi medical specialty forum in Baghdad in February (Psychiatric News, April 2) on behalf of APA. She also participated with an ISP leader and other international leaders in a presidential symposium at the APA annual meeting in New York in May.

Ritchie is also organizing a workshop that will be held this month at USUHS to learn from psychiatrists deployed in Iraq and Afghanistan about what treatments have been most effective in preventing combatstress disorders and reducing psychiatric symptoms in soldiers.

A research project that Ritchie is helping to plan will assess which medications are the most effective in reducing psychiatric symptoms following incidents of mass violence. "There has been a lot of research on psychological interventions [after traumatic events], but very little on medications," Ritchie said.

She is the principal author of the landmark 2002 report "Mass Violence and Mental Health: Evidence-Based Psychological Interventions for Victims/Survivors of Mass Violence" (Psychiatric News, October 18, 2002). The report, published by the Government Printing Office, was the outcome of a 2000 best-practices consensus workshop organized by the Department of Defense and other federal agencies. Ritchie and 50 trauma experts participated in the workshop.

Ritchie was assigned to, though not at, the Pentagon when the terrorist attack occurred there on September 11, 2001. "There were many mental health workers who responded. I helped to coordinate the response in the difficult weeks following the attack," she said.

She has since written several articles and a book chapter (in press) on the mental health response to the Pentagon attack and was chief editor of a book devoted to this topic. She engaged in these activities while serving as program director for mental health policy and women's health issues in the Office of the Assistant Secretary for Defense for Clinical and Program Policy. She resigned last year after four years to begin her disaster-psychiatry fellowship at USUHS.FIG2

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Col. Cameron Ritchie and her colleagues Larry Ronan, M.D. (to left of Ritchie), an internist at Massachusetts General Hospital, and Ed Keenan, M.D. (to right of Ritchie), a pediatrician at Massuchsetts General Hospital, are given a tour of the emergency room of the pediatric teaching hospital in Baghdad. Recovery of the very sick children there is hampered by poor sanitation, shortage of medications, and lack of equipment. 

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While at the Department of Defense, Ritchie drew attention to health issues that affect women during deployment. These include hygiene, pregnancy screening, earlier Pap testing, increased availability of good medical care, and increased research into women's health during deployments, according to Ritchie's article "Issues for Military Women in Deployment" in the December 2001 Military Medicine.

Ritchie also raised safety concerns in the article about military deployment policies that require women in the same unit as men to sleep in separate locations.

Ritchie said she and another woman physician were put in harm's way due to this policy when their 12-member preventive medicine unit was deployed to Somalia during Operation Restore Hope in 1993.

"The Marine Corps general in charge of the operation had decreed that military men and women would sleep in separate areas," said Ritchie." I wanted to remain with my unit because I thought we would be safer all together. Instead, the female physicians had to walk quite a distance, and one of us had to stand guard outside our tent constantly to prevent theft. At one point, the men were warned about upcoming tensions and probable gunfire. When the bullets flew over the wall, the men retreated to the safety of a walled complex, but since no one warned us, we were stranded outside the tent," Ritchie recalled.

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Ritchie experienced isolation for different reasons during her first overseas tour of duty in South Korea from July 1990 to June 1991. "I was the first female psychiatrist assigned to the 2nd Infantry Division at Camp Casey, near the demilitarized zone that separates North and South Korea. The location was remote and hours from the capital, Seoul," said Ritchie.

"Although there were other female medical officers there, we were still a minority, and I felt I was living in a glass bowl most of the time."

She added, "I was also halfway around the world from my family and friends, and communication was mainly by slow mail."

Ritchie returned to South Korea for her second tour of duty in July 1994 as chief of inpatient psychiatry at the 121st General Hospital in Seoul.

Forensic psychiatry is a long-standing interest of Ritchie's. She achieved" added qualifications" in forensic psychiatry in 1994.

She has testified for both the defense and prosecution in more than 28 trials in military and civilian courts. Her areas of expertise include competency, reactions to rape, posttraumatic stress disorder, child sexual abuse, and delusional disorder.

"A significant forensic accomplishment was getting the military to change its policy on psychological autopsies. The military no longer requires psychological autopsies be done routinely after all suicides, but only when the [cause of] death is equivocal," Ritchie said.

This change was important for many reasons including protecting the privacy of the deceased. For example, a reporter obtained sensitive personal information through the Freedom of Information Act from the psychological autopsies of military personnel who committed suicide and published it in a newspaper, Ritchie explained.

Her last clinical position at Walter Reed Health Care System was chief of forensic psychiatry from 1998 to 1999.

Ritchie entered active duty in 1983 through the Health Professions Scholarship Program, which paid for her private medical education. She received her medical degree in 1986 from George Washington University Medical School.

She has been married for10 years to a civilian attorney and has two young children. When asked how she juggles her profesional and family responsibilities, Ritchie noted that it isn't always easy but that she's very fortunate to have a supportive family and access to high-quality child care.▪

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Col. E. Cameron Ritchie, M.C., stands in front of the Tigris River in Medical City, Baghdad. Shortly after this picture was taken, red spots from a sniper scope were observed on her back by her colleagues. The group decided to leave the area and return to the Green Zone, the area in Baghdad where the coalition headquarters is located. 

Anchor for JumpAnchor for Jump

Col. Cameron Ritchie and her colleagues Larry Ronan, M.D. (to left of Ritchie), an internist at Massachusetts General Hospital, and Ed Keenan, M.D. (to right of Ritchie), a pediatrician at Massuchsetts General Hospital, are given a tour of the emergency room of the pediatric teaching hospital in Baghdad. Recovery of the very sick children there is hampered by poor sanitation, shortage of medications, and lack of equipment. 

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