“Pass me the dry wall and some nails.” One can imagine the young Christopher Thompson (“Kip,” as he is known to family and friends) hearing such a request from his father, who, in his spare time, undertook refurbishing old, broken-down properties. From the age of five, Kip was an important partner in his father's building projects, which undoubtedly helped him develop his capacity to see things, not only for what they are, but for what they could become with some solid effort and teamwork. Add to the developmental mix his father's full-time vocation as a school psychologist and his mother's professional role as a psychologist on the adolescent inpatient unit of a state psychiatric hospital, and it is not hard to see how four decades later, Dr. Thompson is refurbishing and rebuilding juvenile forensic mental health systems in Los Angeles County and the State of California. To provide better service to the challenged, disadvantaged, and struggling youth who have been swept up into the world of juvenile justice, foster care, and county educational services, he has worked with county administrators, the courts, and legislators. Through his work in juvenile justice, he has seen firsthand what psychiatrists, with their highly specialized knowledge and skills, can do to change systems for the better to help vulnerable youth at critical crossroads in their lives. Dr. Thompson, in his new role as American Academy of Psychiatry and the Law (AAPL) President, brings his rich professional and personal life experiences to our organization, along with a vision of how AAPL can participate more fully in building a better future for those struggling with mental health challenges in correctional settings and other forensic contexts.
Christopher R. Thompson, MD
Sometimes in jest it is hypothesized that a child with a parent in the mental health field will have some problems to work out in adulthood. However, Dr. Thompson, doubly blessed, is a substantial and effective person who is highly ethical, has great compassion for others, and holds a humble view of himself as a responsible member of his community. He carries out his self-affirmed duty to use his knowledge and skills for the benefit of those in need. Back in Ambler, just outside of Philadelphia, Dr. Thompson's parents obviously did quite a bit right. So how did that youngster who spent weekends and summers with his dad learning carpentry, plumbing, and roofing, wind up as an Associate Clinical Professor of Psychiatry at the University of California, Los Angeles (UCLA), and now the president of AAPL?
During his childhood, when Kip wasn't enjoying hockey, basketball, tennis, or soccer, or helping his father on construction projects, he was doing well in school. He graduated as valedictorian of his high school in Ambler and was accepted at Princeton University in nearby New Jersey. At this point, one would expect the usual progression for a future medical school professor: success at an Ivy League college, admission to a prestigious medical school, then residency, fellowship, and so forth, with some extracurricular activities that can be included on various applications to show how “well-rounded” the individual is, despite the high grade-point average. However, thinking that he'd probably better appreciate college after having more life experience, Kip put Princeton on hold so he could take a year off from school. While taking a “gap year” is common these days, back then in Ambler, the fact that the high school valedictorian was not going to college surprised everyone.
Instead, he went in search of experience that would further build his character and enhance his self-reliance. He parlayed what he learned from his father into jobs in construction, working for the Sierra Club building trails in Wisconsin, clerking in the produce section of a supermarket; and then working as a seasonal employee in the Student Conservation Corps in Smoky Mountains National Park in North Carolina, where he maintained trails and boundaries and went on patrols. While making his rounds in the back country, he stumbled onto a field of well-tended and pungent Cannabis sativa. Before he could decide on the appropriate action, a shot rang out and a bullet whizzed overhead, greatly facilitating the problem-solving process that he had just gotten started. Escaping intact, the future Dr. Thompson went on to wrestle with some other challenges, such as wrangling sows and piglets in the park's wild boar relocation program.
After emerging from the mountains, Kip returned to Ambler, only to discover a letter from the University of Virginia that offered him a partial scholarship to a university scholars program. Ever responsible when it comes to money, he took a look at the school (after all, it was far less expensive than Princeton University). It was love at first sight. The university, founded by our esteemed third President, the wonderful charm of Charlottesville, and, of course, the good time shown to him at the fraternity he stayed at during his visit, resulted in a change of plans. He developed a keen interest in science, imagining himself as a cell biologist or virologist, conducting research in a university setting. To help support himself, the always practical young man delivered Chinese food when not studying for his biology class. While not exactly revealing itself in a fortune cookie, his future became much clearer through working for the Chinese restaurant.
Late one evening, dropping off egg rolls and wonton soup to last minute test-crammers and paper-writers at the university, he had one last delivery run, which took him to a strikingly dilapidated apartment complex in not the best of neighborhoods in Charlottesville. While holding a plump paper bag with a widening oil stain suggesting the delicacies within, he rang the doorbell of the appointed unit, as was his customary practice, hoping the inhabitants would show mercy and give him a decent tip. However, this time when the door opened, Kip came face-to-face with none other than his biology professor! Surprise and uncomfortable mutual recognition took over the visages of both participants in this chance meeting. After a quick exchange of goods for cash, he scurried out of the sagging complex, disheartened by the discovery that his professor was living in such an undignified abode. At the end of the next day's class, his professor, apparently feeling a need to debrief them both, sat down and chatted with the young university student, querying him about his future career plans. “Go to medical school,” Kip's professor advised after hearing that Kip wanted to go to graduate school and become an academic researcher. “You will have a lot better options to be a researcher and will be more in demand.” As an assistant professor still battling the challenges of academia while in his 50s, Kip's professor was himself the persuasive argument for going to medical school.
Kip spent his senior year catching up on his premed requirements, taking the MCAT, and gathering the application materials for medical school, to which he would apply after college graduation. As the winds were howling one June morning in Hays, Kansas, Kip, during a road trip with buddies to see the World Cup, dropped into the corner mailbox a stamped, oversized envelope containing his medical school application materials and his hope for the future. When he arrived in the City of Angels, another chance event influenced his future. While attending soccer games with friends, he met his future wife, Mei Lisa, who worked for a local advertising agency. Kip stayed in San Clemente, California, delivering pizzas and surfing when he wasn't interviewing for medical school. After completing his last interview, he channeled the spirit of Jack Kerouac, once again going on the road, staying in his car or at friends' places, splurging for some weekly rentals, and rooming with an “interesting group of guys” outside of New Orleans. He worked odd jobs in Las Vegas, Boulder, New Orleans, Atlanta, and Florida before winding his way back in the late spring to Ambler, where he learned that he had been accepted to a few medical schools. One school, the University of North Carolina at Chapel Hill, presented the fiscally responsible young man with a very affordable option: tuition of $880 per year once he gained residency status after his first year (and including a $1,500 scholarship given to all in-state students).
Off he went to Chapel Hill, where it took a couple of months for the aspiring doctor to transition from living on the road to taking basic science classes. Imagining that he would go into primary care, the future Dr. Thompson did rotations in rural North Carolina, ultimately despairing that primary care was rather routine and a bit boring. At about that time, his attention was drawn to psychiatry, which he found fascinating and unpredictable, such as when he was rather exquisitely cursed out by a patient during psychiatry rounds. His interest was further kindled by an elective at Dorothea Dix hospital, which at the time housed a patient adjudged not guilty by reason of insanity (NGRI) who had, as a law student, murdered two citizens of Chapel Hill and ultimately sued his treating psychiatrist for negligence that caused his long-term confinement.
After a long-distance romantic relationship of several years' duration, Dr. Thompson made it back to California, marching into UCLA's psychiatry residency, where he happened upon yet another situation that influenced the direction of his career. One of his first-year residency rotations was in the psychiatric intensive care unit (PICU) at the affiliated VA medical center. He found himself in a forensic psychiatry educational cauldron, cooked up through a collaboration of Dr. Robert Weinstock, the co-director of a former UCLA forensic psychiatry fellowship at that time, and Dr. Mace Beckson, medical director of the PICU. Dr. Thompson thrived in this environment, attended forensic fellowship lectures, and was selected to be PICU chief resident, the diving platform for a plunge into a career of forensic psychiatry. His future as a forensic psychiatrist was thus sealed by the mentorship of Drs. Weinstock and Beckson, who were fortunate to have the opportunity to work with such a sharp and enthusiastic resident. During a rotation at Los Angeles County's Twin Towers Correctional Facility, sometimes referred to as the largest mental health facility in the country, Dr. Thompson realized he would rather work with a 15-year-old who had gotten into trouble with the law because of antisocial behavior than with more “hardened” 35-year-olds who were incarcerated with a long history of criminal behavior. With this in mind, as well as his positive experience on the UCLA Child Psychiatry Inpatient Unit, Dr. Thompson decided to become a forensic child and adolescent psychiatrist. In retrospect, this should not have been a surprise to anyone, given that Dr. Thompson's gratifying work with children and adolescents began as an undergraduate, when he participated in the Big Brothers program and tutored local high school students in chemistry and physics.
Following in the footsteps of previous PICU chief residents, Drs. Gregory Sokolov and Cameron Quanbeck, who had gone on to forensic psychiatry fellowships at the University of California (UC) Davis, Dr. Thompson was pleased by the prospect of learning forensic psychiatry from Dr. Charles Scott, a forensic child and adolescent psychiatrist, and accepted an offer from Dr. Scott. On day one of the fellowship, Dr. Scott pushed an impressively tall stack of papers and folders across the table at the three new fellows, explaining that this was their required reading for the fellowship. At this point, Dr. Thompson realized the academic experience that was in store for him, and he was eager to undertake it. He found his year with Dr. Scott to be intense, rigorous, and educational, by far the best year day-for-day of any of his years of medical training. At the end of his fellowship, he emerged feeling very competent to work as a forensic psychiatrist. During his fellowship year, adding to the overall challenge, Dr. Thompson flew back and forth between Davis, in northern California, and Los Angeles, in southern California, where he had his home. During this time his wife Mei Lisa then was working at the Los Angeles Times.
Returning to Los Angeles to stay, Dr. Thompson, now with a one-month-old son, Cole, started the UCLA Child and Adolescent Psychiatry Fellowship, which was another positive experience for him. Toward the end of this fellowship, his career plan to go into private practice was changed by another fortuitous event. His UCLA Child Fellowship mentor, Dr. David Feinberg, suggested that Dr. Thompson look into an opportunity in the Los Angeles (LA) County Juvenile Justice Mental Health Program. Initially assuming that the county job would be temporary, he then found great enjoyment working with the youth and operating in the various county systems, such as probation, child and family services, and the office of education. Dr. Thompson realized that he liked having an impact on systems and doing things on a “meta” level, as well as making a difference in individual lives.
He worked at juvenile hall and the Probation Department's girls' and boys' camps, helping to redesign the camp system to improve delivery of psychiatric, educational, and other services to reduce recidivism rates. He also worked with juvenile court judges and commissioners, public defenders, district attorneys, child advocates, and academic researchers to implement a new standardized assessment protocol for the competence attainment program. Promoted to the position of Medical Director of the Juvenile Justice Mental Health Program and Juvenile Court Mental Health Services in July 2011, Dr. Thompson currently supervises more than 20 psychiatrists who provide evaluation and treatment to children and adolescents in the custody of the Los Angeles County Probation Department, and he interfaces with other county agencies in the delivery of health services to youth in this system. A focus has been Juvenile Court Mental Health Services, a program that provides consultation to judicial officers and dependency attorneys about mental health problems (especially psychotropic medication) in foster youth. A significant achievement has been the development of new guidelines for approval of psychotropic medications for youth in foster care.
It has become clear to Dr. Thompson that psychiatrists must interface with policymakers and the public to effect change in the juvenile justice system. In this vein, he has increasingly collaborated with judges, the Probation Department, the County Board of Supervisors, and state legislators. While Co-chair of the California Academy of Child and Adolescent Psychiatry (Cal-ACAP) Government Affairs and Advocacy Committee and President-Elect of Cal-ACAP, Dr. Thompson has been very involved in guiding legislation via the education of lawmakers. He chaired the Cannabis White Paper Task Force, which produced a report on the impact of cannabis use during adolescence, to educate legislators, the public, and psychiatrists. Through his work for the County of Los Angeles and Cal-ACAP, Dr. Thompson has seen the difference that psychiatrists can make in policy and practice and the role that psychiatrists can play in redesigning systems to be more effective. For example, he has witnessed the positive impact of psychiatry's involvement on multiple pieces of California legislation involving judicial and medical board oversight of psychotropic prescribing to youth. In the future, he hopes to help the County's systems focus more on prevention and diversion initiatives, rather than on detention and reintegration, by targeting interventions at children who are at high risk of becoming involved with the probation and juvenile justice systems.
Dr. Thompson's interest in forensic psychiatry extends beyond just youth. He served as Associate Chair of the Judicial Action Committee of the California Psychiatric Association, which was chaired by Dr. Weinstock. He was perhaps the only member of the committee (other than Dr. Weinstock) who read all the distributed material. Dr. Thompson plans to use those interests and abilities in his role as AAPL President as he encourages AAPL to play a larger role in mental health jurisprudence. He currently plays a central role in a new, academically oriented UCLA forensic psychiatry fellowship. Dr. Thompson is making good use of his teaching and supervisory skills by directing the L.A. County and UCLA portions of the fellowship, and his mentorship now extends to include UCLA child and adolescent and forensic fellows. He is a superb mentor and has already encouraged numerous trainees to go into forensic and child forensic subspecialties. Wherever problems arise, he invariably plays a role in finding solutions.
As President of our organization, Dr. Thompson's goal is to see AAPL become more open to taking on a leadership role in providing education and guidance to judges, legislators, the media, and the public. With forensic mental health concerns commonly in the national spotlight, often provoking strong emotional reactions, and sometimes based on limited knowledge and understanding, he believes that AAPL can support the quest for rational and effective approaches by enhancing knowledge and understanding among stakeholders. Appreciating in AAPL the uniquely abundant individual and organizational expertise, Dr. Thompson would like to expand our organization's definition of education to facilitate AAPL's positive impact on mental health care, particularly in forensic contexts. He would like AAPL to reinforce its ties with the American Psychiatric Association, using APA's infrastructure to address legislative, administrative, and judicial matters related to forensic psychiatry. In addition, he would like to explore the possibility of AAPL's involvement as a legislative influence in Washington, D.C., and to join consortium with other forensic organizations (e.g., the American Academy of Forensic Sciences and the American Psychology-Law Society of the American Psychological Association) for combined efforts in legislative, administrative, and judicial interactions. He envisions AAPL's having judicial action, legislative, and media and public relations committees to influence the discussion about pressing matters in forensic psychiatric contexts. Ultimately, Dr. Thompson sees a future in which AAPL is the premiere organization to which legislators, the courts, administrators, and the media turn for education and guidance on forensic mental health topics, and a future in which AAPL plays a leadership role in the development of standards, policies, and procedures in the field of forensic mental health.
Dr. Thompson is one of the youngest presidents in AAPL history and perhaps one of the most physically fit. His regular exercise routine supports an array of activities and responsibilities. When he is not advocating the remediation of problems in the juvenile justice system or providing expertise to the courts, there is a good chance that he is evoking laughter with his laser-sharp wit. One of his best attributes is that he never takes himself too seriously.
Throughout his personal and professional life, Dr. Thompson has demonstrated wisdom beyond his years. He has always had the vision to see how things are and how they could be in the future (not only with respect to his uncanny knack for picking the Super Bowl winner before the football preseason has even started). At times making the unconventional but smart choice, Dr. Thompson has been an eager adventurer on and off the road, seeking the higher purpose while maintaining personal balance and responsibility. His lifestyle has served him well in his continuing growth as husband, parent, physician, psychiatrist, mentor, administrator, educator, colleague, friend, and, not least, an advocate for improving systems that serve juveniles with mental health problems in forensic settings. He is not a blind idealist, as he always has an eye on political realities and what reasonably could be accomplished under the circumstances. He sees AAPL taking on an expanded role as educator and guide in the field of forensic psychiatry. He believes that the organization and its members have the expert knowledge, skills, and tools to refurbish the nation's many systems serving those with mental health challenges in legal contexts. Now as AAPL President, he invites the membership to join him and to bring along the proverbial dry wall and nails.
- © 2018 American Academy of Psychiatry and the Law
