Psychiatrist Robert Jarvis is bringing hope to Arkansans with mental health disorders
By MELANIE KILGORE-HILL
Robert M. Jarvis, MD, is changing the stigma around mental health. A native of Fayetteville, Jarvis completed a Bachelor of Arts in music and psychology from Trinity University in San Antonio. Following graduation, he worked multiple jobs including positions at the Elizabeth Richardson Center in Fayetteville and Habberton House, a long-term behavioral health facility within Ozark Guidance Center in Springdale. “After college, I started thinking about further education. Several friends had gone into medicine, and their enthusiasm inspired me,” said Jarvis, the son of a psychiatrist.
“Entering medical school, I was very open minded about the many branches of medicine, but it was the Behavioral Science course that rekindled my interest in my college studies. During clinical rotations, I realized that the relationships you have with patients in psychiatry are special and, to me, more personal. I felt like I could really make a difference in someone’s life as a psychiatrist.”
The path to psychiatry
While serving as chief resident at the University of Arkansas for Medical Sciences, Jarvis developed an interest in mood disorders and electroconvulsive therapy (ECT). “I wanted to develop a skill set that allowed me to do everything I could to help patients,” he said. “ECT can be a lifesaving treatment that not many offered in the state at the time.” After receiving specialized training in ECT at Washington University in St. Louis, Jarvis returned to UAMS and helped launch the institution’s ECT service in 2004. He served as a clinician-educator in the Department of Psychiatry at UAMS from 2004 to 2007, but his desire to focus solely on patient care drove him to join Arkansas Psychiatric Clinic, an outpatient private practice in Little Rock, where he still treats patients. He also serves as Director of Electroconvulsive Therapy and Medical Director at The BridgeWay, where he treats adult inpatients. A specialist in mood disorders, including major depression and bipolar disorder, Jarvis is board certified in psychiatry by the American Board of Psychiatry and Neurology.
Hope through ECT
Nearly two decades since he helped launch UAMS’s ECT program, Jarvis continues working to spread awareness of mental health treatment options and is helping to change the stigma once associated with mental illness. He said the shift in attitudes is evidenced by the number of patients actively seeking out therapies like ECT. The treatment has a high success rate among those who haven’t achieved desired results through pharmaceuticals, and Jarvis said the treatment can be significantly more effective than years of medication therapy.
“It’s rare to see someone seeking ECT who hasn’t been around the block with other treatments,” he said. “If you had the option to treat people earlier in the course of their mood disorder with ECT, you could have much better long-term outcomes.” In fact, Jarvis said he’s only seen a handful of patients not respond to ECT during his 20-year career. Unfortunately, ECT patients often fall into the same relapse cycle as those who rely on medications.
“Many ECT patients stop treatment when they feel better despite maintenance recommendations – a treatment every four to six weeks for up to a year,” Jarvis said. “ECT and medications are no different in that if a patient stops the treatment as soon as they feel better, their risk of relapse is much higher than if they continue the treatment that got them better.”
COVID and mental health
Like most mental health practices, Jarvis’s office hit peak volume in the height of COVID and has yet to slow down. “There’s no shortage of patients, but there is a shortage of appointment slots,” he said. “COVID opened a door and it just stayed open because people are more aware they need mental health services.”
Fortunately, the pandemic-driven practice of telehealth is still being utilized for many mental health patients. “I’m so thankful this field lends itself well to that,” Jarvis said.
“I still prefer in-person appointments, but now most practitioners are experienced in telehealth as well.” And while virtual mental health appointments are still permitted under a COVID-driven emergency ruling, Jarvis said consumers will be a loud voice in keeping that gate open for years to come. “I hope they do keep it available, because it broadens access and it just makes sense,” he said.
Another evolution in the field of mental health is the use of Transcranial Magnetic Stimulation, or TMS. The noninvasive procedure uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression and is being considered for use in other psychological conditions. Like ECT, TMS may be effective when other treatments haven’t worked. Jarvis also credits ketamine as a game changer in mental health. FDA approved esketamine, under the brand name Spravato, a nasal spray used by adults with major depressive disorder (with or without suicidal ideations) who haven’t been helped by antidepressant pills. Patients may also receive ketamine treatment intravenously.
The opioid aftermath
Like most of the country’s mental health providers, Jarvis also has seen an uptick in patients struggling with fentanyl addiction, particularly in the inpatient setting. “Many are suicidal and trying to detox off opioids,” he said.
“The pendulum is swinging back in the right direction following the last six to eight years of litigation and drug companies pushing opioid prescriptions. Regulations are changing and that helps psychiatric patients.”
Embracing mental health care
Jarvis urges providers to continue encouraging patients to not be afraid to seek help if they need it. “People need to know it’s not as hard as they may think,” he said. “Once they walk through the door and see that help is available, they’re typically very grateful they came to get the help they need. That speaks to the improving stigma of mental health.”