PROFILES IN LEADERSHIP

Tracy Glauser, MD: The Child Who Changed His Life

When Tracy Glauser, MD, first came to Cincinnati Children’s, he was focused on becoming one of the world’s best epilepsy specialists, especially in drug development.

“I had this great career,” says the man who is associate director of the Research Foundation, co-director of the Mind, Brain, Behavior Collaborative, and interim director of Biomedical Informatics. “But something happened that made me completely switch my focus to mental health.”

That “something” was the birth of Glauser’s son, Jacob. For the first year of his life, Jacob seemed to be doing well, but in 2001, after he turned 2 years old, it became clear he had a language delay. The delay grew progressively worse, new behaviors arose, and ultimately, he was diagnosed with language regression autism. Unfortunately, he suffered significant side effects to every medication prescribed for his severe behavior problems.

“I pulled together a team of scientists, including a geneticist, a biomedical informaticist, and a pharmacologist,” says Glauser. “We started to explore why Jacob had such severe reactions to medications prescribed for his autism, and we set up the Genetic Pharmacology Service, the first one of its kind in the country.

“Jacob has been a major driver of my focus on mental health, in particular, the genetics of mental health drugs and the potential predictors that could help us identify who would develop mental health problems, whether it be autism, anxiety, depression or suicidal ideation.”

Transformational Work

Glauser, in partnership with John Pestian, PhD, MBA, director of the Computational Medicine Center, connected with Oak Ridge National Laboratories with the goal of developing patient specific trajectories for anxiety, depression and thoughts of suicide. Oak Ridge is one of the Department of Energy’s national laboratories, known for its supercomputer technology that is used for much of the weather forecasting that happens in this country.

“We figured the best way to model the trajectory of mental health is to use the biggest, fastest computer in the world that can model this complex type and large volume of data along with the interactions between health, environment and genetics” says Glauser. “Computations that would take 20-30 years on a laptop takes the Oak Ridge supercomputer a few seconds to do.”

This is an especially exciting time for Glauser’s research. “We expect by this March or April to start generating computer models that can say whether a particular child is on a good or worrisome trajectory for their mental health,” he says.

Glauser compared it to a growth curve that pediatricians often use to determine how fast or slow a child is growing. “Similarly, we will be able to predict if they are crossing lines on the anxiety curve. All of a sudden, we can identify anxiety before it becomes apparent, before it becomes detrimental, before it causes irreversible problems in a child’s life.”

Jacob Glauser, age 23

“He still is my inspiration, and he still inspires me to take everything that I’ve been given, all the privileges and benefits, to help other families. He’s also a pretty cool guy.”

Glauser calls it real progress that could lead to transformational change in the treatment of children with mental illness. “When we finish this modeling, when we learn how to use it properly in pediatricians’ offices, in schools and in healthcare facilities, we will be able to identify children at risk for anxiety, depression, ADHD, autism, or suicide at the earliest possible moment. It would be transformational to see that no child dies by suicide, no child fails in school because of ADHD, and that we’ve identified autism early enough that we can try to reverse it. Think about if we can actually live to see that happen in our lifetime, how inspiring that would be.”

The promise of this research may not have come in time for Jacob, who has spent years in and out of mental health and behavioral facilities, including Cincinnati Children’s College Hill location, but that has only fueled Glauser’s resolve.

“I am driven to help families not have to go through what my son went through because we know that early detection and intervention can give the best outcomes. The earlier we can predict who is at risk for anxiety, depression and suicidal thoughts, the more likely we are to help them. I know what it’s like as a parent to have to wade through the healthcare system and not get answers until it was later than I would have liked or it was too late.”

Glauser is often overcome with emotion when speaking about his son, who is now 23 years old.

“He was the first kid we tested in the Genetic Pharmacology Service,” he says. “I tell him the service he helped developed, after 20 years, has helped over 2 million people with psychiatric diseases around the country.”

Glauser says Jacob is still challenged but doing okay.

“He still is my inspiration, and he still inspires me to take everything that I’ve been given, all the privileges and benefits, to help other families,” he explains. “He’s also a pretty cool guy.”

How does he reconcile his work as researcher—changing other’s lives through discoveries in mental health with the inability to help the patient he loves the most?

“It’s been humbling,” he says. “We are trained to be doctors and heal people. I always try to give people hope that we will not give up the good fight, that we will work with them and do everything we can to help them and give them the best life possible. So, although dealing with my son and his challenges has been a struggle for me, it’s made me a better doctor. In the end, what makes him happy makes me happy.”

The Future of Mental Healthcare

As part of his Performance Leadership Team (PLT) responsibilities, Glauser worked with the Convalescent Hospital Fund for Children to secure a $36 million dollar donation to help support the College Hill expansion project—$30 million to build a new facility and $6 million to develop transformational mental health programs. Work is underway on the project, which is expected to be complete in late 2023.

With an estimated one in five people suffering with mental health issues, the College Hill expansion project couldn’t have come at a better time. Glauser describes the state of mental health as “a crisis beyond anything except the pandemic. There’s a lot of anxiety, depression, and suicidal ideation. We have unusually high census at College Hill, and it’s been exacerbated by COVID.” Glauser points to his experience with his son Jacob as an example of why College Hill needs to be redone.

“I couldn’t stay with him when he was being treated there,” he says. “There wasn’t room. We had to leave him overnight.”

While the challenges that surround mental health are some of the biggest in the medical field, Glauser remains hopeful.

“I wake up every day excited about the opportunities that Cincinnati Children’s offers to kids. With the College Hill expansion, we’re investing in making a better life for kids who are suffering from acute mental illness. In the community, we are embedding psychologists in pediatrician offices. On the research side, we’re working to identify high-risk kids sooner so we can help them before significant harm happens. There are early warning signs. These are not conditions that happen overnight; they build over time. If you could predict when someone is going to become suicidal or severely depressed two years before it happens, you’d have all that time to help them—that’s the work we’re doing.

“I hope to take all those years of training, all those years of investment from Cincinnati Children’s, all the science that we do here in partnership with other members of the team and leave the next generation of Cincinnati kids better than before.”

There is no question, Glauser is helping change the outcome for kids with mental illness for generations to come. Through it all, he remains grateful and humble, realizing he is but one player on the team at Cincinnati Children’s.

“You can have a star pitcher, but if there’s not a catcher, first baseman or an umpire, you don’t have much of a game,” he says. “We’re all a part of a team. We work together, and we win together.”

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