In my first week of rotations, I was assigned to work in our inpatient psychiatry unit in San Francisco. The unit works with a huge population of homeless patients. It’s interesting that the many homeless individuals are diagnosed with a mental illness, as well as substance use disorder. In listening to patients and speaking to the medical team, there are so many factors–biological, psychological, social–that contribute to what feels like a never-ending challenge.
One of the biggest challenges this presents is in helping patients be successful after treatment. Inpatient psych is an acute facility, meaning the goal is to get patients stable enough so that they are not a danger to self or others, and that they are capable of taking care of themselves (or have someone take care of them). But what if a patient is homeless, and they don’t have the resources to take care of themselves? What if they can’t afford to take the appropriate medications? What if their living situation actually is dangerous, and may affect their mental illness?
That’s why on our team we have a psychologist, nurses, physician, med students, and social worker. If it’s the physician who is in charge of medical management, it’s the social worker who is in charge of medical reinforcement. They are the ones who really get to know the community, understand the resources available, and helps connect the patient to these resources. I’ve been so impressed with our social worker.
It really does take a village, because these resources are constantly changing, and I’m truly impressed with the whole team.