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Program for Residency Education, Community Engagement, and Peer Support Training (PRECEPT): Connecting Psychiatrists to Community Resources in Harlem, NYC

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Structural Competency in Mental Health and Medicine

Abstract

Inequalities in the diagnosis, treatment, and outcome of disabling serious mental illnesses (SMI) due to race, ethnicity, and socioeconomic status have been well established. SMI are associated with frequent use of emergency and inpatient services and with social conditions such as unstable housing and income and lack of supportive social networks. Such social conditions are rooted in race and class disparities and are predictive of poor mental health outcomes. Social services and community support systems are associated with better mental health outcomes; however, clinicians receive little training on how to strategically use these resources to address the social determinants of health that contribute to poor mental health outcomes. Psychiatry residents require additional training within the framework of structural competency to learn how to bridge clinical care with community resources and learn how to collaborate with mental health peers and community organizations. In this initiative, trainees will develop the tools to connect structural community factors to individual clinical outcomes and learn how clinicians can play a role in intervening on social conditions. This paradigm shift in psychiatric clinical training is essential for stemming professional burnout, better equipping trainees to enter the public mental health system, and empowering physicians to redesign the structures that shape mental health outcomes.

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References

  1. Office of the Surgeon General (US); Center for Mental Health Services (US); National Institute of Mental Health (US). Mental health: culture, race, and ethnicity: a supplement to mental health: a report of the surgeon general. Rockville: Substance Abuse and Mental Health Services Administration (US); 2001.

    Google Scholar 

  2. McGuire TG, Miranda J. Racial and ethnic disparities in mental health care: evidence and policy implications. Health Aff (Project Hope). 2008;27(2):393–403. https://doi.org/10.1377/hlthaff.27.2.393.

    Article  Google Scholar 

  3. Safran M, Mays R, Huang L, McCuan R, Pham P, Fisher S, McDuffie K, Trachtenberg A. Mental health disparities. Am J Public Health. 2009;99(11):1962–6.

    Article  Google Scholar 

  4. Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiat. 2015;72(4):334–41.

    Article  Google Scholar 

  5. Benston EA. Housing programs for homeless individuals with mental illness: effects on housing and mental health outcomes. Psychiatr Serv. 2015;66(8):806–16.

    Article  Google Scholar 

  6. Palumbo C, Volpe U, Matanov A, Priebe S, Giacco D. Social networks of patients with psychosis: a systematic review. BMC Res Notes. 2015;8:560.

    Article  Google Scholar 

  7. Schnyder N, Panczak R, Groth N, Schultze-Lutter F. Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis. Br J Psychiatry. 2017;210(4):261–8.

    Article  Google Scholar 

  8. Aubry T, Nelson G, Tsemberis S. Housing first for people with severe mental illness who are homeless: a review of the research and findings from the at home-chez soi demonstration project. Can J Psychiatr. 2015;60(11):467–74.

    Article  Google Scholar 

  9. Latimer EA. Economic impacts of supported employment for persons with severe mental illness. Can J Psychiatr. 2001;46(6):496–505.

    Article  CAS  Google Scholar 

  10. Anderson K, Laxhman N, Priebe S. Can mental health interventions change social networks? A systematic review. BMC Psychiatry. 2015;15:297.

    Article  Google Scholar 

  11. Galanter M. The concept of spirituality in relation to addiction recovery and general psychiatry. Recent Dev Alcohol. 2008;18:125–40.

    Article  Google Scholar 

  12. New York State Department of Health. Program overview and background: doctors across New York, physician practice support and physician loan repayment programs cycle IV. 2016. https://www.health.ny.gov/professionals/doctors/graduate_medical_education/doctors_across_ny/background.htm

  13. Krupka C. Nearly half of physicians struggle with burnout. AMA News. September 3, 2012. http://www.amednews.com/article/20120903/profession/309039952/2/

  14. Dyrbye LN, Tait SD. Physician burnout: a potential threat to successful health care reform. JAMA. 2011;305(19):2009–10.

    Article  CAS  Google Scholar 

  15. Clancy G. Understanding deficiencies in leadership in advancing health equity: a case of pit bulls, public health, and pimps. Acad Med. 2015;90:418–20.

    Article  Google Scholar 

  16. Metzl JM, Hansen H. Structural competency: theorizing a new medical engagement with stigma and inequality. Soc Sci Med. 2014;103:126–33.

    Article  Google Scholar 

  17. Hansen H, Rohrbaugh R, Braslow J. Structural competency for psychiatry residents: a call to act on systemic discrimination and institutional racism. JAMA Psychiat. 2018;75(2):117–8.

    Article  Google Scholar 

  18. Hansen H, Metzl J. New medicine for US health reform: training physicians for structural interventions. Acad Med. 2017;92(3):279–81.

    Article  Google Scholar 

  19. Kleinman A, Benson P. Anthropology in the clinic: the problem of cultural competency and how to fix it. PLoS Med. 2006;3(10):e294.

    Article  Google Scholar 

  20. CDC. Social ecological model: a framework for prevention. March 25, 2015. http://www.cdc.gov/ViolencePrevention/overview/social-ecologicalmodel.html

  21. Davidson L, Bellamy C, Guy K, Miller R. Peer support among persons with severe mental illnesses: a review of evidence and experience. World Psychiatry. 2012;11:2.

    Article  Google Scholar 

  22. Repper C, Carter R. A review of the literature on peer support in mental health services. J Ment Health. 2011;20(4):392–411.

    Article  Google Scholar 

  23. Chinman M, George P, Dougherty R, Daniels A, Ghose S, Swift A, Delphin-Rittmon M. Peer support services for individuals with serious mental illnesses: assessing the evidence. Psychiatr Serv. 2014;65(4):429–41.

    Article  Google Scholar 

  24. New York City Department of Health. Parachute NYC: tracing the origins, development, and implementation of an innovative alternative to psychiatric crisis. White Paper December 18, 2015.

    Google Scholar 

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Author information

Authors and Affiliations

  1. New York University, New York City, NY, USA

    Selena Suhail-Sindhu & Helena Hansen

  2. Mount Sinai Medical Center, Miami Beach, FL, USA

    Parth Patel

  3. Center for Urban and Community Services, New York, NY, USA

    Judith Sugarman

Authors
  1. Selena Suhail-Sindhu
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  2. Parth Patel
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  3. Judith Sugarman
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  4. Helena Hansen
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Corresponding author

Correspondence to Helena Hansen .

Editor information

Editors and Affiliations

  1. New York University, New York, NY, USA

    Helena Hansen

  2. Center for Medicine, Health, and Society, Vanderbilt University, Nashville, TN, USA

    Jonathan M. Metzl

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Suhail-Sindhu, S., Patel, P., Sugarman, J., Hansen, H. (2019). Program for Residency Education, Community Engagement, and Peer Support Training (PRECEPT): Connecting Psychiatrists to Community Resources in Harlem, NYC. In: Hansen, H., Metzl, J. (eds) Structural Competency in Mental Health and Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-10525-9_11

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  • DOI: https://doi.org/10.1007/978-3-030-10525-9_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-10524-2

  • Online ISBN: 978-3-030-10525-9

  • eBook Packages: MedicineMedicine (R0)

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