Educate psychiatric trainees on the social determinants of health

Some psychiatric care teams have had no choice but to better research and address the social determinants of health that impact their patients’ communities, whether due to factors within the boundaries from the doctor’s office or far beyond their walls.

The benefit of implementing such considerations with mental health care is substantial enough that some directors want the social determinants of mental health to be part of the curriculum for psychiatry residents.

In an interview with HCP Live at the 2022 annual meeting of the American Psychiatric Association (APA) in New Orleans last week, Ana R. Ozdoba, MD, director of the department of residency training in psychiatry and behavioral sciences at the Albert Einstein College of Medicine and Montefiore, explained why applying the social determinants of health in psychiatric assessment and care is not common practice, but why it is an important opportunity for residency training programs.

Ozdoba pointed to available evidence showing the impact of social factors on individuals’ mental health, acknowledging that some may not identify it as a necessity amid rising rates of new patients.

“The main obstacles to teaching about the social determinants of health are that sometimes our situations are not on the same page to have these important discussions – the assessment of education, living conditions, difficulties transportation is limited in some institutions,” Ozdoba said. “We’re all pressed for time, we’re all seeing a lot of patients, and sometimes collecting the social determinants of health isn’t a priority.”

Ozdoba and his fellow psychiatry residency directors came together at APA 2022 to examine and share their own institutions’ strategies for educating trainees about the social determinants of health, the resources of which are endless. She noted that regional map information, interactive games, collaborations with local historical societies and other community representatives could be enough to better inform residents about the neighborhoods they cover.

Speaking specifically to her Montefiore team, Ozdoba highlighted the system’s partnership with the Office of Population Health, through which she and her colleagues can visit community centers and be better informed about the most coveted resources and requested by residents that may be their responsibility.

“If they don’t trust the mental health system, then we come to them,” she said. “Coming to faith communities, the resources they have helps us connect with the community in a different way, and it also teaches our residents and faculty to be patient advocates.

Even for teams like his that have prioritized the social determinants of mental health in their work, there are many more factors to address: issues of racism, discrimination and community safety are among the major burdens that ‘Ozdoba would like to see better treatment in it. work as a psychiatrist and educator in Montefiore.

“There are a lot of different structures that impact care that we’re always trying to understand, and that’s why we need to teach our residents to think about that as part of treatment,” she said.