Evaluating Integrated Care and Mental Health Resources in Student-Run Homeless Clinic

Background: People with major mental illness have life expectancies 10-20 years shorter than expected, but this is not necessarily due to suicide, accidents, or violence. Even patients with mental illness who die of natural causes are likely to die at a younger age than the general population. Untreated mental health or substance abuse disorders in primary care settings are associated with treatment nonresponse, higher complication rates, and increased healthcare use. Integrated care is defined as co-located multi-disciplinary approach to care addressing both physical and mental symptoms in an outpatient setting. With this in mind we evaluated TCOM's homeless clinic resources in order to improve patient care by integrating mental health education and screening into the student-run clinic. Case Information: The clinic provides health screening services for the patrons of TrueWorth shelter. Most clinic volunteers are preclinical TCOM or PA students who reflect the Reporter of the RIME model of medical education (Reporter, Interpreter, Manager, Educator). Thus, mental health interventions must reflect the services offered and abilities of the students. Students equipped with mental health tools, such as PHQ9, screen patients and provide them printed lists of local mental health resources. Conclusions: Homeless populations experience higher rates of mental health conditions and substance abuse. These often contribute to homelessness or joblessness; and likewise homelessness can contribute to mental health conditions. If such conditions are identified and treated, patients can break the cycle. Providing students with the proper framework enables referrals to local resources and better patient care.