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Clinical decision-making process
Clinical decision-making process
Clinical decision-making process
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The decision to become a doctor was an easy one for me. I consider myself to be quite fortunate to do something that I thoroughly enjoy and have a chance to relieve suffering of fellow human beings. After graduation with First class Honor from one of the Top Medical Schools of Thailand, I could not see myself settle to follow the typical path for us, the Thai medical doctors. There are so much out there that I had not experienced. I decided to pursue more advance training in the United States. The requirement for the international medical graduate to fulfill this aspiration demanded a lot of time and commitment to prove that, despite our language barriers, our medical knowledge is either as good or better to compensate for the shortcoming we have as the foreign international graduates, whom English is not our first language. As my dream to enter the training system in the US became possible, I entered the national match for General Psychiatry Residency Program. Fortunately, I was accepted into General Psychiatry Residency training at University of Hawaii, where I met my lifelong teacher and mentor, Dr. Iqbal Ahmed who has been instrumental in providing the needed tools and supports for me to succeed in my career. My last year of my General Psychiatry training as …show more content…
To satisfy my Visa requirement, I spent 3 years providing outpatient psychiatric care to homeless patients, many of whom suffer chronic mental illness and substance abuse problems. That was my first opportunity to learn about how much Policy affecting the life of my patients and my ability to help them, whether they would have money to feed themselves, have a place to call their own, or get the helps and treatment they deserve. Fortunately back then, the resources available to them seem to be adequate as long as the patients were willing to do their parts, they would get the helps they
Kathleen’s book brings up many detailed facts about how homelessness is a never ending situation due to mental illness, poverty, social structure and political parties. She discusses how much of society groups Illegal immigrants, mentally ill, jobless and many other categories under the homeless category.
In my clinical experiences in Canada and the United States, I managed patients that had co-morbidities that with appropriate psychiatric care, and psychopharmacology, not only were able to improve physiologically, but also were able to have a more meaningful life. Because of my passion for Psychiatry I have consistently been involved with Psychiatry CMEs, attended Psychiatry conferences as well as had hands on clinical rotations in Adult Psychiatry, both inpatient and outpatient. I have started working with a reputable university in Canada as a Program assistant to help improve the professional life of internationally trained Medical Professionals.
Gulcur, Leyla, Padgett, Deborah K., and Tsemberis, Sam. (2006). “Housing First Services for People Who Are Homeless with Co-Occurring Serious Mental Illness and Substance Abuse.” Research on Social Work Practice, Vol 16 No. 1.
Tunstall, L. (2009). Homelessness: an overview. EBSCO Publishing Service Selection Page. Retrieved February 5, 2011, from http://web.ebscohost.com/pov/detail?hid=119&sid=d5f751fa-0d0d-4ed1-8deb-483e701af50c%40sessionmgr111&vid=3&bdata=Jmxhbmc9ZW4tY2Emc2l0ZT1wb3YtY2Fu#db=p3h&AN=28674966
The homeless- found on city park benches, street corners, and subway grates. Where did all of these people come from? One third, to one half of the homeless suffer from a mental illness. A lot is said about the homeless-mentally ill, but what their plight says about us may be more significant. We still have not found a place for those who are both poor and insane. Once there was a place for them; the asylum fulfilled the basic needs of thousands for decades, but now these institutions lay empty and in ruin. Has the hope to heal the mentally ill also been abandoned? Is there once again a need for the asylum? The disbandment of the asylum was the first step in ending segregation for those with mental illness, but we have yet to accomplish integration.
1. Please briefly share the influences on your decision to pursue the field of medicine, including shadowing experiences and other medical related activities.
It is nearly impossible to walk between any two points in New Haven without being affected in some small way by our city’s homeless problem. On seeing these people, in many cases, it becomes clear that they suffer from some mental disability that, unaided, will obviously impede their living a normal life. In fact, according to the Report of the Federal Task Force on Homelessness and Severe Mental Illness, one in every three homeless people suffers from a severe mental illness, most of which are treatable. In a country that devotes so many resources to various welfare programs for nearly every group, how can this problem persist? The answer to this question lies in a major national policy shift, deinstitutionalization, which occurred progressively between 1960 and 1980. Though deinstitutionalization addressed a necessary problem, in practice, it only worsens the problems facing the mentally disabled and society at large. What prevailing social ideas and changes brought an end to our nation’s established system of state psychiatric hospitals? What is the logic behind our new and inefficient system of community centered outpatient mental health?
Despite the variety of health care options offed to the public, most homeless people find that their medical needs are not even being acknowledged. There are many programs that are categorized as healthcare programs, which include things as broad as having a regular primary care giver to things as specific as dental needs or being able to get help from a specialist if needed. Whether or not medical needs are being met is qualified by what defines a “need”. In a study of the homeless population in the New England region, participants were asked “Have you needed to see a doctor or a nurse in the past 12 months but were not able?” (Hwang, Stephen, Ueng, Joanna, Chiu, Shirley &ump; Tolomiczenko, George, 2010, p.1455). If the people in th...
...icates that 95% of projects are catering for people with mental health needs and further research by Homeless Link shows that 7 out of 10 of homeless people experience one or more mental health problems. Their recent research findings on the mental health needs of homeless clients indicate that 44% of those with a mental health problem said they self medicate with drugs or alcohol; 35% of those with a mental health need said that they would like more support – including talking therapies and services for dual diagnosis; 60% of people in homelessness services have been found to be affected by complex trauma;14% of clients stated that they self-harm, compared with 4% of the population; one fifth of clients who had recently attended A&E had done so because of either mental health or self-harm; and only 10% of clients have additional support from mental health services.
Zlotnick, C., Zerger, S., & Wolfe, P. B. (2013). Health care for the homeless: What we have learned in the past 30 years and what's next. American Journal of Public Health, 103(2), 199-205.
Having a normal life requires having a guaranteed home to live in. Yet homeless people with no home and unable to afford any living factors struggle throughout their life. The way we live our daily life can have a big impact on our health. Everyone around us needs to be able to have most of the healthy life factors, such as clean food, clean water, income, housing and health resources to depend on. For instance, in Canada, the discrepancy in health care quality has stymie
Another major problem that has to do with mental health and homelessness is that fact that many either do not know they are sick or deny the fact that they have a sickness. If a person does not know they are sick or neglects their sickness their disease becomes worse and no treatment can be provided to them. Without treatment, these individuals living on the street become more of a treat to regular civilians because mentally unstable people are more likely to be violent without being
One third to one half of homeless adults in the United States have a mental illness. The mentally ill become homeless in many ways. It is sometimes difficult for them to deal with landlord tenant situations because there is not an adequate case management system. The mentally ill may also become homeless because of the desire to become dependent and not ready to be sheltered, some may also like the freedom of alcohol and/or drugs on the
There are multiple barriers which can affect a homeless person’s access to health care. Structural barriers lead to health inequalities in the homeless and create challenges for the homeless in accessing health care services. There are various structural barriers which can restrict access to health care services for the homeless, through the health care service itself or as a consequence of being homeless (John & Law, 2011; McNeil, Guirguis-Younger, Dilley, Turnbull & Hwang, 2013). Structural barriers which can be caused by the health care service include inflexibility of primary health care organisations and appointment times (John & Law, 2011; Rinehart & Borninkhof, 2012), geographical factors such as the location of the health care services (Bungay, 2013; Rinehart & Borninkhof, 2012), health care services lack of resources to manage the complex health care needs of the homeless (Moore, Manias, Gerdtz, 2011), restricted opening hours and lack of after-hours services (Hauff & Secor-Turner, 2014; Moore et al., 2011), shortage of bulk-billing general practitioners, fees that the health care service may charge and general practitioner health care services may be at full capacity and not taking on any new clients (Rinehart & Borninkhof, 2012). Health care service policies can also be a structural barrier for homeless people as there are admission criteria and protocols which the service has to follow (Moore et al., 2011).
Many homeless people do not have access to healthcare and they go many years without seeing a doctor. According to Fitzpatrick, “there is a clear and defined need for healthcare for homeless people and their families.” She is right, it todays society homelessness is just ignored by many people and has became a serious problem. Most of society does not know about the organizations that help the homeless. For example, Fitapatrick believes in a organization called The Opening Doors Project it is a group of nurses and other health professionals that look at substance abuse within the homeless community. Due to not seeing a doctor and the common knowledge of homeless people abusing drugs and alcohol, “homeless people can have complex and multiple health problems” (Who quoted it). Not everyone agrees with Fitzpatrick, “I am convinced that handouts are basically wrongheaded,” says Sherman. She believes giving anything to the homeless will not help change the homeless persons situation (Sherman). Sherman's advice does not make sence, ignoring the problem will not help either and without proper medical care there is no way to improve homeless health which will cause many people to die a unessary death. According to Hopper, “generative forces behind widespread homelessness runs deep and their correction will req...