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L.A.’s ‘Street Psychiatry’ Team Could Transform Homeless Work in the U.S.

L.A.’s ‘Street Psychiatry’ Team Could Transform Homeless Work in the U.S.

In Los Angeles, Dr. Shayan Rab of the Los Angeles County Department of Mental Health is pioneering a bold and innovative to psychiatry practice, taking his work out of the office and into the streets, offering on the ground mental health services to L.A.’s homeless community.

Some are calling it “street psychiatry” and while it remains small (Rab leads a team of four psychiatrists and two psychiatric nurse practitioners), early results are promising. They’re part of the country’s Homeless Outreach and Mobile Engagement (HOME) program, which employs a fleet of outreach workers, social workers, nurses and substance abuse counselors as an alternative to sending police. The hope is that sending a team of trained mental health workers can accomplish what police aren’t equipped to handle by treating people’s actual needs where they’re at.

The movement is growing, as more major cities like Atlanta and Boston start investing street psychiatry teams. “To target people who experience chronic homelessness, we must immerse ourselves into their lives and penetrate that bubble,” Atlanta-based social worker Franco Bejarano wrote for Social Worker Today. “We are not going to do that sitting behind a desk, inside an office, asking a person with mental illness to maneuver public transportation across town, requiring them to keep an appointment.”

Obviously, programs like this take time and resources to build. Street psychiatrists can’t just start walking around town. Instead, they take time to get to know not just the people, but also the homeless networks and communities that their patients live in. As far as a time investment goes, it’s quite a bit more labor intensive than a simple arrest, but it’s likely more just the impact could end up being far more transformative.

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