Familiar Faces - Providing Integrated Medical and Social Services to a Vulnerable Population

Claudia S.P. Fernandez

A chapter in From Clinical Practice to Public Health Applications - The Successful, Sustainable and Scalable Outcomes of the Clinical Scholars Program from IntechOpen

Abstract: Because existing safety-net systems often lack integrated services to meet the complex needs of vulnerable individuals, these individuals have frequent interactions with various crisis systems, becoming familiar faces. Their unmet medical and mental health needs and the current system's misallocation of resources create our Wicked Problem. We formed a team of local government, community hospitals, health systems, and community stakeholders to identify the barriers to and gaps in service that prevent the effective interaction of vulnerable community members with frontline service providers. We initiated several pilot projects to reduce and eliminate the barriers, creating immediate and long-term solutions to break the vicious cycle of fragmented treatment of complex needs. A key aspect is the creation of care navigators to facilitate the integration of treatment with the provision of social determinants of health. With community support, this strategy can be expanded to cover the entire population of vulnerable individuals in our community.

Keywords: mental health; social determinants of health; mental illness; crisis systems; vulnerable individuals; homelessness; Clinical Scholars (search for similar items in EconPapers)
JEL-codes: I11 (search for similar items in EconPapers)
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Persistent link: https://EconPapers.repec.org/RePEc:ito:pchaps:330925

DOI: 10.5772/intechopen.115586

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