Discussion – Social Determinants of Health

Unit 10 Discussion – Social Determinants of Health

By the first month of enrolling in this course, we covered several tools/ instruments for assessing both non-clinical of our clients to provide the needed psychosocial assistance. According to Sola & Marquez (2020), the tools include but are not limited to Protocol for Responding to and Assessing Patients Assets, Risks, and Experiences (PREPARE), Health-Related Social Needs(HRSN), and the American Academy of Family Physicians Social Needs Screening (AAFP-SNST). For this discussion, I selected the AAFP-SNST, a simple yet effective tool that looks at social determinants of food, housing, finances, personal safety, education, employment, child care, and transportation. (Discussion – Social Determinants of Health)

At the same time, I opted to focus on J.D., a 23-year-old female patient with a history of bipolar and substance abuse. The patient was sober and had a relapse of smoking cannabis after relocating to a different state in a hurry. She reports she could not organize how to have her Medicaid transferred to reflect the new provider for her therapy and MAT. She also expressed a desire to have the two resumed as soon as possible. She was meant to be recruited and work for a friend’s hotel, and the friend had promised to accommodate her but failed to keep the promise, leaving J.D. without a home and a steady source of income. The AAFP-SNST was able to resolve J.D.’s social needs.

Pertinent to my recommended treatment plan, I arranged for a social worker to consult and help her with the Medicaid issue locate a provider to offer her the needed care(O’Gurek & Henke,2018). In this patient scenario, the outpatient department of the acute care facility I am working in can handle these needs. Regarding transport, the patient agreed to shelter in a park neighborhood within walking distance to the clinical facility, where follow-up will be easy. The patient is eager to resume therapy and take a prescription, saying she has had the longest time being sober. Without a source of income and a new state, JD is a candidate for food insecurity, leading to other mental issues like depression, anxiety, and stress. She admits that while food may be available, her choices are limited. (Discussion – Social Determinants of Health)

This underpins the importance of having a source of income.  The next social determinant of health that needs to be addressed is the issue of shelter. She contends that she would rather she live in the streets. Narendof (2017) notes that homelessness and increased mental health issues are co-related hence should be addressed as a matter of priority. Besides food insecurity and homelessness, poverty is the third element that proves to be an intractable problem for this patient (Chung et al., 2016). Securing her some form of employment would help her support herself, remain sober and adhere to her medications.

References

Chung, E. K., Siegel, B. S., Garg, A., Conroy, K., Gross, R. S., Long, D. A., … & Fierman, A. H. (2016). Screening for social determinants of health among children and families living in poverty: a guide for clinicians. Current problems in pediatric and adolescent health care, 46(5), 135-153.

Narendorf, S. (2017). A mixed-methods study of young adults who accessed psychiatric emergency services. Children and Youth Services Review, 81, 54–62 (Discussion – Social Determinants of Health)

O’Gurek, D. T., & Henke, C. (2018). A practical approach to screening for social determinants of health. Family Practice Management, 25(3), 7-12. (Discussion – Social Determinants of Health)

Solá, O., & Marquez, C. (2020). Integrating Social Determinants of Health Into Clinical Training During the COVID-19 Pandemic. PRiMER: Peer-Review Reports in Medical Education Research, 4.

All Solved Essays

Unit 4 Discussion Discussion – Social Determinants of Health

Initial Response on Discussion – Social Determinants of Health

Social determinants of health refer to conditions in which individuals are born, grow, live and age, where the multilevel distribution of resources, money, and power shapes these determinants. The conditions include but are not limited to children’s access to quality education, employment for grownups, and wealth distribution that significantly impact an individual’s opportunity within their respective society. Healthcare experts with a specific bias towards mental health providers acknowledge that understanding these conditions as they impact health places the responsibility of mental health and mental health equity on a wide range of stakeholders, not just healthcare practitioners but also political leadership, to policymakers and governance experts (Andermann et al., 2016). Therefore, this post proposes to determine three priority SDHs to assess the patient represented in the SOAP note on schizophrenia. The patient is a 37 -year -old female who was brought into the state psychiatric hospital by police with a chief complaint ‘You are all morons! I want to go home. (Discussion – Social Determinants of Health)

A review of the patient’s SOAP note led me to consider the patient’s homelessness, traumatic life experiences like the death of her son that triggered her depression exacerbated by divorce, and difficulties keeping a job as the three priority SDH. Psychiatric mental health providers opine that social factors impact the risk for mental illnesses and substance abuse disorders besides the health outcomes of individuals with these disorders. Suffice it to say that the patient’s homelessness significantly affected her social isolation (Ayano, 2019). This isolation further denies the patient the required social support to cope and manage her schizophrenic symptoms.  At an individual level, the patient has also had traumatic life events like her son’s death, which triggered her depression (Kleber, 2019). Divorce from her marriage only served to make a bad situation worse, while her family history demonstrates that the one person she could have depended on was her mother, who was diagnosed with schizophrenia at 36. The third and last of the three priority SDHs selected for this patient is income inequality resulting from her inability to keep employment in the primary care setting where she has worked as a nurse.

As stipulated in the plan, identifying priority SDH is instrumental in formulating a care plan to resolve the challenges they create for identified patients.  Effective addressing these challenges requires individual intervention, some of which is delivered within a clinical setting (Daniel et al., 2018). The provider should also adopt a bigger picture approach and advocate for policy change on homelessness at the societal level intervention. Relevant clinical-level interventions are also needed.

In conclusion, this post acknowledges the need to address the conceptualization of the SDH of mental health as mental health providers seek to dissect the forces that drive social, environmental, and behavioural risk factors leading to poor health at the mental and physical levels. (Discussion – Social Determinants of Health)

References

Ayano, G., Tesfaw, G., & Shumet, S. (2019). The prevalence of schizophrenia and other psychotic disorders among homeless people: a systematic review and meta-analysis. BMC psychiatry, 19(1), 1-14.

Andermann, A. (2016). Taking action on the social determinants of health in clinical practice: a framework for health professionals. Cmaj, 188(17-18), E474-E483. (Discussion – Social Determinants of Health)

 Daniel, H., Bornstein, S. S., & Kane, G. C. (2018). Addressing social determinants to improve patient care and promote health equity: an American College of Physicians position paper. Annals of Internal Medicine, 168(8), 577-578.

 Kleber, R. J. (2019). Trauma and public mental health: A focused review. Frontiers in psychiatry, 10, 451.