Clarivate Analytics’ Highly Cited Researchers List is an annual report of individuals who demonstrate a significant and broad influence in their field or fields of research.
This week, we talked to Katherine Koh, MD, a practicing psychiatrist at Mass General Hospital and a member of the Street Team at the Boston Health Care for the Homeless Program.
Dr. Koh is part of the Boston Health Care for the Homeless Street Team, which provides face-to-face medical care for individuals who are homeless and sleep on the street. This group is known as Boston’s “rough sleepers,” and they commonly face conditions such as extreme weather, violence, and trauma.
What is the biggest barrier right now to homeless individuals receiving the necessary mental health care services they need?
I would say the lack of proactive outreach models to reach this population. So many people experiencing homelessness have had unimaginable trauma in their early life, which understandably leads them to have difficulty trusting healthcare professionals. In addition, many have had prior negative experiences with the healthcare system.
Also, some have difficulty with insight, or understanding the mental health symptoms they experience, and therefore prioritize other needs over their mental health. As a result, people often do not seek care on their own from more traditional clinical settings.
It is therefore critical that we design and implement more proactive outreach models such as street outreach or clinics embedded in places like homeless shelters, to bring care to people who may not be receiving it otherwise.
In your recent paper, you mention three aspects to creating a better mental health care system for homeless individuals, can you briefly describe those?
I think the three pillars of an ideal mental health system for homeless individuals include preventive, community, and facility-based services.
Prevention is critical as so often the focus is on housing those who are already homeless, but in order to truly nip this major crisis in the bud we have to start further upstream and focus on reducing the factors that lead people to become homeless in the first place, including lack of affordable housing, cost and capacity barriers to mental health care, racial inequities, and adverse childhood experiences.
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