Students and professionals from Arizona State University, University of Arizona, Northern Arizona University and other organizations gathered Saturday to discuss the benefits and challenges of interprofessional practice.
The inaugural conference was hosted at the Phoenix Biomedical Campus by Student Health Outreach for Wellness, an organization made up of representatives from all three universities working to develop a free, student-run health clinic for the homeless in downtown Phoenix. The conference was co-sponsored by ASU’s Barrett, the Honors College, The Macy Project and Scottsdale Healthcare.
The conference’s first session introduced a variety of health professions such as scribe, physical therapist, registered dietitian, and social worker. The second session gave an overview of Mountain Park Health Center while the third session discussed common issues health care providers run into when treating homeless individuals.
Representatives of each of the three state universities — ASU College of Nursing and Health Innovation Professor and Associate Vice Provost David Coon, NAU College of Health and Human Services Executive Dean Leslie Olmstead Schulz and U of A College of Medicine — Phoenix Professor Sarada Panchanathan — also spoke about the interprofessional health programs at their schools.
“Interprofessional teamwork is both a necessity and a luxury … it benefits the patients, and it can prevent future health problems,” said Panchanathan, who will serve as the medical director for the SHOW clinic.
ASU College of Nursing and Health Innovation Professor Kay Jarrell and ASU School of Social Work graduate student John Gallagher led the session on health care for the homeless. Jarrell and Gallagher both volunteer regularly with Health Care for the Homeless.
Gallagher said vulnerable populations such as the homeless often experience multiple risk factors. This leads to being affected by multiple conditions at the same time.
“HIV is never good. Mental illness — schizophrenia — is never good. Having schizophrenia and AIDS is not just additive,” he said. “There’s something synergistic that starts to happen.”
Health care providers need to utilize two frameworks in order to treat the homeless, Gallagher said. They need to understand problems that affect the demographic as a whole, but still work on an individual basis to treat unique situations. Although homeless people are often at a greater risk for many diseases than the rest of the population, that doesn’t mean everyone who is homeless is affected by those conditions.
“Please don’t confuse the characteristics of homelessness with the causes of homelessness,” Gallagher said. “I am a firm believer that substance abuse per se doesn’t cause homelessness, macro-socioeconomic factors generally cause homelessness. … Characteristics are not causality, and population-level descriptions are not how everyone’s gonna present.”
Jarrell said the homeless are often “sub-Maslow.” Referencing the psychologist Abraham Maslow’s Hierarchy of Needs, she said the immediate needs of the homeless are not being met.
Health care professionals might want to address higher-level issues causing a homeless individual’s addictive behavior, Jarrell said, but when the person doesn’t even have regular access to food, this approach is largely unhelpful. Moreover, lower-level needs that are not being met may contribute to the individual’s situation. If they don’t have somewhere to store medication, it can easily be lost or stolen.
“You have to be flexible,” Jarrell said. “Work with them to get them what they need.”
Another approach Jarrell and Gallagher discussed is harm reduction. Rather than trying to cure all of someone’s problems on day one, a professional using harm reduction would try to treat an aspect of their condition or prevent additional problems.
“It is an issue of changing the power dynamic of provider and client,” Gallagher said. “Whose life are we talking about at the end of the day? It’s not my life. I’m here to give input, to be a resource, but at the end of the day … we just need to remember that and not get stuck in those power struggles.”
The SHOW clinic, which is expected to open in spring 2014, will address some of those problems while giving students the opportunity to work directly with patients.
SHOW itself is an example of the interprofessional partnerships the conference wanted to highlight. After just a few months, the organization has more than 200 student and 30 faculty volunteers. Additionally, SHOW has community partnerships with Central Arizona Shelter Services, the Human Services Campus and the Maricopa County Department of Public Health.
Contact the reporter at kimberly.koerth@asu.edu
