Teaching Residents How to Screen for Social Determinants of Mental Health/Practical Training For Residents-View Presentation

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Dr. Danielle Dayon-Harriston and Dr. Paul Rosenfeld, experts in psychiatric education, discuss integrating social determinants of mental health (SDMH) into psychiatry training and curricula. They emphasize understanding systemic factors—beyond individual patient care—that influence mental health disparities, linking structural racism and public policies to outcomes. Both highlight holistic residency recruitment focusing on applicants' dedication to culture, diversity, and underserved populations, facilitating engagement with SDMH education.<br /><br />They describe successful curricula from Howard University, Yale, and UCLA that combine didactics, experiential learning, community engagement, advocacy, and tools like Metzl and Hansen’s structural competency framework. Examples include community field trips, social determinants case conferences, and interactive exercises like the ACEs game to teach adverse childhood experiences and resilience factors.<br /><br />Screening tools discussed include ACEs questionnaires, expanded versions considering community-level adversities, and structured interviews assessing factors like food security and discrimination. Importantly, they stress going beyond screening to actionable steps, such as linking patients to resources, peer support, transportation, and community partnerships, and advocating for policy change.<br /><br />Addressing contemporary challenges, they note constraints posed by political resistance to diversity, equity, and inclusion (DEI) efforts but affirm that these topics remain essential evidence-based medicine. They advocate creativity and leadership in sustaining these educational efforts amid evolving policies.<br /><br />They also highlight the promise and caution in AI applications in mental health, calling for clinician involvement to prevent bias. Finally, they underscore the importance of institutional support, faculty development, and evaluation of training efficacy, aiming to empower psychiatry residents to improve mental health equity through systemic understanding, clinical practice, advocacy, and community collaboration.

Keywords

social determinants of mental health

psychiatry training

mental health disparities

structural racism

holistic residency recruitment

structural competency framework

adverse childhood experiences

screening tools

diversity equity inclusion

AI in mental health