Description 

Mental health service providers in safety-net settings provide care to the most vulnerable psychiatric populations. They intersect with multiple systems to support patients and address the social and structural determinants that lead to increased mental healthcare needs. For patients with substance use disorders (SUDs), significant structural, organizational, and individual barriers can lead to fragmentation of mental health and substance use treatment and perpetuates health inequities. Thus, there is an importance of tailored, innovative and collaborative interventions for substance use screening and treatment services, and increased accessibility of resources and workforce diversity, to facilitate a more equitable future in mental health. In this session, fellows from the UCSF Public Psychiatry Fellowship (PPF) at Zuckerberg San Francisco General Hospital will demonstrate how understanding system interfaces and partnering with a variety of stakeholders can improve health equity and advance mental health services in safety-net settings. The session will begin with a brief overview of public psychiatry and introduction to the UCSF PPF. Next, we will present the quality improvement projects each fellow has conducted at their clinic and discuss how understanding systems and funding models plays an integral role in promoting health equity. The specific initiatives included a qualitative exploration of the interpersonal and structural drivers of SUDs at a community-based case management program that has experienced high rates of overdose deaths; examining multisystem barriers to diagnosing SUDs, Medication Assisted Treatment (MAT) initiation and facilitating treatment services referrals for patients at community mental health clinics in two different counties; and exploring challenges to advancing healthcare workforce diversity in public and academic healthcare settings. System interfaces include county behavioral health clinics, intensive case management programs, substance use disorder treatment, crisis and emergency services and a psychiatry residency training program. In discussing the quality improvement projects, we will describe how the UCSF PPF is able to uniquely engage leaders, community and academic partners, and people with lived experience in this work—modeling a true public-academic partnership. Then, participants will break into small groups to discuss challenges in their own clinical settings, reflect on the role of system interfaces in their identified problems and brainstorm ways they can engage key stakeholders to identify potential quality improvements. Finally, we will end the session with a reflection and takeaway message about how the diversity of patient populations requires partnership between health care services, other systems and communities, and the need for providers to think about systemic issues in their role in addressing social and mental health inequities.

Format 

Recorded webinar.

This content was recorded during the APA 2023 Annual Meeting.

Learning Objectives 

1. Understand how public-academic partnerships can provide infrastructure to implement evidence-based practices in safety-net settings.
2. Demonstrate how public psychiatrists are uniquely positioned to address mental health inequities.
3. Illustrate how equity-focused and targeted interventions can improve mental health outcomes for patients with substance use disorders. 
4. Examine the role of workforce diversity in addressing health inequities facing racialized minority populations.
5. Explore practices on how to leverage clinic resources through feasible, small-scale quality improvement projects.

Target Audience 

Residents/Fellows, Psychiatrists, Psychologists

Estimate Time to Complete 

Estimated Duration: 1.25 hours
Program Start Date: May 1, 2025
Program End Date: May 1, 2028

How to Earn Credit 

Participants who wish to earn AMA PRA Category 1 Credit™ may do so after completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned. 

Continuing Education Credit  

In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

The APA designates this live activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Faculty and Planner Disclosures 

The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity. 

Instructors 

• Lucy Ogbu-Nwobodo, MD, MS, MAS
• Samuel Saenz, MD
• Harminder Gill, MD, PhD
• Paul Wallace, MD

Planners  

• Vishal Madaan, MD, Chief of Education and Deputy Medical Director at the American Psychiatric Association.

Accessibility for Participants with Disabilities 

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. Please contact the American Psychiatric Association at 202-559-3900, if you require assistance seven (7) business days prior to the start of a live webinar. 

Technical Requirements 

This internet-based CME activity is best experienced using any of the following: 

• The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari 
• Internet Explorer 11+ 

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player. 

Optimal System Configuration: 

• Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version) 
• Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version) 
• Internet Connection: 1 Mbps or higher 

Minimum Requirements: 

• Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content 
• Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content 

For assistance: Contact educme@psych.org for questions about this activity | Contact learningcenter@psych.org for technical assistance