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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.
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 soonest 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’s 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.
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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 lived 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 to 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
O’Gurek, D. T., & Henke, C. (2018). A practical approach to screening for social determinants of health. Family practice management, 25(3), 7-12.
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.
