Promoting Health Equity Through Voter Support Activities for the Inpatient Psychiatric Population.

Individuals with mental illness often face barriers to voting. One of the primary barriers is not being registered to vote. This paper describes voter support activities (VSAs) provided to hospitalized adults on the acute inpatient psychiatric units at Pennsylvania Psychiatric Institute. During the six weeks preceding the 2020 general election, adult inpatients were offered six VSAs and an optional survey examining previous voting behaviors and barriers encountered to voting. VSAs included checking voter registration status and polling location, completing a paper or electronic voter registration application, and requesting a mail-in ballot. Of 189 patients approached, 119 individuals participated in the survey and 60 individuals utilized at least one VSA. This project demonstrates that VSAs are a welcome and feasible resource for psychiatrically hospitalized adults. Psychiatric providers can serve an important role in promoting access to voting-related activities for their patients.

Preparing for the future of medical education: A case series of traditional and virtual clinical rotations in addiction medicine spanning the COVID pandemic.

Background: Substance use accounts for more than 400,000 deaths annually in the United States and overdose rates surged during the COVID pandemic. While the pandemic created increased pressure for better prepared providers, it simultaneously placed restrictions on medical training programs. The purpose of this educational case series is to assess the feasibility of a virtual addiction medicine training program and conduct a qualitative evaluation of medical student attitudes toward caring for people with substance use disorders, both before and after their addiction medicine training experience. Methods: We conducted a qualitative analysis related to course content focused on strengths and limitations of in-person and virtual training modalities. Individual quotes were evaluated and content themes were developed after a thorough review of all codes and detailed examination of interviewee quotes. Results: The primary themes that emerged were (1) Addiction medicine content is important to improve care of patients with substance disorders and is not fully addressed in undergraduate medical education (2) In-person and virtual training contain unique strengths and weaknesses and (3) Students perceived that both experiences provided positive and needed training in addiction medicine that shifted perspective and enhanced confidence to practice. Conclusions: Remote training via virtual lectures and patient visits may enhance training opportunities for students with limited exposure to addiction medicine patients and faculty with addiction medicine expertise. There is a need to further refine virtual care for patients with SUDs and virtual training to meet the needs of patients and learners across the country.

Psychiatry's Obligation to Promote Voting Among Patients With Mental Illness.

The American Medical Association adopted a resolution in June 2022 recognizing voting as a social determinant of health. As psychiatric professionals and trainees with experience in civic health, the authors argue that psychiatrists must consider the relationship between voting and mental health as part of care delivery. People with psychiatric illness can experience unique barriers to voting and garner mental health benefits from civic engagement. Provider-led activities to promote voting are accessible and simple. Given the benefits of voting, and the availability of interventions to foster voter engagement, psychiatrists have an obligation to promote voting access among their patients.

Organizing Chaos: Iterative Professional Identity Formation Through the Lens of Mask Making.

INTRODUCTION: Professional identity formation (PIF) is a sociocultural process through which medical students adopt the professional role of physician. This process is often unscripted and influenced by informal curricular elements. PIF is as important as the acquisition of knowledge and clinical skill in the continuum of medical education. METHODS: Using the ancient art of mask making, we created a process of reflective expression to explicitly examine and formally promote PIF. Students created individual masks to express elements of self in the context of their medical education experiences. Coupled with a narrative reflection describing the mask and the process of mask making, students were challenged to examine and give shape to their evolving sense of professional identity. Using a retrospective pre/post design, we used the mask-making process to examine identity across 4 years of medical school in a cohort of graduating students. RESULTS: The masks and accompanying narratives showed themes of moving from anxiety and uncertainty at matriculation to a more calm and focused state at the time of graduation. Other themes included the ability to organize complex material and the accumulation of a broad fund of knowledge. Students found the mask-making experience to be introspective and enjoyable. DISCUSSION: Mask making is both a product (mask) and process (creation). As such, mask making is an innovative strategy to examine PIF within individuals and across time. Organization, focus, and self-understanding were common themes of professional growth.

Understanding Perceived Barriers to Care Among Suburban Super-Utilizers Who Have an Identified Primary Care Provider.

Patients who are admitted to the hospital frequently (>3 admissions in a 6-month period) are a large driver of health care costs. Recently, research has focused on these groups of super-utilizing patients to try to find ways to meet their care needs in the outpatient setting. However, most research so far has focused on the urban underserved population who do not have a usual source of care. The goal of this study is to identify a group of patients from a suburban academic family medicine practice who have been admitted to the hospital frequently over a 6-month period and interview them to identify patient-perceived barriers to care in the outpatient setting. Nine of the 176 patients identified as frequently hospitalized were interviewed. Interpretive phenomenology analysis was used to identify perceived barriers and facilitators to care. Although some identified barriers were similar to those noted in groups of the urban underserved, including chronic disease and polypharmacy, other barriers were uniquely identified in the nonurban population, including transportation and support at home. Transportation issues, lack of support at home, and poor interdisciplinary communication were found to increase risk for readmission. Conversely, good interdisciplinary communication and ample support from family, including support services at home, were viewed as facilitators to outpatient care.