Street psychiatrists engage in homeless outreach as part of innovative program in LA County

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Wednesday, December 28, 2022
Street psychiatrists engage in homeless outreach in LA County
Street psychiatrists are engaging in homeless outreach in Los Angeles County as part of an innovative program.

LOS ANGELES (KABC) -- Mental illness is a major factor in chronic homelessness. But asking someone struggling with sanity to find transportation to an in-person office appointment -- while navigating the red tape of health services -- isn't always effective.

So Los Angeles County is sending psychiatrists to the streets.

"When it comes to someone who's living on the streets, if you don't know the realities of their living conditions it's hard for you to make clinical decisions," Dr. Shayan Rab said in an interview.

Rab is a street psychiatrist with the LA County Department of Mental health. Street psychiatry is a small but emerging specialty in the field of mental health.

"Street psychiatry is different from traditional psychiatry because I'm not going up and saying 'how are your meds' I'm saying 'how are you getting your food?'" Rab told ABC7.

Rab, four other psychiatrists and two nurses work with the county's Homeless Outreach and Mobile Engagement team. They treat clients where the find them -- surrounded by noise and filth but able to build relationships with a client who becomes more willing to accept medication to improve physical health, which is often an obstacle to their mental health.

"I genuinely believe we're out here saving lives," said Aubree Lovelace, an L.A. County mental health program manager. "I think we're seeing people who, without support and intervention, are dying. So I think that it's a great success."

There are nearly 40,000 people living on the street in Los Angeles.

Psychiatry in the streets is not generally the first interaction with a person who is homeless -- outreach teams create that initial contact, and once it is determined that the person needs mental help, Rab and his team are called in.

"If someone is unprepared or not sufficiently ready to be housed and you put them in that level of care, you could be doing more harm than good," Rab said.

Outreach and treatment lay the foundation for interim housing, where patients like a woman named Diana can begin the difficult process of stabilizing her mental health to prepare her for more permanent housing.

Even with difficult work still ahead, she is an example of the value of taking mental health care to the streets.

"It's very rewarding," Rab said. "There's a lot of roadblocks, but when we get that transformation it really keeps us going."