Psych- what are my options for working with marginalized populations?

[questforstarfish]

I haven't been to medical school yet, but of course, being in the process of trying to get there, it's hard not to think about what area of medicine I'd like to work in. Up until now I was thinking of either family medicine or emerg. There are two areas of my life that I'm trying to plan for:

 

at home- I want to do something meaningful to me, and working with marginalized populations is most important to me. I love the idea of working with homeless populations, at-risk youth, substance abusers and the mentally ill. I volunteer with those populations and I've known since I was young that this is where my interest mainly lies.

 

away- I've also had a very keen interest in doing international aid work since being a young teenager. I would say this was the original reason I went into health care, and it's definitely become a passion of mine. Working with Doctors Without Borders has always been my dream.

 

 

After a lot of thought lately (and a lot of reading), I think I've decided that I want to do something that makes a more lasting impact in the lives of my patients. I want to contribute to lasting change, and try to do more for a positive future, and mental health seems to be the best way for me to do that- I know I absolutely want to work in medicine, but I want to do more than stitch someone up and send him on his way. Saving lives and helping people to survive long enough to make good decisions is obviously hugely important, but helping people to gain the tools they need to live a happier and healthier life is much more up my alley!

 

Anyway, the question I have, as I know very little about the field of psychiatry and am not sure how to properly search for what I'm looking for, is what kind of opportunities are there out there relating to what I'm interested in? Obviously mental illness is rampant in homeless populations and at-risk youth, but what options are there for psychiatrists to work with these groups? All I know of is the either psych ward at the hospital or your own practice (but with those prices, how can these groups access that kind of service?). Any insight or help would be hugely appreciated! It feels right thinking about going into this specialty, but I really have no idea what's out there.

[peachy]

There are lots of opportunities for working with marginalized populations in pretty much all areas of medicine. In psychiatry, you can't really avoid it, even if you want to! Our patients, especially if they have serious mental illness, have trouble maintaining relationships and jobs, which is a recipe for becoming a marginalized person.

 

As to what you can do, it really depends what you're interested in. There are unlimited options. I'm not sure where to even start listing because you can do anything that you want! There are patients in need of psychiatric care everywhere, you just show up and work, basically. An ACT team, an intensive case management service, or an inpatient ward would be common places to work with folks with severe psychotic illness. Shelters are often a place to work directly with people who are homeless, and they'll typically have docs come in for 1-2 days a week to see their clients. If you're interested in trauma or personality disorders, psychotherapy ranging from group programs in hospitals to individual private practice in the community would be some typical options.

 

I don't know what you mean when you talk about prices -- psychiatry, like other areas of medicine, is covered by provincial health insurance such as OHIP, so patients do not pay out of pocket.

[apache]

tons, private practice you can take on the ppl most people don't wanna c, inner city clinics sometimes have psychs, addictions is great too… private practice always gives you most flex though unless you get a job say with the provincial addictions agency where u r… my doc doesnt see schizophrenics period really, just the learning disabilities, plus the unpleasant patients everyone refers because they don't wanna deal with them

 

oh… ps, forensic impatient has some pretty often marginalized people, inpatient developmental disabilities, impatient geri's, acute intake

 

yeah impatient anything is blah… the only good inpatient psych job is consult laison in my opinion… you get to remember your medicine too , and help people who have tons of other stuff going on on top of their mental health issues.

[Satsuma]

You could also consider community medicine.

 

Also, social work, if you decide not to go down the medicine route.

 

As you are interested in humanitarian work you may be interested in a program at Harvard at some point- Harvard Humanitarian Initiative (you can google it). It is a great program, introduces you to the functioning's of NGOs, UN etc. Discusses Sphere Standards and there is a disaster simulation. It was a great course.

[apache]

cool beans, good to know!

 

You could also consider community medicine.

 

Also, social work, if you decide not to go down the medicine route.

 

As you are interested in humanitarian work you may be interested in a program at Harvard at some point- Harvard Humanitarian Initiative (you can google it). It is a great program, introduces you to the functioning's of NGOs, UN etc. Discusses Sphere Standards and there is a disaster simulation. It was a great course.

[questforstarfish]

Thanks for the information, guys, much appreciated! I've definitely come to serious consideration for psych one day, down the road. It sounds amazing!

 

And peachy, I was just confused because I saw a psychiatrist once before when I was much younger, and I remember that my dad's insurance plan with work only covered 75% of the fee or something like that (and he had a pretty good job). Perhaps I'm mistaken in that memory, though. MSP is a wonderful thing

[apache]

hmm, psych can be amazing, or awful … depends on the individual practicing, and of course, the location

 

Thanks for the information, guys, much appreciated! I've definitely come to serious consideration for psych one day, down the road. It sounds amazing!

 

And peachy, I was just confused because I saw a psychiatrist once before when I was much younger, and I remember that my dad's insurance plan with work only covered 75% of the fee or something like that (and he had a pretty good job). Perhaps I'm mistaken in that memory, though. MSP is a wonderful thing

[peachy]

And peachy, I was just confused because I saw a psychiatrist once before when I was much younger, and I remember that my dad's insurance plan with work only covered 75% of the fee or something like that (and he had a pretty good job). Perhaps I'm mistaken in that memory, though. MSP is a wonderful thing

You probably saw a psychologist not a psychiatrist. Physicians are covered by OHIP, and it's actually illegal for them to charge you out of pocket, so it's not possible that you saw a psychiatrist and had to pay. A psychologist is someone who has a PhD in psychology, so they are called "Dr." as well, which is where the confusion usually arises.