What does ‘shelter in place’ mean for those without a home? This team provides care for the homeless during the coronavirus pandemic

As the coronavirus pandemic has forced us to self-isolate in our homes, we’ve been encouraged to pay an extra amount of attention to not only our physical health, but also our mental wellbeing. But according to Dr. Anthony Carino, director of psychiatry at the Center for Urban Community Services (CUCS), under normal circumstances, less than half the people with mental health conditions are able to get effective care in the United States. This number goes down as the severity of the mental illness increases.

CUCS is the largest provider of psychiatric care to homeless and formerly homeless people in New York City, where at any given time there are about 63,000 people in homeless shelters and 4,000 people on the streets. Carino sat down with Yahoo Life to explain how the coronavirus has impacted this population and how his team continues to provide proper care to those with pre-existing mental health conditions.

“Our mission is to serve the highest-needs individuals that have the poorest access to psychiatric and mental health care,” Carino shares.

Carino walks us through the approach that his “clinical SWAT team” takes to identify the individuals in need, and put them on a road to recovery. After establishing a strong relationship with these patients, treatment typically involves a combination of talk therapy, medication and psychosocial support.

Among the many barriers that the homeless population faces in receiving proper care is the stigma surrounding homelessness, mental health conditions and addictions. With the spread of COVID-19, Carino explains how various driving factors have contributed to the vulnerability of this population.

Carino says, “Individuals experiencing homelessness don't have a capacity to isolate. They're oftentimes in congregate care situations such as in shelters. They don't have individual bathrooms or eating spaces and they also have a lot of the medical comorbidities that we see are associated with poor outcomes with COVID-19.”

Carino’s team is working actively to provide a continuity of psychiatric care while also limiting the spread of the coronavirus to this very vulnerable population. To do so, his clinicians have been broken up into a remote team providing tele-psychiatry and an onsite team treating people in shelters.

Because social isolation is especially hard on individuals with trauma, Carino is mindful of the mental health consequences of the coronavirus. “We're seeing more people in some program sites ... than before. They need mental health right now,” says Carino.

He adds that these individuals are usually the first to give back to the community.

“They respond when people do connect with them with a sense of humanity,” Carino says.

“So many of the people that we work with, once they get a little bit of stable footing, are the first to say. ‘How do I give back’?

Video produced by Jenny Miller

For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.

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