Model and Strategy
In the United States, mental illness is one of the largest causes of homelessness for single adults. Among San Francisco homeless residents, most who are “chronically homeless” (four episodes of homelessness in the last three years) experience psychiatric or emotional conditions. Zuckerberg San Francisco General (ZSFG) is the city’s community institution on the front lines of addressing the crisis of homelessness and mental health.
This project was developed in response to the needs of the patient population at ZSFG. The ultimate goal is to develop and implement a collaborative, multidisciplinary, holistic and trauma informed model of care that will not only become fully entrenched within the ZSFG’s future, but also better serve our patient population to address their direct social needs.
Impact
Social Medicine will address the needs of our city’s most vulnerable population, helping individuals break free from a negative cycle of social and behavioral health needs not being addressed. This pilot program also empowers healthcare providers as well as patients to address healthcare holistically. Our work represents a profound change in how we care for vulnerable patients—a multidisciplinary approach incorporating a person’s complex social and medical needs as equal priorities.
This approach is timely in that it provides a more systematic approach to addressing the true needs of our vulnerable population in San Francisco. This cultural shift in care coordination has created transformative outcomes in patients since launching the first phase of the pilot. Patients now have access to medical and social services, such as access to treatment for substance use and mental health challenges, which in turn help them have a chance at overcoming homelessness. The Social Medicine model allows public health leadership to refocus on delivering more effective care and open pathways for resources in the San Francisco health network. We are both helping patients as well as bridging systems in the medical and social services to productively work together.
Leadership
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Dr. Hemal Kanzaria
Director of Complex Care Analysis, SF Health Network and Associate Professor, UCSF, Emergency Medicine at ZSFG
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Dr. Jack Chase
Medical Director, Department of Care Coordination and Associate Professor, UCSF, Family Community Medicine at ZSFG
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Ann Lazarus
Interim CEO, San Francisco General Hospital Foundation
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Jenna Bilinski, RN
Director Kaizen Promotion Office, San Francisco Department of Public Health at ZSFG