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A Survey of American Psychiatric Residency Programs Concerning Education in Homelessness

Dr. McQuistion is Associate Clinical Professor of Psychiatry at the Mount Sinai School of Medicine, New York, New York. Dr. McQuistion is also Faculty, Fellowship in Public Psychiatry at the New York State Psychiatric Institute, New York, New York, and Chief Medical Officer for the Division of Mental Hygiene at the City of New York Department of Health and Mental Hygiene, New York, New York. Dr. Ranz is Director, Fellowship in Public Psychiatry at the New York State Psychiatric Institute, New York, New York, and Professor of Clinical Psychiatry of the College of Physicians and Surgeons at Columbia University, New York, New York. Dr. Gillig is Professor of Psychiatry and Director of the Division of Rural Psychiatry at Wright State University, Dayton, Ohio, and Chief Clinical Officer of the Mental Health, Drug, and Alcohol Services Board for Logan County and Champaign County in Ohio. Address correspondence to Dr. McQuistion, The City of New York Department of Health and Mental Hygiene, 93 Worth St., New York, NY 10013; hottod{at}optonline.net (E-mail).

Objectives: This study aims to document how psychiatric residencies address homelessness and mental illness, to discover training barriers, and to identify educational recommendations. Methods: The authors mailed a survey to 178 American psychiatric residency programs, requesting information about didactic and clinical offerings in homelessness. Programs without offerings were asked to provide reasons why. Results: Of 106 responses, 60% had educational offerings. Concerning clinical experiences, most had fewer than 20% of residents rotating, and only 11% had mandatory rotations. Programs without offerings usually noted that training in this area was a low priority, and this was most frequently linked with perceived low community homelessness prevalence. Conclusion: Psychiatric residency programs have addressed education in mental illness and homelessness in various ways. That there were few residents in clinical rotations suggests a need to explore causes, including funding problems, and whether there is sufficient academic community psychiatry faculty. The findings also evoke the need for a model curriculum that enables clinical competency in this public health problem.

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