Public Service Psychiatry
Who says psychiatry is a profession in an ivory tower, alone? The image many have of psychiatrists is that of a scholar working at the elite level of psychological theory and practice, working with wealthy clientele in a private practice setting or forced to render judgement on the problem cases of others in a hospital or corrections setting. But there is a distinct subset of psychiatrists working in and around American communities, universities and clinics (none too small, but lesser known about) whose work is actually antithetical to this image.
These professionals practice in an area best described as community psychiatry, or as it is often called, public service psychiatry.
Now, community mental health is not such a foreign concept. However, one tends to think of social workers, agency directors, caseworkers, addiction counselors, psychologists and therapists as those who hash out details of mental health consumers’ needs. Indeed, it is the psychiatrist who must be called upon to do the initial assessments and diagnose disorders, but their active role usually diminishes, as they bow out (for the most part) of the developing psychosocial picture.
Not so for public service psychiatrists. In addition to their regular duties, they truly partner with urban and rural health service providers and consumers in their region. They look to the unique psychological needs that arise in specific environments and individual communities, and always aim to serve the underserved.
The department of psychiatry at the University of Pittsburgh (Penn.) Medical Center, along with their esteemed affiliate Western Psychiatric Institute and Clinic (WPIC), operates one such Center for Public Service Psychiatry (CPSC). The Center is “dedicated to the development and practice” of this subset of psychiatry, “providing leadership, collaboration, education and community based research.” Input from consumers and others ‘affected’ is especially fostered, with weekly discussion meetings open to community service providers, family members and interested others. Along with graduate fellowship students in the program under the mentorship of Dr. Wesley E. Sowers, CPSC director, and associate director Robert Marin, it makes for a colorful mix of an informed and invested population of consumer-providers both.
Wes Sowers certainly is not the stereotypical psychiatrist. He doesn’t attend the CPSC meetings in white coat or even suit and tie. Both he and his colleague Dr. Marin are unassuming leaders of this relaxed weekly gathering on the periphery of the Pitt campus, albeit with ambitious three-part curriculum content (and suggested reading material) and teleconferenced seminars with their colleagues around the United States.
“Wes,” as fellows and others in the group call him, has a background that naturally fits the mold of a person dedicated to applying his expertise in underserved communities. He began international work in public health after his internship, spending a year in Sudan, working with Ethiopian refugees, and helping to train local health workers in Nigeria and El Salvador.
Once back in Pittsburgh, in the early to mid-1990s, he became the medical director of St. Francis Hospital. It is one of two major institutions in the region (WPIC the other) that served the psychiatric and substance abuse populations in surrounding Allegheny County. This writer once worked with a psychosocial agency in the Oakland area on the Pitt campus, interfacing with doctors, clinicians and therapists from both institutions. St. Francis had a reputation as humane, compassionate and collaborative.