Shifting the power imbalance in healthcare through mental health outreach

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Shifting the power imbalance in healthcare through mental health outreach

Toronto, November 4, 2020

By Natalie Leung

Dr. Saadia Sediqzadah (left) and Shinkay Karimi are two members of the FOCUS team.
Dr. Saadia Sediqzadah (left) and Shinkay Karimi are two members of the FOCUS team. (Photo: Yuri Markarov)

When Dr. Saadia Sediqzadah started her residency, she saw herself practicing psychiatry in a big room with a Persian rug, her patients lying on a couch while they discussed how they felt. Now a Psychiatrist at St. Michael’s Hospital, her workday looks a little different.

A few days a month, Dr. Sediqzadah changes into jeans and bikes around the city as part of the FOCUS program, a mental health outreach program. Instead of seeing patients in a traditional clinic, she meets them in their homes, at shelters and in coffee shops.

The program is a partnership between St. Michael’s Hospital Mental Health and Addictions and Cota, a community-based mental health organization. Operating 24 hours a day, seven days a week, the interdisciplinary team supports people experiencing serious mental health problems. Many are also facing socioeconomic challenges, such as inadequate housing and shortage of food.

“Going into the community helps with the power imbalance that’s inherent in health care. It’s no longer – I’m the doctor in a clinic and you are the patient coming into my space. This flips it to – I’m the doctor and I’m coming to meet you in your space,” explains Dr. Sediqzadah, “I’m often wearing casual attire, so we all kind of look the same.”

Shinkay Karimi, Peer Support Specialist at St. Michael’s, says the program works well because the team looks at a combination of biological, psychological and social factors that affect mental health. She focuses on providing emotional support for her clients.

“Being in their homes and in their spaces, I get to see what the majority of society doesn’t see. I have a better understanding of how factors, like living in a boarding home and systemic discrimination, affect mental health.”

The interdisciplinary team consists of psychiatrists, nurses, social workers, occupational therapists and other allied healthcare professionals. They provide supports that are individualized to each person such as psychotherapy, medication management and assistance with accessing financial support programs.

Karimi has seen many individuals secure housing, adhere to treatment and live a much more meaningful life thanks to the program. She also noticed benefits to her personal mental well-being.

“Sometimes my clients will express some thoughts and I will recall being in that situation myself and how I can really relate. I feel inspired to take the knowledge, skills and lived experiences I have to help them accomplish their goals.”

Dr. Sediqzadah was not aware of outreach when she started her career in psychiatry, but now biking through the city to see patients is one of her favourite parts of her job. She hopes medical students and residents will consider this an option when choosing their career paths.

“It was a beautiful fall day and I stopped and I thought – this is awesome. How many health care jobs are there where you can be out and about in the city? I definitely had a moment of gratitude.”

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit

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