The Process of Piloting Psychiatric Services at a Medical Student-Run, Shelter-Based Free Clinic

Student-run free clinics (SRFCs) enable medical students to care for communities disproportionately burdened by mental illness and health inequities. More literature is needed on the process of piloting psychiatric services in the SRFC setting. In 2021, a team of medical students piloted psychiatric services at an existing SRFC within a transitional housing facility for women affected by domestic violence. This article narratively describes and reflects on this process. The process of piloting psychiatric services included (1) assessing the need for psychiatric services; (2) establishing stakeholder and institutional support; (3) defining the mission, scope of practice, and liability coverage; (4) defining the roles and responsibilities of medical student volunteers; (5) training medical student volunteers to deliver psychiatric care; (6) establishing a clinic workflow; (7) establishing access to and protocols for prescribing for psychotropic medications; (8) partnering with community behavioral health providers; (9) planning for prospective program evaluation; (10) preparing the clinic for psychiatric care delivery; and (11) evaluating implementation and outcomes. The successful pilot of psychiatric services at this SRFC was facilitated by its use of existing infrastructure and the commitment of its student leaders and faculty mentors. That said, this initiative would have benefited from a formal needs assessment and literature review and faced challenges with prospective program evaluation. This article provides a roadmap for medical students and physicians at other SRFCs who aspire to fill gaps in access to psychiatric care for patients from underserved communities and enhance medical education in psychiatry at their institutions.