During her fellowship, Dr. Sawhne learned about treating patients who struggle with challenges such as homelessness, addiction, and isolation, and require significantly more attention. The program taught her how to use systems-based practice management—the concept that doctors must learn to work effectively within a complex set of overlapping healthcare systems. She learned to determine which resources she could rely on from the federal government or the state to provide the best possible care.
Dr. Sawhne’s fellowship led to a full-time job at Horizon House, an organization that serves the homeless and people with mental and behavioral health needs and intellectual and developmental disabilities. The community-based work she is doing with Horizon House is significant, as there is a substantial national shortage of psychiatrists and other mental health providers, especially in rural regions, urban neighborhoods, and community health centers, according to the AAMC.
Dr. Sawhne also works with the Assertive Community Treatment (ACT) team, which uses evidence-based practices in behavioral healthcare to help people with severe mental illness. “Many people have been hospitalized and can’t function in the community,” said Dr. Sawhne. “They need a lot of extra support and very personalized care.” Dr. Sawhne also works on a team dedicated to early intervention for people who are experiencing psychosis—losing touch with their sense of reality—for the first time. The team’s goal is to intervene prior to them going into a hospital.”
“With psychosis, most of the time we think of major disorders like schizophrenia and bipolar disorder, but actually psychosis is just defined as when a patient experiences a disconnection from their version of reality. This usually shows symptoms between the ages of 15 and 25,” she said. “Most people who have symptoms don’t get care until a year or two later. Getting them care earlier reduces the number of days they spend in the hospital, and then they can re-engage back into college or work. I enjoy working with the younger population because I can intervene early and change their trajectory.”
Much of Dr. Sawhne’s work in the mental health field revolves around battling cultural stigmas. Many people resist seeking help because of the stigmas that exist around mental illness. And people often mistakenly associate mental illness with violence, when in reality, less than 1% of people with mental illness are violent.
“A lot of the work is educating people about mental illness,” she said. “It’s not a weakness, it doesn’t define you as a person, and you can still be highly functional despite having this condition. The goal is not to label the patient with a diagnosis. The goal is to manage the symptoms, so that patients can have a long-term plan and an achievable goal.”