ANDREW SHANER, MD

Community Psychiatry

VA

HPACT Partner and Faculty

andrew.shaner@va.gov

Andrew Shaner is a Professor in the Department of Psychiatry and Biobehavioral Sciences at the UCLA School of Medicine and Attending Psychiatrist for a Homeless Patient-Aligned Care Team (HPACT) at the VA West Los Angeles Healthcare Center. He earned a B.S. in Biomedical Sciences from the University of California, Riverside in 1978 and an M.D. from UCLA in 1981. He completed a residency in General Psychiatry (1985) and a Fellowship in Child at Adolescent Psychiatry (1986), both at the Los Angeles County at the University of Southern California Medical Center. With support from NIMH, NIDA and the Department of Veterans Affairs, he developed new treatments for schizophrenia and co-occurring substance dependence, including a widely-used skills training manual. His article in the New England Journal of Medicine (1995) drew national attention to the need for better treatments for people with schizophrenia and co-occurring addictions. He has also published research on the application of fitness indicator theory (from modern evolutionary biology) to schizophrenia and autism. His research now focuses on the development of the Humanism Pocket Tool, as small set of techniques designed to help inter-professional trainees maintain a humanistic approach with challenging patients.

SELECTED PUBLICATIONS

Humanism Pocket Tool (see link below photo)

AVAILABLE TO RESIDENTS FOR:

• Clinical mentorship at the VA HPACT Clinic (PGY3-4):

HPACT is a cutting-edge VA Special Program focusing only on Homeless Veterans until they are stably housed and independently caring for their physical and mental health. The team is interprofessional and includes internists, nurse practitioners, psychiatrists, psychologists, social workers, and pharmacists. Even the clerk is on the team. This highly collaborative approach, with access to a vast array of housing and rehabilitative services, makes it possible to help veterans we could not previously reach.

HPACT is also the site of a new specially-funded training program to teach trainees from multiple disciplines how to work together to treat homeless veterans. In this training program, there is a “trainee HPACT team” in which psychiatric residents work closely with faculty and trainees from other disciplines and professions including advanced practice nurses, , social work, internal medicine and psychology. This opportunity prepares residents to work in the rapidly expanding field of interprofessional healthcare.

The curriculum focuses on three main topics—(1) interprofessional team work, emphasizing integration of mental health care into primary care, (2) the social determinants of health and (3) humanistic healthcare for challenging patients. The resident will not only learn, but also teach trainees from other disciplines.

• HUMANISM POCKET TOOL:

The Humanism Pocket Tool is a small set of techniques, summarized on a pocket card, and designed to help clinicians maintain a humanistic approach to homeless patients, especially those whose appearance, odor, behavior or complexity elicit fear, anger, contempt, disgust or hopelessness among clinicians. Ultimately, the techniques are aimed at (1) understanding each patient’s personal story, including their aspirations and the obstacles to these aspirations, (2) condensing the story into a highly compact form, termed a “vivid vignette” and (3) using the vivid vignette in progress notes and conversations to inspire and coordinate inter-professional healthcare.

See the attached files for more information.