This week, Maddie Stewart departs Places for People to enter medical school in pursuit of her dream to become a doctor.
The two years Stewart spent at Places for People – first as a volunteer and then as an employee – have made an indelible impact on her future focus. “It’s made me commit to community health as the basis for what I do,” she said.
Stewart maintained an interest in public health throughout her college career. She graduated in 2018 from Washington University in St. Louis with a Biochemistry major and an Anthropology minor. She enters medical school at Boston University in August.
The Boston native discovered Places for People in the spring of 2017 while researching potential placement opportunities as a Civic Scholar at Washington University in St. Louis. Through the Civic Scholars program, Stewart was given the opportunity to learn about civic and community engagement from an interdisciplinary group of mentors and peers, shaping her perspective on how to combine the field of medicine with social justice.
“I wasn’t focused on mental health or substance use in particular, I was thinking more about the integration of social services with health care as a way to address the social determinants of health and health disparities,” she recalled. The integration of physical health and behavioral health occurring at Places for People also caught her eye while researching potential opportunities.
In June 2017, she started her placement at Places for People in the Research and Evaluation Department. She assisted with the evaluation of a grant project funded by the Marillac Mission Fund (formerly Daughters of Charity Foundation of St. Louis) that focused on the impact of social connectedness on older adults living with mental illness.
In her role as research interviewer, Stewart set up appointments and interviewed individuals ages 50 and above served by Places for People. “It gave me a lot of exposure to talking to people about what their life had been like, their social support, and the impact that Places for People had on their life.”
She continued to volunteer at Places for People after finishing her time as a Civic Scholar. Last August, Stewart was hired by Places for People as Hospital to Community Liaison in the Outreach Department.
In Outreach, Stewart explained, “You’re trying to meet people where they are and build a relationship with people over time.”
The Places for People Outreach Team identifies and provides short-term case management for people living with mental illness who are high-utilizers of emergency departments, involved in the St. Louis city courts, on probation or parole, homeless, or referred through community agencies.
Initial meetings with the individuals who Stewart works with mostly occur in the hospital. “My role is meeting people in the hospital when they are in inpatient psychiatry and then being that bridge to Places for People services,” she said. “The goal is to build our relationship to the point where I can bring them into their intake appointment and get to know them well enough to know what kind of services that they need from the agency.”
Often the victories at this stage are small, but mighty.
“When I meet people in the hospital, it’s often a difficult and vulnerable place. I think some of the happiest moments I’ve had are picking people up from the hospital and bringing them here,” she said. Helping an individual get a cup of coffee and take a shower in the Places for People Welcome Center is an important step in building rapport and trust, and is a first step toward accessing healthcare options at Places for People. It also helps a person regain a sense of dignity. “Just feeling like a full person again after getting out of the hospital. There’s a lot of joy in that.”
Stewart estimated that about half of the people she works with don’t have health insurance, and many are unhoused. Even when individuals have insurance, they may face challenges. “I was talking to someone the other day who couldn’t get his medication because he had a $2 co-pay on his meds,” Stewart said.
Situations like this have demonstrated to Stewart the need for greater allocation of resources. When asked what people can do to help, she suggests advocacy and action to help secure a greater investment in public services—emergency shelters, affordable housing, quality and accessible healthcare, and public education. “Make it a priority when you are voting. Talk to public officials and your friends. Leverage any resources—from money to political capital – that you might have.”
As Stewart prepares to begin medical school at Boston University in August, she will let her rotations guide her choice of specialty. “I’ve had a lot of people ask me if I’m going to become a psychiatrist now. I’m open to the idea, but I don’t really know.”
Two years ago, Stewart stated on her volunteer application that she want to be placed at Places for People because she thought it would be “eye-opening for me in terms of learning about this system of delivering health care.”
It’s safe to say that happened.
The experience has shaped how she wants to deliver services when she becomes a practicing physician.
“I’ve realized how much you miss when you’re in the hospital and the clinic about what people’s lives are actually like and what their actual healthcare needs are,” she said. “I’ve been thinking about how to provide healthcare in an interdisciplinary way with both social services and medical care, and doing it in settings where you’re bringing it to the people where they are, rather than making them come into a hospital to get the care that they need.”