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How shots instead of pills could change California’s homeless crisis


Doctors on the front lines of California’s homelessness and mental health crises are using monthly injections to treat psychosis in their most vulnerable patients.

As Dr. Rishi Patel’s street medicine van bounces over dirt roads and empty fields in rural Kern County, he’s looking for a particular patient he knows is overdue for her shot. 

The woman, who has schizophrenia and has been living outside for five years, has several goals for herself: Start thinking more clearly, stop using meth and get an ID so she can visit her son in jail. Patel hopes the shot — a long-acting antipsychotic — will help her meet all of them. 

Patel, medical director of Akido Street Medicine, is one of many street doctors throughout California using these injections as an increasingly common tool to help combat the state’s intertwined homelessness and mental health crises. Typically administered into a patient’s shoulder muscle, the medication slowly releases into the bloodstream over time, providing relief from symptoms of psychosis for a month or longer. The shots replace a patient’s oral medication — no more taking a pill every day. For people who are homeless and routinely have their pills stolen, can’t make it to a pharmacy for a refill or simply forget to take them, the shots can mean the difference between staying on their medication, or not.


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