Saira Rabia Afzal is a PhD Candidate at the Graduate School of Social Work and Social Research of Bryn Mawr College. Her research centers on developing and implementing youth suicide prevention and intervention strategies, with particular focus on marginalized populations. We spoke to Saira about her work in the social work field, and about her experience at the GSSWSR.
My scholarship as a doctoral student is focused on youth mental health and suicide prevention, particularly among marginalized and underserved populations. This focus is deeply rooted in my life experiences, including ten years of clinical experience across various healthcare settings, most recently at the Children’s Hospital of Philadelphia (CHOP) in the emergency department. I found the pace and acuity of the environment both rewarding and stressful, and during the COVID-19 pandemic, I found myself thinking about making a change to translate my clinical experiences into larger change. I started to consider going back to school for a doctoral degree as a way to continue working on improving mental health care for youth in crisis, and to teach future generations of clinicians.
Around this time, I was invited by my supervisor to join a new project aimed at improving care for pediatric patients experiencing boarding in the emergency department while awaiting psychiatric treatment. The experience of witnessing youth in mental health crises waiting days, sometimes weeks, for appropriate psychiatric care was unsettling to myself and my colleagues and motivated us to try to improve the care youth in mental health crises experienced.
I joined a multidisciplinary team that used a quality improvement (QI) framework to create and implement a protocol for stabilizing pediatric patients during psychiatric boarding. This initiative combined elements of family-centered care and therapeutic evidence-based practices to improve care for youth. The impact of this project was significant, and as I reflected on it a year later, I reached out to my coauthors about writing up the results. The manuscript, "Stabilizing Pediatric Patients During Psychiatric Boarding: A Quality Improvement Project," reflects the collaborative, multidisciplinary effort that shaped the project. For me, this work exemplified the intersection of clinical care and research.
The article was recently published in Pediatrics as an open-access piece thanks to the support I have received from my participation in the Health Policy Research Scholars program. Publishing it as open access ensures that clinicians can access the findings and consider how similar improvements might be implemented in their own institutions. This is a big part of what motivates me: translating research into practice to directly impact mental health care for youth.
At Bryn Mawr, my coursework and discussions with faculty, particularly Dr. Leslie Alexander, have been inspirational as I worked on this manuscript. In my first year, Dr. Alexander and I had several conversations about the strengths and limitations of research versus quality improvement. This ongoing conversation has shaped my perspective on how to navigate the challenges of conducting work that is both rigorous and applicable in clinical settings. This balancing act is something I continue to consider in my current research.
The article I co-authored has sparked some interesting conversations within the field, particularly around how QI initiatives can influence future research. A commentary in Pediatrics that appeared alongside our article pointed out that while QI projects might not have the same level of evidence as traditional research studies, they can still play a meaningful role in guiding future research and making more rapid change in clinical settings.