Breaking down barriers to healthcare

Outreach counsellor Alyssa Ranieri meets patients experiencing homelessness where they are.

Breaking down barriers to healthcare

I met Mike (not his real name) this past April. He’s in his 30s and lives with schizophrenia, anxiety, fetal alcohol syndrome and PTSD. It’s a lot to carry. I first met him at St. Michael’s Hospital, where he was admitted with an acute illness. He was homeless at the time.

I work in the hospital’s Navigator Program. I am a Homeless Outreach Counsellor, which means I work with patients who are homeless and who have a serious health condition requiring care in the hospital. My job is to make the healthcare experience easier and more comfortable while patients are in hospital, and afterward to help them access healthcare and other services in the community so they can avoid another hospitalization.

I arranged to meet Mike at a shelter shortly after he was discharged. We try to work with people where they are, whether on the street or in shelters. I wish more programs did this. It can be so difficult just to manage basic survival needs when you’re homeless – so we make this part easier. The people we work with don’t do well if they have to show up in an office at exactly the right time. They also often feel stigmatized in traditional healthcare settings and may have experienced discrimination in the past.

When I got to the shelter, Mike wasn’t there. I went to the pharmacy that he had told me he used regularly. He was surprised to see me. I think it convinced him that I really was on his side.

Over the next few months, Mike and I did a lot of work together. When we first met, he was in a bad cycle. People with fetal alcohol syndrome can be an easy target for bullies and thieves. He was using drugs to cope with the stress of being on the street. Then the drugs would make him paranoid and he’d end up in hospital.

Our goal was to break the cycle.

We found him somewhere to live – first in a shelter, then in a rooming house. His drug use was putting him at high risk of an overdose, so we helped him get into a new harm reduction program called Safer Opioid Supply. It’s a mobile team that includes physicians, nurses, nurse practitioners and case workers who visit people who use street drugs; the team administers a weekly supply of safe opioids. And we talked, a lot, as I tried to help him build the confidence he would need to try to overcome the hurdles standing between him and a healthier, safer future. Through all this, I was always impressed by Mike’s courage and resiliency.

I completed my time working with Mike in October, as the Navigator Program is intended to make a difference in people’s lives over a time-limited period. Over the course of several months, Mike made a lot of changes. He got settled in housing. He has supports. He’s safer and, I think, less anxious. He knows there are people who care about him.

The last time I saw Mike, he told me how grateful he was. He said he was really going to miss me. Thousands of people in Canada, just like Mike, need this kind of helping hand to improve their health. I’m doing my best to reach as many as I can.

The Navigator Program has been generously supported by the Schroeder Foundation, the Estate of Colin Irving, and the T.R. Meighen Family Foundation.

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