Dr Myles Sergeant
Bringing together health care, shelter and interdisciplinary education.
Established in 2005, the Shelter Health Network is a collaboration of health care professionals and social service organizations serving a high risk population without stable housing and who have complex health problems.
As of 2017, our group consists of 17 family doctors, two nurse practitioners, four registered nurses, eight midwives, two internists and two psychiatrists. Our numbers continue to grow.
We provide primary care to patients at several locations in Hamilton. These include shelters and transitional housing programs, drop-in centres, addiction facilities and mental health facilities.
Our patients often face numerous barriers in accessing the traditional health care system:
- not having health cards nor the ID necessary to obtain one
- not having a phone or address to receive appointment information
- feeling stigmatized when they access care.
We bring health care directly to people who face the most barriers in accessing it.
The Shelter Health Network is also committed to teaching medical students, post graduate residents and other health professionals. Our experienced health care providers help learners understand the social determinants of health.
Dr Shelly Sender
Background
Over the years, federal, provincial and municipal governments have issued key mental health and primary health care policy documents concerned with reform. From these reports, emphasis has been placed on:
- developing comprehensive care in the community that is accessible, integrated and multi-disciplinary
- offering a level of continuity, quality and satisfaction to both clients and providers
- focusing on health promotion, independence and choice
Within the context of these reforms, those who are experiencing homelessness pose special challenges to the provision of health care in terms of:
- the complexity of health care needs and
- being able to provide accessible and appropriate levels of health care.
People living in poverty or who are homeless have lower levels of general health. They experience multiple and often chronic physical, mental health and addiction problems resulting in higher levels of health care use including emergency room visits and lengthy hospital stays. Hamilton has one of the highest poverty rates in Ontario.
Dr Lori Regenstreif
In a comprehensive survey of more than 350 people living in relative or absolute homelessness in Hamilton, nearly 1/3 of participants reported being admitted to hospital in the previous year. Given the high poverty rate as well as the rate of acute care service use reported by those surveyed, hospitals in Hamilton can expect an alarming rate of at least 1 in every 5 admissions and perhaps as high as 1 in every 3 admissions to be that of someone living in poverty presenting with a complex health care need.
Barriers to accessing and using more appropriate levels of health care services can in part be attributed to significant gaps existing within the delivery of services. These include:
- lack of coordination and continuity of health care services across sectors particularly from acute care into community settings
- lack of integration between health and social services
- lack of harm reduction housing
- lack of understanding by health care professionals of issues related to poverty and homelessness
- lack of co-ordination across all three levels of government
Many of these issues are beginning to be addressed by the establishment of the Greater Hamilton Health Network (GHHN). Health care providers affiliated with the Shelter Health Network are pleased to be involved with the work of the GHHN.