ID: HR19-1066

Presenting author: Elaine Polflit

Presenting author biography:

Ms.Elaine Polflit has been working in the field of addiction and homelessness in Montreal for the past 15 years. She is currently the Program Manager for the Urban health programs at the CIUSSS Centre-Sud. Recently, she has managed Montreal’s four Supervised Injection Sites and the Relais Low-Threshold OST Clinic.

Growing old on the streets: story of a partnership between emergency shelters and the healthcare system in Montreal

Elaine Polflit

Issue

Access to adapted healthcare is an important obstacle facing people who are homeless and living with a drug addiction in Montreal. Cognitive decline and chronic health issues often go undetected and untreated in this aging population, which leads to frequent visits to the emergency room, poor contacts with healthcare providers and the absence of adapted follow-up. In return, many PWUD living in homelessness have developed a distrust of healthcare services, creating the need to develop services that operate outside the traditional bounds of the healthcare system.

Setting

The CIUSSS Centre-Sud, located in the downtown core of Montreal, offers health services to the largest population of PWUD who currently identify as homeless or in residential precarity in all the province of Quebec.

Project

With funding from the provincial government and in partnership with some of Montreal’s busiest emergency shelters, the CIUSSS Centre-Sud has pioneered outreach clinics offering on site in five emergency shelters medical clinics and follow up services. Combined with ease of access to specialized evaluations, these clinics can not only address basic health needs but also detect more complex neurological needs linked to advanced age that necessitate specialized evaluations. These clinics combine counselling from a social worker, healthcare from a nurse and global health care from a general practitioner, allowing for access to detox, MMT, access to housing and stabilization of chronic health issues among other things.

Outcome

The outreach clinics have proven instrumental in reaching aging PWUD who do not use traditional health services and present complex health needs. The clinics bridge the gap between the streets and the healthcare system, allowing hundreds of emergency shelter users to access health services or adapted housing. A more specialized geriatric service offer is being created to further support aging homeless PWUD.