On cold nights, it’s hard to find safe places to discharge unhoused patients, Hamilton emergency-department doctors say.
But thanks to a new partnership with downtown drop-in centre The Hub, local hospital networks have a reliable place to send people who have nowhere else to go.
Patients who don’t need to remain in hospital are commonly released with instructions for followup care, Dr. Erich Hanel, interim chief of emergency medicine at St. Joseph’s Healthcare Hamilton, said in an interview.
“That’s a real problem when people have nowhere to go or they have no ways to access resources,” Hanel said.
On dangerously cold nights, discharge may be impossible.
“We can’t discharge someone to an unsafe environment in any case, and extreme cold is no different,” he said.
In some cases, unhoused people stay overnight in emergency departments, said Dr. Alim Pardhan, chief of emergency medicine at Hamilton Health Sciences (HHS).
“We were getting pretty worried in the last few weeks” about not being able to find shelters since hospital emergency departments are not well suited to serve as shelters, he added.
At least 40 people since Christmas
The pilot program — between St. Joe’s, HHS and The Hub — helps patients experiencing homelessness and frees up emergency department resources, thereby benefiting the whole community, Hanel said.
This new pilot partnership is a vital lifeline to our unhoused community, who are already facing so many challenges.– Jen Bonner, The Hub’s executive director
Often, “overworked” nurses would have to figure out where unhoused patients could go, he added. While nurses and hospital social workers can call shelters, they can’t guarantee spaces or that a patient would be admitted.
The new pilot, which the hospital networks say has helped at least 40 people since it launched just before Christmas, dedicates The Hub spaces to people referred from hospital visits. The drop-in centre on Vine Street is open seven days a week from 11 p.m. to 7 a.m. regardless of temperature. It’s known to be a low-barrier site, meaning people who can’t go to shelters due to restrictions on drug use, for example, may still be welcome.
“This new pilot partnership is a vital lifeline to our unhoused community, who are already facing so many challenges,” Jen Bonner, The Hub’s executive director, said in a joint news release with the hospital networks.
A hospital spokesperson told CBC Hamilton that the pilot is being funded through the end of March.
The Hub helps people connect to supports
The Hub’s staff are outreach workers, students enrolled in health-care programs such as nursing and people training to be police officers.
Hanel said it helps his team to know there are resources available at The Hub, and that staff can connect patients with further care and help facilitate followup appointments.
People with no permanent home often need care for chronic conditions such as diabetes or lingering infections such as cellulitis, Hanel said.
In the winter, Pardhan noted, frostbite and hypothermia are serious risks. So too are burns and carbon monoxide poisoning, dangers that can arise when people use heaters or stoves, for instance, in enclosed spaces in an effort to keep warm.
More than 80,000 people in Ontario were homeless last year, a new report from the province’s municipalities shows, in what is the clearest picture of the issue to date.
In his experience working nights, connecting patients to The Hub has “worked quite well,” Pardhan said, adding the more shelter spaces and services are available, the better.
Hanel said he’s never seen a program like this in a city of Hamilton’s size and thinks other organizations could learn from it.
“It’s been fantastic,” he said. “I think it’s a really good lesson learned that under the time pressure of a cold snap that you know is coming, you can find a solution that works.”
On Tuesday, Hamilton Mountain MP Lisa Hepfner announced $4.3 million in funding for a program in which people with lived experience of using drugs will provide peer support in hospitals.
The program, with a start date that has yet to be announced, will also include three months of followup care for discharged patients, a Health Canada news release said.
Earlier this month, a new report from the Association of Municipalities of Ontario (AMO) detailed the human and financial cost of the homelessness crisis in the province. Over 80,000 people were homeless last year, according to the report. It also said tackling the crisis would require an $11-billion investment over 10 years to create over 75,000 affordable and supportive housing units, and some $2 billion over eight years is needed to ensure people living in encampments are properly housed.