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New mobile clinic brings physical, mental health care to at-risk Ottawans

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New mobile clinic to bring physical, mental health care straight to at-risk Ottawans
WATCH: A van that is custom-designed to provide primary physical and mental health care services to homeless people and drug users will operate between Ottawa’s four supervised injection sites – Jan 14, 2020

A new clinic on wheels hopes to make it easier and more comfortable for some of Ottawa’s most vulnerable citizens to access health care by bringing primary medical and mental health services directly to them.

The mobile clinic — a partnership between Ottawa Inner City Health, the city’s public health agency, three other local health centres and TELUS — aims to break down some of the barriers that people struggling with homelessness and addictions face in the medical system, including stigma and distrust of health professionals.

When its doors are open, the custom-designed van is staffed with a nurse practitioner, a mental health nurse and a psychiatrist. That team is also supported by “peers” with lived experience, who will help connect people who need care to the mobile clinic and build their trust.

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Matty Gaudet is one of those peer support workers. Once homeless for many years, he said many at-risk people are more preoccupied with where they’re going to sleep and find their next meal than they are with seeking medical care.

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On top of that, many don’t feel comfortable seeking care in a traditional doctor’s office, he said.

“When I was out there, whenever I would go to a medical professional of any type, there was this stigma because I was a street person and I felt my care wasn’t at the same level,” said Gaudet, who battled addiction. “I used to think it was in my head but now that I do this job, I will often take people to appointments, and as soon as I identify as a peer, the health-care professional will look at my arm to see if there’s any track marks.

“[By] bringing non-judgmental health-care professionals directly to our clients and meeting where they’re at, we can take away that stigma and take away some of the barriers that are blocking our clients from getting the help that they actually need.”

Local health officials agree that drug users face the greatest barriers to health care in Ottawa, said Wendy Muckle, CEO of Ottawa Inner City Health, a dedicated group of health professionals focused on the city’s homeless and disadvantaged citizens.

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Health providers say many of those users don’t have health cards and their life circumstances make it too hard to make medical appointments.

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For the mobile clinic project, officials surveyed that population to find out what health services they needed most, Muckle told reporters. Their number one priority? Mental health.

“Many people acknowledge that they have significant mental health problems and no great way of getting care, and so bringing the mental health services to them is really innovative,” Muckle told reporters.

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Many physical and mental health services in Ottawa are offered in large hospital buildings and those institutions can be “scary” for people who are dealing with trauma, according to Simon Hatcher, a psychiatrist with The Royal’s community mental health program who works on the van.

The mobile clinic addresses that problem by offering those services in a “safe, private and confidential place,” Hatcher said.

“It’s like the first step in trauma-informed care,” he said.

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“It’s about trying to create a safe space and have clear boundaries so people are willing to come back again and engage and get some help.”

So far, the response has been “amazing,” Muckle said.

“We had thought that people might be reluctant to come on the van and talk about their mental health problems but that’s not been the case at all. People have been really, really keen on getting help,” she said.

The mobile clinic first hit the road on Dec. 1 to allow for a gradual rollout and integration with existing services, Muckle said. The financial support from TELUS will keep the mobile clinic in operation for at least three years, she said.

“It’s a pretty significant gift to the community,” Muckle said.

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The van has been equipped to provide routine testing, contraception, STI treatment, harm reduction services and mental health care and counselling, according to a news release announcing the mobile clinic on Tuesday.

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Inside, there’s one area for patient reception and nursing care and another for an examination table and a workstation for staff. TELUS has connected the van to its LTE Wi-Fi network and its electronic medical record technology.

The van operates a set schedule between the city’s four supervised consumption sites, Muckle said. It may be stationed at a site for a half or whole day.

The Sandy Hill Community Health Centre, Somerset West Community Health Centre and the Royal Ottawa Mental Health Centre are the other partners in the mobile health clinic.

TELUS has already helped launch similar mobile clinics in Montreal, Vancouver, Victoria and Calgary and says more are on the way in Waterloo, Toronto, Edmonton, Halifax and Surrey.

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