March 31st, 2014

News | January 20th, 2014
New rules to treat the homeless
Temporary measures implemented in Montreal hospitals
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The Montreal Health and Social Services Agency, a government agency overseeing Montreal’s health establishments, has introduced a change in the way homeless people with mental health issues are assigned to hospitals for treatment. Homeless people in Montreal requiring treatment will now be transported to the nearest hospital.

Introduced in early January, the new system replaces the previous rotational program, wherein Montreal hospitals would alternate taking in homeless people on a weekly basis.

According to the Montreal Health and Social Services Agency, the objective of the change is to provide better care for the patients. “We noticed that the homeless tend to always stay in the same sector,” explained Geneviève Bettez, spokesperson of the agency, in French. “So with this change, there is a good chance that they will be directed to the same establishments more frequently.”

“We believe that healthcare professionals will develop a better knowledge of each homeless person and of their file, which will improve the treatment of the patients,” Bettez told The Daily.

The decision, while only temporary, was imposed on the hospitals because of the weather conditions. “With the coming of the cold weather, the measure has been implemented early. […] It’s only in place until February, and then we’ll reevaluate it with our partners,” added Bettez.

The measure has been criticized by hospital officials at the Centre Hospitalier de l’Université de Montréal (CHUM). According to a CBC article from January 10, Paul Lespérance, the head of psychiatry at the CHUM, worries that the downtown Notre-Dame Hospital may become overcrowded. Lespérance noted that it will be admitting about 50 per cent of the patients.

The Old Brewery Mission, which provides emergency, transition, and housing services to the homeless population of Montreal, praised the move as a step in the right direction.

“I think, generally speaking, it’s a good move to do what they did. […] I think it’s much better to be able to get services as nearby as possible, because we are dealing with people who are coping with a crisis,” said Matthew Pierce, Director General of the Mission.

Pierce recognized that the concerns of overcrowding at the CHUM are valid. “I don’t think it’s going to be a massive influx of people, but I think if I were at the downtown hospital, I would be concerned,” he said.

The difficulties faced by homeless people in obtaining effective treatment are not limited to transportation. According to Pierce, homelessness carries a social stigma which impedes access to medical care.

“People are not comfortable with homeless people. When they’re in an emergency room in the hospital, they often don’t get the same treatment as other patients. They’re often treated very cursorily, very quickly, and not given the same kind of attention,” said Pierce.

“Often […] the homeless person is seen quickly, they’re given their prescription and pills […] they come to the front door of our shelter and sell [the pills] and then don’t go back next week. So it’s a complete waste of our dollars.”

Pierce pointed to the Old Brewery Mission’s current partnership with the CHUM for treating homeless people with mental health issues as an effective method of providing care. Under this pilot program, a psychiatrist, a psychiatric nurse, and a psychiatric social worker treat the patients at a ward allocated by the Mission.

“We have a partnership with the CHUM hospital system’s department of psychiatry, whereby homeless people with mental health disorders are dealt with inside our pavilions. […] We can make sure they live in a stable, peaceful and secure environment. We expect that the health outcomes, especially mental health outcomes, will be significantly accelerated, and we’re already seeing that, in fact.”

Pierce also highlighted the necessity of transitional measures to get homeless people out of shelter life. “The mission of the Old Brewery Mission is to end homelessness, not to manage homelessness,” he said. “We want to continue to evolve until we get it done.”

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