Road service: these clinicians take to the streets to provide care

A cooler, loaded with ice packs and bottles of water, and a collection of light weight, second-hand clothing accompanies the medical kits hauled onto the passenger van. On a hot summer day, these ‘extras’ are equally important to the patients who will be visited by two nurses during this unique medical house call for people living with schizophrenia. Twice a week, St. Joe’s Mobile Mental Health Clinic brings necessary outpatient care to the doorstep of patients unable to get to the West 5th campus.

It began as a short-term necessity during the height of the pandemic. Some patients were too fearful of contracting COVID-19 to take public transit or even walk through the doors of the hospital. But many depend on consistent medication injections for stability, so the best solution was to deliver care to the patient’s home environment in the safest manner possible. The passenger van gave them space and privacy to conduct blood work and administer injections. It also provided an environment that could be easily sanitized between patients, and minimized the risk of COVID-19 exposure to staff, by eliminating their need to enter congregate care settings.

Now, with the worst of the pandemic in the rear view, St. Joseph’s Healthcare Foundation has funded the mobile clinic, keeping it on the road until at least the end of March 2024. This fortunate extension is also viewed as a necessity.

“Some patients are not self-aware about their illness, so maintaining a medication routine is not top of mind,” says Yasheika Turner, one of four nurses who travel on the mobile clinic. “Our visits help to keep their condition stable.”

Care homes are not the only locations attended by the mobile clinicians. Not all patients have a permanent residence. Getting to know their clients’ habits and hangouts is an important part of the job.

“Sometimes we find them in their favourite coffee shop or at the public library,” adds Theresa Radocaj, also part of the mobile team. “Other times, it means driving around downtown streets in the areas they frequent.”

As difficult as it can be to locate patients who are unhoused, this special team knows the value of their work. It’s much more than delivering necessary medications. Wellness checks are common. Meeting patients where they are strengthens the relationship between clinician and client. It also gives them a better impression of how a person is doing.

Since 2020 when the unit first hit the streets, the team has administered care to more than 250 unique individuals, making thousands of visits to people from Beamsville to Brantford.

There are roughly 800 outpatients registered with St. Joseph’s Schizophrenia Outpatient Services, according to Unit Manager Alycia Gillespie. The van meets the needs of 10 percent of that total.

“This mobile clinic isn’t just making the process more convenient for a patient,” says Gillespie. “It truly is providing a more holistic approach to patient care.”

Photo source: Cathie Coward, Hamilton Spectator Photojournalist