Nearly every day health care practitioners from Mount Carmel Health System in Columbus, Ohio, practice an outreach effort known as street medicine – or “street med” for short. It’s a combination of direct service to people living in homeless camps around the city and the delivery of medical treatment through mobile clinics in some of its neediest neighborhoods.
The health system’s mobile medical coach began providing free care to people on the streets more than 20 years ago. The coach parks in places like trailer parks, community centers or near soup kitchens, where the homeless are likely to gather.
Today, the outreach includes a street med team who visit homeless camps. The team’s patient outreach advocate often is out on his own to check up on unsheltered residents – the estimated 240 indigent population living under bridges, along railroad tracks, on downtown streets or in tents or shanties along riverbanks. About 4,000 indigent residents last year were in transitional or emergency shelter, according to the Community Shelter Board (CSB), which coordinates emergency housing programs in the city.
Mount Carmel’s medical van last year cared for several hundred homeless people, who made more than 7,000 visits to community sites for treatment and counseling. In addition, the street med team had about 500 encounters in camps last year with unsheltered homeless residents.
The program offers the city’s homeless hope, tries to get them into housing and lets them know somebody cares for them, says Ladonya Brady, Mount Carmel’s outreach clinical manager.
“We are about building trusting relationships,” she says. “We know them and we are concerned about them and we will give them a hug. We may be the only ones they trust enough to talk to.”
A chaplain accompanies the mobile team to the soup kitchen and churches. “We want to treat the whole person, including the spiritual person,” says Brady.
In the camps and shanties, the most common ailments the street med team treats are high blood pressure and respiratory problems, such as asthma and bronchitis, along with infected cuts, abscesses and rashes. The team brings along a glucometer to check blood-sugar levels, a thermometer and an otoscope, used to check ears.
They carry bandages and other supplies to care for wounds, medications for blood pressure and diabetes, as well as antibiotic ointments, oral antibiotics, inhalers and ant-fungal cream. They also write prescriptions for medications they don’t have. During the winter, the team gives out hats, gloves, scarves, coats and other cold weather gear to homeless people camping in the woods.
Mount Carmel’s outreach seeks to treat the urgent health care needs of the homeless, while also working as part of a broader regional effort to find solutions to homelessness. It partners with a wide range of organizations to provide homeless people with access to care, housing, food and employment.
The Mount Carmel Foundation contributes about $1 million annually for the health system’s outreach, which since 2010 has included mental health services provided by Southeast, Inc. of Columbus. Southeast Inc. staff are on the mobile coach and at soup kitchens and other sites to do screenings and mental health assessments. They want to connect those in need to follow-up psychiatric counselling and treatment, and link them to housing and social service agencies.
The partnership with Mount Carmel “has allowed us to reach people we wouldn’t normally be able to reach,” says Kim Cooksey, a Southeast Inc. clinical director. “They may be OK with receiving medical care, but not psychiatric care. So we can create a bond with them and talk about psychiatric illness and try to get them the care and support they need.”
Mount Carmel’s “life-saving efforts” play a vital role in caring for the city’s unsheltered residents, says Michelle Heritage, director of CSB, the umbrella organization that supports homeless programs and services in Columbus. She calls its services a “critical first step” in finding broader, long-term solutions to homeless. The health system “shows great care, dignity and respect for each person they meet,” she says.
Mount Carmel’s Brady observes that the health system mission’s statement is “to heal body, mind and spirit, to improve the health of our communities, and to steward the resources entrusted to us.”
“We feel we are fulfilling our mission,” she says. “Every day we make a difference in somebody’s life.”