Street Connect team helps homeless in Fort Mac

Collaborations during third wave strengthened community ties

Story by Diana Rinne

To find the definition of collaboration, look no further than the Alberta Health Services (AHS) Street Connect team in Fort McMurray during the third wave of COVID-19.

A multidisciplinary team, Street Connect provides services to the homeless, or those at risk of homelessness, to address their mental health and psychosocial needs as well as gaps in care.

The third wave hit the city hard this past spring, with an active case rate high of 1,928 per 100,000 people in early May. As the vulnerable street-involved population felt the brunt of the pandemic, the Street Connect and Assertive Outreach Teams were there to help.

“We were approached by one of the local shelters requesting some immediate need for prevalent swabs,” says Stephanie Clark, clinical educator for Addiction and Mental Health in Fort McMurray. A psychiatric nurse, Clark was part of the Street Connect team at the time.

“Generally, if someone is seen at one shelter, they are also seen at the second,” adds Clark. “From that, we ended up doing prevalent swabs at the second shelter the next week. With that, when you swab symptomatic individuals, comes the isolation for the homeless population.”

Fort McMurray had three isolation sites to serve the homeless population and beds filled up quickly.

“The need became pretty significant and we faced a couple of unique barriers with our population. Not only were they sick — and maybe didn’t have a family physician or weren’t really managing their chronic conditions — but now they were also fighting addiction concerns,” says Clark. “What that looked like was withdrawal from various substances ranging from alcohol to some stimulants and opiates as well.”

To respond to the high needs of the clients, Street Connect, which includes four core staff as well as a casual RN and two casual undergrad nursing students, provided seven-day-a-week support to the isolation sites, which were contracted from community service providers Centre of Hope and the Salvation Army.

“They had their own staffing and they were really apprehensive about how to keep their staff safe while providing services to these individuals on a 24/7 basis,” she says. “We quickly became pretty overwhelmed just by the acuity of everyone’s conditions. Because we are already dealing with individuals who have underlying health needs, not everyone did really well.”

However, EMS also provided support to the team by sharing their triage protocol, so the team could effectively decide who needed to go to the hospital, which was facing its own pressures as a result of COVID-19.

Support for the team’s work came from all sectors, says Clark. From psychiatrists who prescribed medication for withdrawal, anxiety or other needs of the clients, and community partner pharmacies who provided medications and personal care items, to those behind the scenes who did deliveries for the team — it was a collaborative effort from start to finish.

“We were also doing the alcohol withdrawal assessments and we had a couple of individuals going through opiate withdrawals and having COVID,” says Clark. “It was really upsetting to see someone in that state, so we did work with the Virtual Opioid Dependency Program (VODP) who were able to do the assessment right on the spot for everyone we called and to get them some opioid agonist therapy pretty quickly.”

The team also enjoyed the support and access to hospitalist Dr. Johannes Benade at Northern Lights Regional Health Centre.

“He was phenomenal in terms of having access and really providing the team with the level of support they required to ensure clients remained safely in isolation and that their medical and physical needs were met while in isolation. And identifying that point when someone needed to be transported to the hospital,” says Rosilita Jn-Pierre, manager for Addiction and Mental Health in Fort McMurray.

As the third wave rolled on, the team also juggled discharge planning to ensure those who came out of isolation would have continued support, including access to a COVID-19 vaccine.

“What we didn’t want was that vicious circle of the individuals getting off isolation, not being vaccinated,” Jn-Pierre adds. “So while they were in isolation, the team was (also) making appointments for vaccination at Mac Island, or community pharmacies.

“It really was collaborative. One Sunday the PCN had 50 spots open up for vaccines and we were able to work with them to get some of our clients access to those vaccines. We knew that was a key piece, so we made every concentrated effort to work with our community partners to ensure that vaccinations were available.”

At times, Clark says, the third wave felt more like a tsunami.

“I think the experience, as hard as it was, helped our team band together. We’re closer because of that. I think the only reason we were able to get through this was because we were showing up for one another — that we were recognizing that this is really difficult for me, and I see that it is really difficult for you, and I appreciate that you are here with me.”

Clark says she believes that their collaborative efforts, in addition to making the Street Connect Team stronger, created a stronger sense of community.

“It wasn’t a single profession or single person, it really was a team effort,” she says. “Having us show up and having that constant communication, (our clients) saw that we were visible and hands-on and wanted to ensure they were safe as well. This strengthened the relationships, which ultimately is going to positively impact client care.”

Jn-Pierre agrees: “There were lessons learned that can impact on other areas of care. There is potential to continue to work together and collaborate together to really serve the population.”