Drop-In Centre to Provide ‘Holistic Care’ for the Homeless

They have become a feature of commercial areas in the Kingston Metropolitan Area. Homeless people. Sleeping in shop doorways at night and begging money to buy their meals. Some are young, others not so young, but most of them have one thing in common; they suffer from a mental illness.
While many organizations and groups have come to the support of street people over the years, in terms of providing them with food, clothing, medical care and temporary shelter, the Bellevue Hospital is seeking to prevent persons from coming on the streets in the first place, and for those already on the streets, to get them back with their families and in a state where they can begin to take care of themselves in a respectable way.
One major part of that initiative is the establishment of a drop-in centre, where homeless persons can be treated in a “holistic manner”, explains Dr. Maureen Irons-Morgan, Senior Medical Officer (SMO) of the hospital.
She tells JIS News, that work is underway on the renovation of a building on the grounds of the hospital, located on Windward Road, where the centre will be housed. Already, the building plans have been completed and the quantity survey has been done, she informs. The Culture, Health, Arts, Sports and Education (CHASE) Fund is financing the project at a cost of $4.28 million. The project should be completed by mid 2005.
Dr. Irons-Morgan explains that the idea for the drop-in centre came out of the recognition of the need for a holistic approach to the hospital’s Assertive Outreach Programme.
“It was well known that for a long time, we have had a challenge in dealing with persons who are mentally ill and are homeless,” she points out, adding that over the years, a number of initiatives had been undertaken but these were usually centered around picking up people off the streets and taking them to an institution. “Whereas this has been successful to a large extent, we realized that more is needed because there are still many others who are constantly appearing on the streets. More and more we are taking a thrust towards community-based mental health services,” Dr. Irons-Morgan states. “So, in our team meetings, it was recognized that we really needed to do something at the community level to really deal with this problem. Possibly, we can prevent, treat and rehabilitate at the community level,” she adds, noting that other countries have used the approach successfully in mental health treatment.
In recent months she informs, the Bellevue mental health team has been visiting the facilities where homeless persons are cared, such as shelters and the Salvation Army, and are treating individuals there.
“It became obvious that we could provide a more holistic care, in terms of not only meeting their medical and personal hygiene needs, but going further into occupational therapy, social programmes and intensively trying to make the social interventions in terms of connecting with the families,” the SMO points out.
The drop-in centre is expected to provide such a programme, where homeless persons can benefit from a continuous programme of treatment and care to get back into society, “because that too has been a challenge, having a programme that can be properly maintained,” she adds.
The team expects to target all homeless persons, mentally and otherwise challenged. Statistics show that a significant percentage of homeless persons also suffer from some form of mental illness. Dr. Irons-Morgan tells JIS News, that the plan is to interview all homeless persons, assess them and intervene in terms of social assistance even if they do not require medical treatment.
The Assertive Outreach Programme began two years ago, and intensified in 2003. Dr. Irons Morgan notes that most of the work is carried out on weekends, as it is during this period that persons who need assistance are most visible. Tuesdays are dedicated to attending to such persons.
The introduction of the drop-in centre is expected to further enhance the programme, giving it the kind of focus that it has not had before.
At present, the team has an arrangement whereby the persons are picked up and taken to the Salvation Army hostel downtown, where the mental health team provides hygienic, nutritional and medical care. The Marie Atkins Shelter is also used and persons in need of hospital care are taken to Bellevue.
“It’s a process and it takes time to see the impact that it will have. But in the end, the impact will be more lasting than just picking up people, putting them in a hospital and then they walk out the next day,” Dr. Irons-Morgan remarks.
She says that in some instances, when persons receive treatment through the outreach programme, they eventually improve and sometimes request to come off the streets and be reunited with their families. “Part of the treatment programme is about rehabilitating people and bringing them to the point where they themselves want to make that return home,” she points out. Dr. Irons-Morgan tells JIS News, that the construction of the centre fits into the government’s plan of providing community care for mental health patients. Part of the process will involve making adequate preparations in the general hospital system to accommodate persons with acute mental illnesses.
She points to the need for collaboration among state and private sector organization as it relates to the treatment and care of mental health patients and commends CHASE for agreeing to fund the construction of the drop-in centre.
In addition, she says, the New Kingston Civic Association has been an important partner in the hospital’s outreach programme, dealing particularly with the problems of the homeless in New Kingston.
The association employs a mental health outreach worker who interacts with these persons and liaises with the community mental health team, to ensure that these individuals are treated and followed up on. A register of homeless persons in Kingston and St. Andrew, estimated at 200, has been compiled through contact with these individuals.
Dr. Irons-Morgan also pays tribute to the work of the community mental health team, describing the members as a “very vibrant and dedicated group”. The team comprises psychologists, social workers and occupational therapists, and is led by a senior mental officer, who is a nurse with specialist training in psychiatry. There is also a police support team, comprised of specially trained officers, who are assigned to support the community mental health service, in the event of violence. She is also urging the community to support the outreach programme, noting that it is only through support that the benefits will be realized.