The University Health Network said it is deploying an innovative way of helping patients who are experiencing homelessness that also takes pressure off emergency room staff facing ever-increasing patient volumes.
The organization said that in 2023 alone, 51 patients with no fixed address visited UHN’s emergency departments a total of more than 3,300 times.
It's an average of nearly 65 visits per patient — more than once every week — over the course of a year.
But these patients often needed something beyond medical care, said UHN, whose 10 sites include Toronto General Hospital, Toronto Western Hospital, Princess Margaret Cancer Centre and Toronto Rehabilitation Institute.
Enter the peer support workers program.
The initiative was launched in 2020 in a partnership between UHN’s Gattuso Centre for Social Medicine and The Neighbourhood Group Community Services.
Under the program, people who have experienced homelessness and substance use provide specialized care for people facing the same challenges, the hospital network said.
Peer support workers talk to patients to figure out how they can help, whether that’s grabbing them something to eat, calling shelters to find an available bed, or advocating for their care needs.
“Peers’ input helps us understand a patient’s history and realities, including recognizing vulnerabilities that often go unnoticed in the chaotic emergency department environment,” Dr. Kathryn Chan, a UHN emergency medicine and addictions physician, said on the UHN website.
Many of the patients lack trust in the health-care system due to stigma and negative experiences, added Michael Waglay, manager of community peer programs at The Neighbourhood Group Community Services.
“Peers really help people receive the care that they need because they are able to instill more trust and remove some of those barriers,” Waglay said.
This helps patients feel safer about disclosing experiences like domestic violence or mental health challenges so hospitals can provide appropriate care.
“There’s intense stigma against being homeless, having substance use issues, having mental health issues,” Waglay said.
“With the peer program, a lot of their experiences that are so intensely stigmatized have become something of value. That is a very validating experience.”
Peer support worker Patrick Esenerwa recalled a patient who was experiencing suicidal ideation and paranoia.
Recognizing the patient needed a quiet space, Esenerwa coordinated with the lead nurse to find an empty room where he could keep the patient company while they waited for a doctor.
He got the patient something to eat and was able to help them contact their mother, who came to the hospital.
“We bring a different kind of support that’s needed in the emergency department, especially considering the pressure the nurses and doctors go through,” Esenerwa said.
“Now that I’ve seen the peers in action, I simply cannot imagine working without them,” Dr. Chan added.
UHN said the program is impactful for the peers, too, since they often continue to build their careers in social work or auxiliary health care.
