Pressing Healthcare Needs in a Windsor-based Shelter Health Initiative

Background: Windsor Shelter Health (WSH) offers = on-site medical services at shelters and drop-in centres for people experiencing homelessness (PEH) in Windsor, Ontario. PEH face barriers to health, including competing demands that may outweigh their desire for healthcare, transportation barriers, and being lost to follow up. WSH was established to improve healthcare experiences and outcomes for PEH by enhancing access to care that addresses their needs and improves population health. Approach: A survey was developed, validated, and distributed to client-facing staff at shelters and drop-in centres to understand the current state of healthcare access for PEH in Windsor and identify unmet healthcare service needs of PEH in Windsor as understood by client-facing workers to enhance the WSH model. Results: Survey results (n = 60) indicated strong support (96.7%) for continuous, ongoing, and direct shelter health supports accessible to PEH. Services felt to be most important included access to physicians for primary care, psychiatric care, addictions medicine, access to harm reduction, wound care, and counselling. Delays in access to care were felt to be due to clients’ fear and mistrust of the healthcare system, clients’ concerns regarding stigma experienced, and a lack of transportation. Conclusion: Results of the project will serve as a baseline for the development of targeted programs and services to effectively support and improve health care access and outcomes for people experiencing homelessness in Windsor. This may serve as a model for similar jurisdictions on how to build a well-integrated shelter-health model.