Where can a homeless person go for healthcare, specialist referrals and access to medication? The Matthew Talbot Hostel runs one of Sydney’s only healthcare clinics for homeless men. A new UTS research project is set to help the clinic better measure the complex health needs of homeless men and ensure their services continue to meet their clients’ needs.
Every night hundreds of people in Sydney sleep in crisis shelters or on the street. A 2015 City of Sydney survey counted and spoke to more than 500 homeless people in just one week. Over 80 per cent were men.
That survey also revealed that the majority of homeless men have a mental health issue, a history of substance abuse, or both. On top of this, many have other health problems such as diabetes, heart disease, or even pneumonia or bronchitis.
“Many clients have a number of co-existing health problems,” affirms registered nurse and Team Leader at the Matthew Talbot Hostel clinic Julie Smith. “It is very common to see a person who has schizophrenia, metabolic disease and a concomitant addiction issue.”
According to Smith, who oversees the clinical work of nurses and visiting health professionals, the hostel is working to bridge the gap between hospital care and no care at all for homeless men.
In addition to offering temporary shelter, pastoral care and legal services, the Mathew Talbot Hostel, which is part of St Vincent De Paul Society NSW, also includes a clinic that provides medical, psychiatric, optometry, and podiatry care.
One of their primary functions involves ensuring homeless men are getting the medication they need – every day of the year.
“We manage and administer about 60 people’s medication a day,” says Smith. “This means it doesn’t get lost or stolen, we can monitor if a person is taking medication consistently, and we also get to check-in with them on a daily basis.”
The team at the Woolloomooloo clinic also treats everyday first-aid issues like headaches, cuts, wound dressings and infections. They work with specialists to deliver preventive health clinics like Smoking Cessation, Metabolic Health, Diabetes, Liver and Influenza.
While the Matthew Talbot Hostel clinic isn’t the first of its kind, recent closures of similar services in Sydney mean it does offer a unique and essential service in improving the health and welfare of men who need it.
That’s why the hostel has teamed up with UTS’s Centre for Health Services Management. Senior Lecturer Michael Roche is leading a research project aimed at better measuring the complexity of health needs among homeless men visiting the clinic and their patterns of accessing services.
The project, officially titled ‘Primary health care for homeless men: An exploration of the service use and health needs of homeless men in inner Sydney’, has been awarded a $10,000 Health Futures Development Grant by UTS’s Faculty of Health.
The research project has already looked back over the last five years of data collected by the clinic, run a voluntary survey amongst homeless men and attempted to spot salient patterns in service use.
“We asked the men to help with providing information about why they went there, what the outcomes were for them and what they perceived had happened to their health over time,” explains Roche.
“This qualitative information really gives colour and depth to what we’ve found in the clinic’s data, and I hope that will give the clinic a much stronger idea of what the men perceive to be the most effective parts of their service.”
Roche’s background as a mental health nurse gives him an in-depth understanding of the complexities involved in measuring barriers to services and health outcomes in such a diverse population.
He explains: “The barriers to accessing a health service are pretty well established, but there’s also the welcoming aspect which is really important as a facilitator. We’re finding it’s not so much about what stops you going to another service, but what makes you want to come to this one.”
Smith agrees. “A lack of authenticity is picked up on very quickly, and as our goal is to provide high standards of health care with as few barriers as possible, it’s important to be present, transparent and giving.
“I think all the nurses have a great passion to work in the homeless sector. You have to genuinely love what you do, be welcoming and open.”
It’s this attitude that seems to set the Matthew Talbot Hostel clinic apart from hospital emergency rooms or many GP services. And by investigating whether homeless men’s health outcomes could be measured by fewer trips to the emergency room, or just more appropriate visits, Roche hopes to show the hostel clinic is taking the pressure off inner-Sydney hospitals.
“The clinic provides a service that is open and attractive,” explains Roche, “and the men come to them, which is an interesting approach as it’s somewhat different to what we might have seen in other instances.”
Roche hopes his research findings will enable him to recommend “some more elements the clinic could measure in the future that will help develop their services and demonstrate the value of what they’re doing.”
Smith concurs: “The outcomes may generate some important questions and directions for further research and funding applications.
“I am hoping that this initial research heralds the beginning of a strong research partnership with UTS looking at important aspects of homelessness and homeless health in Australia.”
Find out more about this project by listening to 2SER’s Think: Health podcast.