Healthcare and Homelessness

For clients who are homeless or at risk of homelessness, we know that stable, safe housing is key to achieving and maintaining health. And yet, in so many cases, the only place where the housing and healthcare systems intersect is in the homeless client’s experience.

Research conducted in 2019 among healthcare providers in the 10-county region of Northwest Lower Michigan shows that more than 70% report daily or weekly interactions with clients not stably housed; of these, less than 50% report personal confidence in helping these clients, and less than 35% rate their organization as effective in meeting the needs of homeless clients.

So how can we, in our day to day work, address this most critical of issues for those most in need? The answer is surprisingly simple: talk to them.

This summary video (runtime 8:44) of the research, process and outcomes of the NMCHIR Homeless Response System project details simple, concrete and impactful ways to prevent homeless individuals and families from falling through the cracks in the system. We’ve tested and are beginning to implement these throughout our region, but they will have relevance to anyone that follows this blog series: we all are citizens and have a duty to assist those at risk. No one knows or feels this more deeply than those of our readers in the healthcare field.

Key to our discovery process was convening practitioners from both systems in a series of collegial, proactive conversations that led us to preliminary conclusions about how the system works (or doesn’t) and the resources and constraints that each have to offer. We worked closely together to co-design solutions related to policy, data sharing, training opportunities, shared language and more effective use of existing resources.

“Where did you stay last night?”

Asking this simple question upon intake is the key to understanding whether the individual sitting in front of you is currently homeless or at risk of homelessness. We found that healthcare providers across disciplines were reticent to ask given their lack of knowledge about available resources: if you assume you can’t actually help the person, it’s better not to ask.

This simple change, both in awareness and procedure, has already led to connections that would otherwise not have happened. And as our exploration and training expand beyond the pilot phase, we believe that lives will continue to be saved.

“The thing we want to learn about a stranger is fragile. If we tread carelessly, it will crumple under our feet. The right way to talk to strangers is with caution and humility.”

- Malcolm Gladwell

In his book “Talking to Strangers, what we should know about the people we don’t know” Malcolm Gladwell shares several case studies (most notably the traffic stop that ultimately led to the death of Sandra Bland) that illustrate the challenges we have in contemporary society to understand and respond to others based on a lack of knowledge about the context of a given individual’s current behavior. As a result, he implores the reader “Don’t look at the stranger and jump to conclusions. Look at the stranger’s world.”

We know that the individuals we encounter in a healthcare setting have a variety of challenges that impact their lives, and that the role of healthcare providers (physical and behavioral) is to help them manage those challenges. Homelessness is one of the top-ranked social determinants of health identified by the NMCHIR as a “barrier to health and quality of life.”

By watching this video, we hope you’ll take the lessons learned from our 2019 pilot program and apply them to your own area of practice. Please comment below or contact us if you have any questions about the program, its goals and the findings we’ve shared here. And as always, thank you for your contributions to this important work.

Originally posted on connect-cx.com on January 6, 2020

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Partner at Connect_CX, The Adjacency; speaker, facilitator, systems thinker, healthcare experience designer: www.connect-cx.com

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Mark VanderKlipp

Mark VanderKlipp

Partner at Connect_CX, The Adjacency; speaker, facilitator, systems thinker, healthcare experience designer: www.connect-cx.com