‘ABI (Acquired Brain Injury) in the Streets’ is an example of how Guelph Wellington Ontario Health Team partners come together to support some of the most vulnerable people in our community. While brain injury is common amongst people with mental health issues and substance use, those who are homeless are impacted at an even higher rate.
In collaboration with other outreach teams, workers from Traverse Independence visit encampments, shelters and residential settings as well as receive referrals from other community services (Hope House, Guelph General Hospital, Mission City, Homewood – etc.). The outreach workers complete a HELPS screener (an Acquired Brain Injury screening tool). The screener identifies patients with potential or suspected ABI. HELPS screeners have also been embedded in the Emergency Mental Health and Addictions (EMHAS) patient assessment at Guelph General as well as Homewood Health Centre’s Acute Care Unit and Outpatient Services and has been rolled out for use within primary care teams. The goal of the GW OHT collaboration is to further identify patients with undiagnosed ABI in our community, connect individuals to Traverse services through a low barrier access system and reduce repeat or unnecessary ED visits.
Between April and December 2022, across the County of Wellington and the Region of Waterloo 238 screeners were completed by the outreach team. From those screening blitzes, 75% or 174 people screened positive for an ABI which supports the theory that the homeless population is more vulnerable to brain injury as the typical average is 60-65%. When clients who have screened positive with the HELPS screening tool* are referred to Traverse Independence, they will be assigned an outreach worker. This worker, who specializes in brain injury will, work with other community providers to offer care through a brain injury lens, provide information, advice, and training to other team members regarding ABI treatment and support access to the Traverse clinical team and intensive care coordination.
A client from the ABI in the Streets program stated, “I think there’s a direct correlation between addiction and brain injuries and the end product is homelessness.” The client experiencing homelessness continued, “To just eliminate homelessness will never work. But to address how to help people better manage their lives and better function with the limitations that they have, without being scared that if you name a limitation that you’re responsible for it. This is what this program does. It just gets down to the meat and potatoes.”
This low barrier, relationship-based program is meeting people where they areand providing tailored, team-based care. ‘ABI in the Streets’ helps clients put strategies in place, so they may not need services elsewhere in the community, therefore easing waitlists for other healthcare services such as Guelph General Hospital and Homewood.
By collaborating and integrating services, residents of Guelph Wellington will have improved access to mental health and addictions services and their providers will be better able to share information and work together to identify and meet each patient’s goals. This is part of the strategic priorities for the GW OHT.