Ms Grace Bennett-Daly1, Ms Michele Dowlman1, Ms Leigh Harkness1, Ms Maria Unwin1, Dr Thi Thuy Ha Dinh1, Ms Jane Laidlaw2, Associate Professor Kathleen Tori1
1School of Nursing, University of Tasmania, Launceston, Australia, 2Kings Meadows Medical, Launceston, Australia
People who are homeless experience poorer health and often face difficulties engaging with public healthcare services. One Mission Health Nurse-led Clinic (MHNC) was established to meet healthcare needs of this marginalized population in Launceston, Tasmania.
This study examined clients and staff’s perspectives of the MHNC services and explored opportunities for expansion.
The study comprised of using MHNC’s administrative database and face-to-face interviews. Staff and clients were interviewed to determine their perceptions on impacts of MHNC and further services needed. All interviews were recorded, transcribed, and thematically analysed.
A total of 205 presentations were reported by 174 individuals over 25 months. The median client age was 42 years; 60.9% male; 38.5% were homeless or lived in a supported accommodation. Mental health issues and substance/alcohol abuse were most reported in health histories (24.8% and 13.8% respectively). The main reasons for clinic visits included prescription requests (25.3%) and immunisations (20.1%).
Fourteen interviews (10 clients; 5 staff) were conducted. All clients highly appreciated the nurse-led services and identified that the MHNC met their health care needs. Both clients and staff suggested further services including mental health and allied health, extra operating hours and the flexibility of walk-in appointments.
The addition of mental and allied health services, flexible service delivery and street outreach could assist in delivering essential primary healthcare services to homeless populations, resulting in increased engagement and improved health outcomes. Agreed partnerships with interprofessional primary healthcare providers will contribute to addressing unmet healthcare needs in this vulnerable population.
Michele is a Lecturer of Bioscience and Nursing at School of Nursing, UTAS. Michele has discovered a passion for primary health, and as one of the founding nursing partners of Mission Health, has seen the difference that time to listen, empathy and a non-judgemental approach to care, can make to a person marginalised by homelessness and poverty. Michele has a passion for clinical reasoning, and teaching bioscience so that students understand patient presentation and can articulate rationale for therapy. Michele has co-authored an upcoming Anatomy & Physiology textbook, and a Pathophysiology textbook to be written in the near future.