When a person is struggling to meet basic housing and nutritional needs, a visit to the doctor's office likely isn't the first thing on their minds.
But experiencing homelessness is in and of itself a major health risk, said Dr. Mary Stapel, the lead physician for community care and community clinic at OSF Saint Francis Medical Center.
"What we will often see is because of the chronic stress and trauma that folks are living in, definitely mental health, behavioral health struggles, as well as addiction struggles," she said. "Certainly a good mix of chronic physical disease is in that mix. And then, unfortunately, the longer that folks live in a homeless situation, their risk for acute physical illnesses, infectious diseases, wounds, things like that, also increase."
Stapel is part of OSF's Street Medicine Team, which started about two years ago to meet people experiencing homelessness where they are. That includes a shuttle which can provide direct care.
"We will sometimes just go to where we know people are. Sometimes we'll go to a central location like JOLT (Harm Reduction), or another site where we know people might gather, like the bus station," she said. "And then people can be seen either on the van or off of the van."
Stapel said the team can provide food, clothing, and first aid supplies. They also have the ability to check vital signs, blood pressure levels and conduct some basic screenings. They can also make referrals or connections for more advanced services - but that often requires building trust first.
"So many of our patients that we have had really traumatic experiences within the healthcare system. And so, that definitely creates some distance between us, and definitely creates issues in terms of their access to care," she said.
Partnerships with organizations like JOLT can help the street medicine team transfer some trust and begin a conversation, Stapel said. The other important thing is consistently showing up.
"I also think that's the biggest thing, is that (if) we continue to show up, then they start to feel like we're in it for the right reasons, and we really do want to see the best outcomes for them and for their overall health and well-being," she said.
The street medicine team sees a wide variety of clients, ranging in age from 18 to 80 years old. Many of the younger patients grew up in foster care, or were marginalized because they identify as LGBTQ+. Some of the older patients, meanwhile, have lived without stable housing for decades.
"To the best of our ability, (we) take the care that we can to them, and then connect them to the care that we can bring to them," she said.
Stapel said working with the street medicine team is a "transformational experience" on how she and others on the team view homelessness.
"I think it has completely flipped the way my mind handles the whole the whole problem of homelessness," she said.
"I think it's really easy for us to take a viewpoint, when we don't understand the traumas that folks have been through that bring them to that point, it's really easy to feel like, maybe with different choices, they could be in a different situation," she said. "But I think that the more that I get to know people, and the more that I understand what they've been through, more than anything, I'm just so humbled by their resilience, and by the fact that they are still with us, and they still have such an attitude of love and openness, which is just amazing to me."
