Sunday, 23 March 2014

Crisis Intervention In Real Time

"I'm a nurse, can I help?"
These words are not complicated. As nurses, we say this everyday without recognizing the potential impact we can have on someone's life. While assisting in an online crisis intervention, these words are saving lives.

As society becomes more accustomed to sharing our lives openly using social media tools, it only makes sense that persons needing assistance will reach out through this same method. Who is there to offer help? This is where Real Time Crisis comes in.

The concept for Real Time Crisis grew from a focus group comprised of leaders within community mental health, education, social services, law, probation, transit safety, policing, nursing and most importantly persons with lived experience. We have built a collaborative team of professionals all passionate about making a difference and bridging the gaps in our current system.

Our focus is on prevention of mental health crisis. We are proactive in a currently reactive system. We recognize the importance of a "Listen More, Talk Less" approach. Through direct online engagement with the person in distress we provide support and assess level of risk. Communication occurs through private messaging for confidentiality. We incorporate a level of response that is appropriate to the level of risk. Safety of the person at risk and all service providers is of paramount importance.

We are real professionals intervening in real time. I look forward to sharing more information as we move forward in becoming fully operational. Thank you to our team members, followers and all those lending support as we proceed with this exciting new venture.





Saturday, 21 December 2013

Resources - Homeless Community/Winter Storms



I am compiling a list of resources and contacts that anyone can use should you see someone in need of shelter. Please use your judgement and based on your comfort level, you can decide if you wish to approach someone and ask if they need help.

If the person does wish to go inside there are some options:

The City of Toronto has a Shelter Assessment and Referral Centre located at 129 Peter St. (corner of Peter/Richmond) Transportation to that location may be a barrier, you could help with a TTC token or call Streets To Homes at 416-392-0090 and outreach workers can assist. Within the city of Toronto, a call to 311 will also connect you to services, City Shelter Assessment and Referral Centre is a free call from any payphone 1-877-338-3398.
Please see link for City of Toronto services:
http://www1.toronto.ca/wps/portal/contentonly?vgnextoid=cfa2d62869211410VgnVCM10000071d60f89RCRD

If someone does not wish to go to shelter, Out of the Cold programs are a good option. These programs are staffed by volunteers and are available at various locations around the city. Usually dinner is served and also breakfast is provided in the morning. Again, transportation may be a barrier so a TTC token could be helpful.
Please see this link for more information and locations:
http://www.ootc.ca/

If someone appears to be in need of assistance and you would like an outreach team to attend on scene, please call 311 or Streets to Homes at 416-392-0090.

If you are outside of the City of Toronto, please call 211 or visit this link for resources:
http://www.211ontario.ca/

If someone is experiencing a medical emergency or is in acute distress, please call 911.


























Monday, 25 November 2013

Project Winter Survival 2014

At this time of year when our temperatures start dropping, we turn our thoughts to those who are sleeping rough on the streets. Every night in the city of Toronto, there are hundreds of people out there without shelter. When someone is staying outside facing freezing rain and snow, the average life of their sleeping bag can be a few days. If someone is fortunate enough to have a structure to stay within, their supplies may last a little longer.

Persons who are homeless rely on organizations to provide essential supplies such as sleeping bags, hats, mittens, hygiene supplies etc. The reality is that many of these organizations are not for profits and/or charities that are struggling to meet the needs. It is difficult for those wishing to help but facing the frustration of financial limitations.

Fortunately there is an organization called Engage and Change that assists us each year with a program called Project Winter Survival. Last year 3,000 sleeping bags and survival kits were distributed to over 170 social service agencies. The survival kits are backpacks filled with essential supplies that help to ease the strain of life on the streets. Sleeping bags and survival kits are distributed by outreach workers from the receiving agencies.

From an outreach perspective, it is important to note that in many cases these supplies are a tool we use to establish trust with the person at risk. There is often a process involved with getting someone to safety and it may take a few outreach visits with supplies to gain the trust necessary to accomplish our goal of getting someone to safety.

If you are interested in helping with this project, please consider making a donation. With the holiday season fast approaching providing someone with sleeping bag and survival kit could be a unique and meaningful gift.

http://www.engageandchange.org/

Thank you for making a difference!


Thursday, 31 October 2013

Have you ever met "Eddie?"

Yesterday, I was on my way to work like any other day.  As people were rushing out of the subway and toward an escalator, I noticed an elderly man. He was carrying a bag of clothes and walking with a cane. As I walked closer it became obvious that he was visually impaired. I said hello and identified myself as a Street Nurse.

Before I could ask if he needed any help, he told me his name was "Eddie" and that he was looking forward to his day of people watching in the downtown. He was vague about where he stays at night but assured me I had no need to worry about "all of that."  Eddie shared that he had worked as a Chartered Accountant and could have been considered very unlikely to have fallen on hard times. He had a lot of questions about what a Street Nurse would do and advised me to write a book about all the people I must meet along the way.

Eddie was up to date on current affairs and had a lot to discuss about the state of our world. He asked me if I had a Halloween costume and shared what some of his best costumes had been as he was growing up. He also reminded me how in his day, people made homemade fudge and taffy apples for the kids. "And isn't it funny that nowdays you can't give out anything unless its wrapped?" I agreed with Eddie but he said he understands that the world can be a riskier place these days.  He shared some stories about his siblings and their Halloween adventures many years ago.

His face changed quickly as he shared that two of his siblings had then grown up and left for the war. He lost two siblings and life was certainly different after that. Eddie told me that its very important to just keep living your life and not waste time on things you cannot change. I knew that I was going to be late for work but somehow talking to Eddie just seemed more important than the clock.

When it was time for me to leave, he asked me to please remember him and to include him "if you ever write that book."  I hope that all of you get the opportunity to meet an "Eddie".  Don't hesitate to stop and say hello when you see someone in need. Their day and yours as well could be forever changed.

Saturday, 7 September 2013

Stay Connected, Stay Safe


If you are a street outreach worker or setting up a team, it is important to consider incorporating the use of social media into your practice. Although agencies are concerned with costs during these times of budget constraints, it is essential to recognize the positive impact of being connected. For both safety reasons and as a source of knowledge and resources the cost of smart phones is minimal.

During severe weather episodes this past year, an informal group of outreach workers kept connected and were able to provide services across the city in an innovative way. This would not have been possible within our traditional system as our workplaces did not have "partnerships." Fortunately, this barrier did not affect us as we were previously connected on Twitter.

By following weather alerts, social media emergency management teams, emergency services, police etc. we are able to keep updated in real time. We can communicate with each other by using direct messaging, BBM, WhatsApp etc. for privacy. As there are no catchments in the virtual world, we have the ability to connect with other outreach workers in any location. Being connected allows us to be aware of trending issues such as missing persons, viral outbreaks in shelters, harmful street drug alerts and time sensitive issues within our communities.

Real Time Crisis is currently being established as a result of these connections. Follow us @realtimecrisis for more information and for support in connecting your outreach team. Stay connected and stay safe!





Sunday, 18 August 2013

Going Everywhere But Nowhere

Recently, I met a friend for coffee. He was homeless for many years. He has an apartment now and is taking medication regularly.  His symptoms of Schizophrenia are well controlled.

We chatted about his previous days and what his life was like when living under an overpass. As he reflected on those times, he said "I was going everywhere but nowhere then." Profound and insightful words that led to another conversation. Why did he succeed and why is he here sitting with me and doing well? The answer is in two simple words: outreach and relationships.

This man trusted one person in his life that he met in troubled times. He met a police officer who took the time to offer him something to eat and to listen. He was able to de-escalate a potentially violent situation by removing him from noise and a chaotic scene. They met during the G20 in Toronto, a time of heightened stimuli and risk for our mentally ill and homeless population.  From that initial act of outreach by a caring police officer, a trusted relationship began that continued to build over months. Through a referral from this police office to myself as a Street Nurse, the circle of trust was extended for our friend.

With continued outreach efforts and building of trusted relationships, we succeeded in case management of a man who would have been labelled "difficult to serve" by our traditional health care sector.  His road to recovery was not without challenges as there are many gaps in our health care system. However, success became possible because of the relationships developed through our interactions. None of us gave up when we lost contact for periods of time. We were able to use social media to keep in touch. Imagine the potential of case management with smart phones.

We have many agencies in our city doing great work but sadly the outreach piece is being discontinued. Our most vulnerable cannot manoeuver the system to access services. Outreach is essential to help persons in need get to the appropriate supports. It is also important to note that if those who are helping do not establish trusted relationships with the persons at risk, even outreach efforts can fail.

We have formed a working group and are making "Real Time Crisis Intervention" a reality. Fortunately, #HomelessJoe can share his success and look back on the feelings of "everywhere but nowhere." He is somewhere now that is safe and secure. Follow us on Twitter https://twitter.com/RealTimeCrisis and Like our Facebook page https://www.facebook.com/RealTimeCrisis


Sunday, 21 July 2013

Project Water 2013


On July 9, 2013 over 310,000 bottles of water were donated to homelessness service providers. This project is part of the Engage and Change initiative and supported by Bargains Group. Companies interested in offering their employees the opportunity to give back to their communities provided volunteer support. For the first time this year bags containing a re-usable water bottle, a shirt, sunscreen, hat, water, first aid kit and a snack were also provided to agencies providing front line support. Even those living on the streets with a best friend were not forgotten as some bags are packed with dog treats. We are very grateful to this program and the volunteers who made this happen.

This summer, we have experienced several heat alerts and extreme heat alerts in the Toronto area. This becomes even more problematic when the street is your home. If someone is staying overnight in a shelter, they need to leave through the day. It is probable that someone could have water with their early breakfast and not receive any hydration until they check in again at approx 5 pm for an evening meal. For those who are not able to secure a shelter bed even water twice daily could be a luxury.

Every year there are more deaths related to heat than as a result of hypothermia from the cold.  Heat exhaustion without hydration and cooling can lead very quickly to heat stroke and even death. Those most vulnerable include seniors, children and those with chronic medical conditions. There is a high risk among our homeless population particularly for those suffering from mental illness or cognitive impairment.

Many people ask how they can help and my answer is a simple one. Please look out for each other during heat alerts and be mindful of those at greatest risk. Sometimes the smallest gesture can have the greatest impact. If you see someone outside, offer them some water. "Just say Hello and acknowledge me as a human being" said a formerly homeless woman when asked how someone could help.  Kindness and water are simple gestures; you could save a life.