a housing remedy for Canada’s hard-hit ERs - 2024
shot for the globe and mail
words by molly hayes
After three decades as an emergency physician at Edmonton’s Royal Alexandra Hospital, Louis Hugo Francescutti has come to realize that medicine alone is not health care.
For years now, he has watched an alarming spike in the number of homeless patients coming through his ER’s doors. Just as troubling, he says, is that of the nearly 9,000 patients with no fixed address who visited Edmonton emergency rooms last year, many of them wound up sent back to the same illness-inducing circumstances that landed them in the ER in the first place – only to see them return again, sicker.
To break that cycle, last winter, Dr. Francescutti and his colleagues launched a local pilot program that provides transitional housing for patients that would otherwise be discharged from hospital into homelessness. The Bridge Healing Transition Accommodation Program, considered the first of its kind in Canada, provides 36 recovery rooms spread across three buildings in the city’s west end. In the program’s first year, more than 100 people checked into Bridge Healing, staying an average of 45 days each. Many of them have gone onto permanent housing, Dr. Francescutti said.
For years, these patients have been pejoratively labelled “frequent flyers” – accused of tying up the health care system with unnecessary and gratuitous visits. But as homelessness rates increase across the country – exacerbated by a mental health and addictions crisis – ERs have become almost an inevitable destination for Canada’s most vulnerable.
Fearing where things are headed, a chorus of doctors are calling for radical change: making the case, to whomever will hear them, that safe, affordable, secure housing is the best prescription for their patients.
At Toronto’s St. Michael’s Hospital, roughly 20 per cent of the patients Carolyn Snider sees in the ER are homeless. And she stresses that even 20 per cent is likely an undercount. Dr. Snider, an emergency physician and scientist with the hospital’s MAP Centre for Urban Health Solutions, co-authored recent studies on the rise of weather-related injuries caused by homelessness, as well as the increase in “non-urgent” ER visits by patients experiencing homelessness during the winter months in Ontario. The research identified a province-wide spike in these visits of 24 per cent in 2022/23. In Toronto alone, they rose by 68 per cent.
