A new partnership makes care convenient for families

Experiencing homelessness takes a toll on the physical and mental health of those going through it. Children experiencing homelessness are sick four times more often than other children; they have four times as many respiratory infections, twice as many ear infections, and five times more gastrointestinal problems. Mothers experiencing homelessness typically experience depression and anxiety at significantly higher rates than their housed peers. Forty-seven percent of women experiencing homelessness meet the criteria for a diagnosis of major depressive disorder—twice the rate of women in general. We have long known that homelessness worsens health outcomes for children and their families, so as plans for the Edgerley Family Horizons Center took shape, it only made sense to make healthcare more accessible to the families Horizons serves.

Boston Healthcare for the Homeless Program’s (BHCHP) new Family Clinic on the second floor of the Edgerley Family Horizons Center brings health care directly to the families served by Horizons. BHCHP’s high-quality care is just a short walk away from the Early Education Center, making scheduled visits and drop-ins more convenient for families whose child or children come to school at the same location. Before, there were many barriers to families receiving care, some logistical and others psychological. For example, lack of access to transportation and the expense of getting to visits, particularly the many that come in an infant’s first year of life, were often challenging for parents living in shelters. Now, visits can be scheduled before or after the child’s school day, making it more efficient for parents who also need to minimize travel expenses and time so they can get to their employment. Services at the clinic are free of charge to families, so the expense is never a factor in getting the care they need. Says Barry Bock, CEO of BHCHP, “Our mission here at BHCHP is to ensure unconditionally equitable and dignified access to the highest quality health care for all individuals and families experiencing homelessness in our community.  We are thrilled to be able to meet the medical and mental health needs of these families right where they are as it is best practice for clinical medicine and is a core tenet of our health care model.”

“Making pediatric and family healthcare accessible to the families we serve was always one of the promises offered by a new facility, and our partners at Boston Health Care for the Homeless Program (BHCHP) are making that a reality,” said Kate Barrand. “The trauma associated with homelessness takes a toll on the mental health of our families. We are especially pleased that the Family Clinic can provide services for both parents and children so that parents can be their best selves with their children during this challenging period of their life.”

The new Family Clinic also helps address the psychological barriers to receiving mental and behavioral health services. There’s no embarrassment; mental health assessments are integrated into regular visits. Mental health is normalized and a topic that Horizons’ Family Advocates are broaching in their work with families. “While we work with families on their economic mobility, we often see underlying anxiety or depression that might be an obstacle to their progress. Incorporating health and wellness has always been a part of our model working with families; we now have the added resource of trained counselors nearby to whom we can refer parents. Having clinical mental health support within reach complements the work we’re doing with parents to identify and build upon their strengths,” said Ayesha Rodriguez, Director of Family Partnerships.

The new Family Clinic features a Primary Care Provider, Nurse Manager (RN), Medical Assistant, Behavioral Health Clinicians, Benefits Coordinator, and/or a Case Manager. It is open to families Monday through Friday, 8:30 am to 5:00 pm, and Thursday evenings until 7:00 pm. Providers include bilingual clinicians in English and Spanish, both in primary care and behavioral health, and the hope is to include other language-speaking providers in the future. The Family Clinic is taking an authentically patient and family-centered approach, meeting parents where they are without requiring, for example, parents to switch primary care. Families are being seen for both ongoing primary care and episodic/urgent care, and, if needed, the Family Clinic will communicate with the parent’s Primary Care Physician to coordinate care. Behavioral health services include individual therapy, family therapy, play therapy for children, and parenting groups. “Our proximity to Horizons is helping families by improving overall access to good visits and sick visits for children and parents as needed. By partnering together, BHCHP and Horizons are both delivering on our respective missions,” offered Barry Bock.

Families are increasingly using the services offered. In addition to health services, the clinic has also started running parent therapy/support groups where parents can connect with each other, offering connection over their shared experiences. “I appreciate having the clinic right upstairs and the fact that they are always available. If I can’t get to my PCP, Dr. Younkin will always see me. And the resources are amazing; they go above and beyond to make sure the families have what they need,” shared a mom of a child in one of Horizons’ classrooms.

Proximity to the clinic is also helping Horizons and its staff by welcoming them in for support. Over the past year, the clinic offered convenient opportunities for vaccination. And the clinic is not exclusively available to Horizons but offers services to residents in the neighborhood who need care, benefiting the broader community.

As this partnership grows, we all look forward to seeing better health outcomes for both children and their parents and more families taking advantage of convenient care now well within their reach.

[2] Buckner, Beardslee, & Bassuk, 2004.