Providing care for homeless people with mental health problems
8:00 - Coordination meeting
The ESMES team meets every Monday morning to coordinate actions, priorities, and the cases they are managing. The program serves individuals referred by the Barcelona City Council's social services for the homeless (SIS), by street outreach workers (SASSEP), or from the city's various housing facilities (shelters, the Housing First program). It also receives referrals from the psychiatric units of Barcelona hospitals. The program serves more than 500 people annually.
The team discusses the challenges they must consider in their care model, since in most cases, the individuals have not sought help. Being aware of the traumas these people have experienced and offering a psychologically supportive environment is the foundation of their approach.
11:00 - Walking through the streets
The first contact with the person is crucial. Teams travel throughout the city to locate the individual using information received from social services professionals, who sometimes accompany the teams during this initial contact. ESMES always works in sub-teams of nurses and psychiatrists. They also conduct regular visits to the network of shelters and other accommodation facilities where these individuals are cared for.
Establishing rapport and trust between the person receiving care and the ESMES program professional is one of the major challenges. There can often be resistance to contact, which requires a slow, gradual approach, highly tailored to the person's expressed needs.
The model of care for these individuals, who experience the most extreme form of social exclusion, is based on identifying their expressed needs and maintaining a connection with someone living outside of social interaction. Given the dynamic nature of this population, it is crucial to be able to adapt to the type of care the individual desires and determine how to best respond . Working in close coordination with social service providers (municipal social services, Fundación Arrels, San Joan de Déu Serveis Socials, among others) is essential .
15:00 - We had a coffee and chatted.
Unlike other mental health services, the street is a very visible area of focus because it's where these individuals spend much of their day. Therefore, it's possible to visit and assess the person in an environment where they feel comfortable . Having coffee together often creates a moment of connection and closeness that helps them get to know each other better and understand each other's needs.
On other occasions, the professionals also visit the ESMES team headquarters in the San Joan de Déu Numancia building.