Paramedic Partnership Breaks Barriers

Highlighting an innovative model of care with Aleta Armstrong, Director of Community Engagement, Inclusivity and Fundraising at CMHA and Paul Wuergler, Community Paramedicine Coordinator for Simcoe County

It was May that the Ministry expressed interest in CMHA partnering with paramedics to do a ride-along much as the agency already does with police, said Aleta Armstrong, Director of Community Engagement, Inclusivity and Fundraising at CMHA. By June, all partners agreed it was feasible and worth pursuing, but with the provincial government having to adapt in so many ways to the pandemic, the Ministry approved the funding for a pilot partnership just before the December 2020 holiday break.

CMHA had proposed that staff ride-along with paramedics two days a week, using the balance of the days to follow-up with clients in their homes, the partnership aims at getting vital services to those who need them so they get the timely, needed care rather than end up in hospital, an outcome that is worse for them and for a health system that sometimes struggles for resources, especially during a pandemic. But with government approval occurring just three months before the fiscal year ends March 31, CMHA adapted again, modifying the pilot partnership by increasing the number of ride-alongs to three or four times a week.

Plans were then re-jigged a third time when the demands of the pandemic caused a shift for paramedics, but while plans are on hold for now, both partners are excited about collaborating in the future. Before the pilot program, too many people who needed help flew under the radar until they ended up in an emergency room. When they left hospital, too often they went without community care. “(Some) people in need only become known when they are in crisis, when they are at their most vulnerable,” Armstrong. “I’m so excited. This is a true attempt to fill gaps in service.”

Paul Wuergler, Community Paramedicine Coordinator for Simcoe County, agrees.  “This is a fantastic opportunity (and) Barrie is a great place to pilot the program,” he said. The pilot would add to the work CMHA and paramedics have done together to break barriers to better serve those in need. The pandemic also drew both to shelters whose homes were moved to hotels so clients could be physically distanced.

Before the pandemic, paramedics weren’t involved at all in shelters and had but a few involvements with CMHA.“The pandemic changed the face of paramedicine,” Wuergler said.

The spread of coronavirus forced paramedics to suspend home visits, freeing up resources that Simcoe County officials might be put to good use at shelters, where demands were surging. At first, paramedics helped screen homeless people for symptoms of COVID so those who might be infected could be tested and isolated. But once paramedics started visiting shelters, or more specifically, the hotels that were used in their stead, it became evident that more was needed. Paramedics started checking on the general health states of those in shelters, work that made a difference.

Those welfare checks turned up another pressing need: More than half of those seeking help wanted mental health supports, perhaps triple the rate of demand of what paramedics find responding to 911 calls in the community. While some seeking help had a psychotic disorder like schizophrenia or bipolar disorder, many more struggled with anxiety or depression, challenges made more difficult by the pandemic, Wuergler said.

Requests for mental health support pushed paramedics beyond their comfort zone – the training they receive about mental health isn’t extensive – and bogged down their efforts to check on all shelter participants seeking help. So they turned to CMHA, which first offered help remotely, through its crisis line, but soon joined paramedics in hotels converted to shelters. The impact was obvious: Homeless people in shelters got badly needed mental health support and paramedics now had a partner that freed them up to focus on physical needs. “It’s an incredible partnership,” Wuergler said. “I got to see firsthand how they operate.”

The expertise in mental health was not the only benefit CMHA delivered; its staff were much more accustomed to running clinics, a skill that requires them to manage their time and competing interest – not an area of strength for paramedics who are trained to throw all their efforts and focus into each call. “A weight was lifted off our shoulders,” Wuergler said. “People’s needs were being properly met.”

Written by Jonathan Sher

(Please note: Due to the unexpected and tragic COVID-19 outbreak at Roberta Place and the worrisome spread of the COVID-19 variants the launch of the ride-along program has been postponed until further notice)