Sheway A day in the life. Kari Stout Dana Clifford

Transcription

1 Sheway A day in the life. Kari Stout Dana Clifford CONTACT INFORMATION RESOURCES Kari Stout Kari.Stout@gov.bc.ca Dana Clifford - Dana.Clifford@vch.ca British Columbia Centre of Excellence in Women s Health- 1

2 SHEWAY Pregnancy Outreach Program located in the Downtown Eastside of Vancouver program provides health and social service supports to pregnant women and women with children,who are dealing with substance use issues focus of the program is to help the women have healthy pregnancies and positive early parenting experiences Client Population Pregnant and parenting women who live in or frequent Vancouver s Downtown Eastside and struggle with poverty, substance use, violence, homelessness, legal, trauma and/or mental health issues. 2

3 MANY WOMEN AT SHEWAY EXPERIENCE.. Poverty and hunger Violence, trauma and sexual exploitation Inadequate, unstable housing and/or homelessness Trouble with the law Unplanned pregnancies/child removals Substance use Guilt, Shame, Stigma and Mistrust Alienation from health and social service providers Intergeneration effects of trauma on First Nations People Unstable childhoods and lack of positive role models for parenting Chronic stress SERVICES PROVIDED Daily drop in and hot lunch Nutrition counseling and prenatal vitamins Primary medical care Well baby care and immunizations Contraception, STI/HIV/ HCV counseling and testing Overdose prevention services- narcan Referrals and advocacy with other health care providers Parenting support Alcohol and drug counseling Housing and social benefits advocacy Navigating and advocacy with MCFD and the legal system Many of these services may be provided through outreach 3

4 PRIOR TO SHEWAY Targeting High Risk Families study (1993) revealed: 40% babies born in the Downtown Eastside were substance exposed High incidence of low birth weight (33% in exposed infants) 100% of these children apprehended into care of child welfare IMPACTS AFTER SERVICES PROVIDED Accessing prenatal care: 91% of women connected to physician or midwife at delivery (30% no care at intake) Food security issues decreased to 4% 6 months post partum compared to 79% at intake. Birth weights: 87% of women gave birth to infants with birth weight over 2500 gms. 58% of the women leave hospital with babies in their care 4

5 STAFF AT SHEWAY Counselor Community Health Nurses Social Worker Dietician Infant Development Consultants Housing/Outreach Workers Family Physicians Psychiatrist Cook Client Engagement Worker Medical Office Assistant Aboriginal Community Support Worker Administrative Assistant Music Therapist Coordinator PARTNERSHIP Governed by a Council: Ministry of Children and Family Development- Child Welfare Vancouver Coastal Health Vancouver Native Health Society YWCA of Vancouver Ministry of Social Development and Social Innovation Social Assistance 5

6 SHEWAY PHILOSOPHY OF SERVICE Based on the recognition that the health of women and their children is linked to the conditions of their lives and their ability to influence these conditions. SERVICE MODEL We provide services in a flexible, non-judgmental, nurturing and accepting way Use a woman-centered approach Respect and understanding of First Nations Culture Harm reduction approach Trauma Informed Practice Safe drop-in environment Networking 6

7 WOMEN CENTERED CARE Women Centered Care is based on the assumption that women know their own reality best and that practitioners must listen carefully to women as they describe their reality in their own words and in their own ways. TRAUMA INFORMED PRACTICE Work at the client, staff, agency, and system levels from the core principles of: trauma awareness; safety; trustworthiness, choice and collaboration; and building of strengths and skills. Discuss the connections between trauma, mental health, and substance use in the course of work with all clients; identify trauma symptoms or adaptations; and, offer supports and strategies that increase safety and support connection to services. 7

8 BARRIERS TO CARE STIGMA The effects of stigma are particularly important for pregnant women and mothers Because of feelings of fear, guilt, and shame due to misusing substances, women often may not present for prenatal care until delivery Negative and harsh attitudes of providers lead to feelings of rejection during birth Prejudicial treatment during a previous birth may have created or strengthened feelings that the healthcare system is punitive The abrupt removal of an infant by Social Services does not allow women the opportunity to make a transition into being a mother NORMAL DAY No such thing as a normal day at Sheway Day starts with a brief meeting to discuss needs of clients for that day and update from previous day Outreach, accompanying clients to appointments, court, meetings etc. Drop in runs from1030-3:30; client access whatever services they need during this time The medical clinic has a physician and nurses to see clients throughout the day Every staff member at Sheway is involved in advocacy 8

9 WEEKLY PROGRAMS Monday Milk and fresh fruit are delivered; lawyer on site Tuesday- food bank pick up with volunteers who prepare the food bags; eggs; Circle of Security Group; Wednesday: Seeking Safety Group; Tuesday & Thursday afternoons Social Assistance Worker on site Wednesday- Community Kitchen Group; Psychiatrist Friday - Parenting Group; Music Therapist; volunteers to work on completing government forms like taxes, assist clients in registering for schooling Pediatricians from RICHER Program are on site 3 afternoons per week to see Sheway children and other children from the DTES community ANNUAL EVENTS Christmas Party for open and closed clients Summer Picnic Annual Baby Welcoming Ceremony based on First Nations traditional practices 9

10 IN CONCLUSION The workday at Sheway is unpredictable and ever changing-in order to engage with clients we need to be flexible- meet them where they are at Staff never know what challenges and opportunities each day will bring but this is why most of us love our jobs The strength and resilience of the women and children at Sheway inspire us everyday 10