The success of the SABSA solidarity cooperative in reaching and caring for the most deprived in society is partly due to the fact that it offers a “walk-in” service. A real. And that she doesn’t refuse anyone. So much so that the staff of the ordinary network send patients there that they cannot treat or follow in an establishment.
“It wasn’t me who came to help the clinic, it was the clinic who came to help me,” summarizes the Dr Roch-Hugo Bouchard. This psychiatrist was working at the University Institute of Mental Health (IUSMQ) in Quebec when he started seeing a patient at SABSA in 2017. “The patient had had problems with the law, he presented psychotic disorders, he had stabbed someone ‘one and no department wanted to follow him once he left the hospital. »
Since September, the Dr Bouchard works at the SABSA cooperative full time. During the visit to the Dutyhe received Jean-François (we present the patients interviewed under a fictitious first name for reasons of confidentiality), a young man of 27, who came to the clinic because he coughed up blood during a panic attack on his workplace.
He wants nothing to do with hospitals, says he is afraid “of being tied down”. He has ADHD and has used amphetamines since he was a teenager.
In addition to the Dr Bouchard, three specialist doctors see patients at SABSA: in public health, infectious diseases and gastroenterology.
“When SABSA arrived, it shook everyone up, but now, the clinic has become essential in the network,” says Agnès Maltais, president of the SABSA Foundation.
Specialized nurse practitioner (IPS) Isabelle Têtu says she regularly receives “references” from the University Institute of Mental Health of Quebec (IUSMQ), but also from different clinics and other community organizations.
Which she doesn’t complain about. But she believes it is proof that SABSA is filling a void.
“This demand from the network is not decreasing,” she said.
Pierre-Luc
SABSA patients are often “barred” elsewhere, notes the IPS, because they do not keep appointments or because they show up intoxicated or drunk in the organizations, which is prohibited almost everywhere.
This is the case of Pierre-Luc, who was waiting at the door of the clinic when Isabelle Têtu arrived on Monday morning. He lives on the street almost all the time, says he was “kicked out” of the L’Auberivière shelter and a pharmacy.
He is there to refill his prescriptions for methadone and Concerta (for his ADHD). “What does your consumption say about these days? » asks Isabelle Têtu. ” I [ne] consume more morphine. Cannabis, yes. Every day,” the man replies in a low voice, hiding in his hood. The nurse takes the opportunity to ask about the rest. It had been a year since she had seen him. She says he can be “a little bit unpleasant”, but that he was ” top shape ” That day.
The Dr Bouchard has noticed that even the most unstable patients are generally calm when they are at SABSA. “It’s rare that we call the police. People are less afraid, they are less agitated. »
But it’s still more stressful than elsewhere, concedes the receptionist, François Routhier, who describes himself as a “crazy guy”. “I’m moving air. For a receptionist, it’s not ideal, but here it’s good. »
In the waiting room, several patients look intoxicated. The conversation with Mr. Routhier is interrupted by a loud noise in the toilet. The man inside fell to the ground. He comes out dazed, explaining that he hasn’t eaten.
Jade and Danielle
The clinic offers walk-in appointments every afternoon during the week. Jade, a sex worker of indigenous origin, showed up there in a miniskirt on Tuesday, despite the winter cold. “It’s been two months since she took her antipsychotic. She is supposed to take one injection per month,” explains Isabelle Têtu.
“Where can we reach you when you need your injection?” » she asks. The woman does not have a cell phone. She says she’s “staying at a guy’s friend’s house.”
In the first years, the clientele included marginalized people, but also many people from the neighborhood and surrounding areas who simply did not have a family doctor. This is less the case today, according to the IPS.
The GAP is taking care of these people more and more, she notes. On the other hand, the marginalized clientele is increasingly fragile and the cases are heavier. Like asylum seekers, more and more of whom are frequenting it. When passing the DutyIsabelle Têtu received Danielle, a woman who arrived from central Africa in 2019 at the end of a true odyssey of misfortune.
Tears flow slowly down her cheeks as she recounts in a barely audible voice how she contracted HIV during a rape in her home country. Then how her community church ostracized her family when they found out.
She asks if it is because of HIV that she is being refused a work permit. The IPS tells him no. She tells her about a new free medication, asks her about her anemia. “Have you ever taken iron supplements?” » The woman agrees to return in a month for follow-up.
Until then, she will return to the rough seas of her daily life. Steve Giroux, the social worker, sees his job at SABSA as a lifeboat next to a large ocean liner. The boat is the health system and it has several floors. Mr. Giroux says he tries to get patients back on the boat, but is not often successful. “I take the “CIBI”, I call the liner, but the gatehouse doesn’t open. » So, he stays in the inflatable with his patients and continues to fish out others.