Eganville – Local paramedics and crisis response workers are quickly making boots-on-the-ground motions to help people living on the streets get sober, housed and thriving independently.

Renfrew County’s Mesa Initiative has come a long way in its mission to combat the root causes of the homelessness crisis and opioid epidemic. The program was launched in March to provide individualized wraparound care and navigate pathways to help the lowest-income demographic get the support they need. In its first year alone, they’ve done so famously.

The Leader recently followed Primary Care Paramedic Joe Hamilton for a shift on Mesa duty to get a sense of a general day in the life working in Renfrew County. The ride-along revealed several little-known aspects of the program’s operations, like how the county’s relief efforts are improving drastically thanks to its newly formed communication network, and that the most important part of recovery is not only being honest with others, but yourself.

Mr. Hamilton said they like to keep two crews on duty, one starting at the base in Pembroke to cover the west end of Renfrew County and the other at the base in Renfrew for calls in the east end, although they can be easily interchangeable. Crews ideally include two paramedics, but that’s not always the case since the program is only beginning and relatively small. However, he assured the county’s paramedics are more than competent enough to work alone.

“We start the day with, ‘who’s our primary focus.’ There are certain people in a state where we need to deal with it now or they’ll be in the wind and we won’t get our second chance with them,” he said. “We try to prioritize people in immediate need and once we get that dealt with we see who else needs or wants help.”

Mr. Hamilton said the Mesa Initiative’s soft launch was like the Wild West, with no real aim other than getting to know the community.

“We hadn’t quite figured out what our mission statement even was. I kind of took on the idea of hearts and minds,” he explained. “For paramedics to get involved, they wanted to see we were doing something, so we just started going out to meet people.”

So far, it’s been rolled out in three phases. The first was its involvement with local services like The Grind and Ontario Addictions Treatment Centre (OATC) to establish a temporary warming centre in Pembroke. The second was forming mobile response teams with community paramedics and crisis response workers. Phase three has addressed the grey areas in the housing continuum by collaborating with local businesses to provide transitional units.

Establishing the Mesa Initiative has been a game-changer in and of itself since all the provincial resources, like Ontario Works and the Ontario Disability Support Program (ODSP), had never shared clients or functioned as a united front. However, Mr. Hamilton noted this is also the first instance where paramedics emphasize well-being and rehabilitation rather than crime prevention. The paramedics work 12-hour shifts starting with a group call between their units and partner organizations.

Emergency call priority levels are colour-coded, with the highest being purple, most commonly for casualties, then red for immediate life-threatening injuries, followed by orange, yellow and green. Although, Mr. Hamilton said most low-priority Mesa calls are just from business owners who want certain people moved elsewhere.

Engaging the Demographic

According to Mr. Hamilton, the most challenging aspect of the job is building relationships with individuals living on the streets. But it’s also the most vital and continues to work in his favour. Cooperative clientele like Bill Wilson, one of the Mesa Initiative’s first success stories (see page A7 from Nov. 20 edition), have played a pivotal role in helping others in the demographic.

After spending two years living on the streets, Mr. Wilson decided to take his life into his own hands after meeting Mr. Hamilton at The Grind in Pembroke. He started to take his advice and, before he knew it, had become a beacon of community hope. Today, Mr. Wilson continues working with Mr. Hamilton to help Mesa paramedics locate people without a permanent address and attends addicts’ anonymous meetings twice a month.

“The Grind was very key in us building the foundational relationships we have today,” Mr. Hamilton said. “I had one guy show me a spot in the middle of Pembroke where people shoot up and leave their needles lying around, so I went back to base and grabbed one of our big sharps containers.”

He said he returned after only a week to find it full of used drug paraphernalia.

“It can get crazy out there. One guy I was talking to compared it to Mad Max. It’s just complete chaos and insanity at nighttime.”

County Delegation

Contrary to popular belief, Mesa is not an acronym for anything. The name refers to a landform with a high top and steep sides. It joins an existing lineup of county-run specialty units, like their Sierra Team for emergency rural responses in wilderness settings (aptly named after the geological formation of a mountain range) and Remotely Piloted Aircraft System (RPAS) for search and rescue.

It started as a multi-agency collaboration between three of the county’s internal service providers: Community Services, Paramedic Services, the Property and Development Department, and many more partner organizations.

Renfrew County CAO Craig Kelley, Jason Davis, Manager of Property and Development, and Community Services Director Andrea Patrick met with Bonnechere Valley (BV) Township Council last Tuesday (Nov. 19) to highlight their progress.

Mr. Kelley said the county has been going full speed ahead on many of its initiatives thanks to plenty of municipal support.

“We are the supporting sides trying to create a level of stability for those in our communities that need it in their life, and Mesa was born.”

He said the next steps for the program include considering “a Mesa approach to building,” and aims to be successful in their hunt for provincial funding.

“If we’re building homes anyways, why not look at creating our own entity to do that? We know the private developers are busy doing their own developments, and that’s their thing. We’re in the social housing business.”

According to Ms. Patrick, the program has been hugely advantageous and may provide an alternative to calling 911 based on the situation.

“We’re really trying to lead some better thinking on how to better reach vulnerable populations in our community,” she explained. “It’s all about individual one-on-one goals and plans. No two people have the exact set of circumstances, so we’re trying to be innovative and think outside the box about how to meet those needs and guide them to a better place.”

Mayor Jennifer Murphy said the owners of the Rocky Mountain House in Renfrew should be applauded for allowing 10 of their units to be used as supportive bridge housing to benefit the program.

“One of the things that was indicated at the health committee, and again at county council; sometimes it’s just about a shower, good hygiene, a good night’s sleep. There were so many reasons for not only not having encampments but getting these people into a situation where we’re setting them up for success.”

Mr. Davis discussed some of the initiatives the county is running to try to increase its housing supply.

“As Andrea (Patrick) mentioned, maintaining the 1,029 units we have is a challenge,” he said. “We know there’s a housing crisis.

“We converted a single-family detached (home) into a duplex. That’s our mantra moving forward. We’re always looking to see what we can do better.”

He said one of the more considerable challenges is that the buildings inherited by the county were built in the 50s and 60s, but plans for their renewal are actively in motion.

County staff reported Mesa outreach teams have been busy since launching last March, with just over 1,500 encounters. Of these encounters, approximately 1,200 were either homeless people, addicts, individuals facing mental health challenges, or a combination of the three.

While their paramedicine services may seem like a cure-all, they’ve made plenty of connections to existing service providers where people might be better served. County staff reported since March, they’ve made 27 referrals to Community Withdrawal Management Services (CWMS), 30 to Renfrew County Housing Corporation (RCHC), 50 to Addiction Treatment Services (ATS), and over 150 to other services.

The Renfrew County District Health Unit (RCDHU) monitors crisis response and hospitalization statistics. Their ongoing surveillance has observed an exponentially rising rate of opioid-related deaths in recent years, a trend aligned both provincially and nationally.

According to page nine of the RCDHU 2023 yearly report, nearly 1,000 naloxone kits were distributed countywide, about 400 more than last year. Increasing community needs also bolstered the use of harm reduction services, with clients being helped 1,723 times, compared to 1,231 last year. The same report highlighted the rate of suspected drug poisoning deaths in 2023 was over three times the rate from 2018 to 2019.

Sidebar: The skyrocketing use of opioids can be traced back to the late 90s when millions of North Americans were affected by chronic pain. It prompted healthcare policymakers to consider a fifth vital sign, discomfort, on a scale of one to 10. Aside from the four existing vital signs, body temperature, blood pressure, heart rate and respiratory rate, the new addition was the only one decided by patient judgement instead of an actual test.

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