Intervention and local management

This programming reflects recognized expertise in the design, implementation and evaluation of local initiatives linked to the needs and resources of the communities to improve access to and continuity of social and health services for vulnerable populations.

An action research project (Project #01, 2017-18) funded by Réseau1 Québec aimed to address the challenge of access to the healthcare and social services network for refugees in the target city, by strengthening the network of actors and services involved with this population, and by supporting the reflection on proposals for integrated, sustainable local interventions based on the needs of the community. The results of this action research were revealed to the community in June 2018 during a day of exchange and knowledge transfer co-constructed with the partners involved in the project. This day was summarized in a report entitled "Qatra Qatra Darya Mesha" (Drop by drop the river forms, Dari, Afghan proverb). This event closed the action research with the participation of nearly 80 people including refugees, provincial and federal deputies and several municipal and institutional actors in health and immigration.

This project gave rise to a second project (Project #02) focused on the mental health issues of refugees and the adequate time frames for conducting initial post-arrival assessments at the Refugee Clinic. The results of this second project showed that mental health, although complex, was central to the refugees interviewed. Health of the “heart and soul” was necessary to regain life balance following forced immigration. The scoping review highlighted that the ideal time frame depended heavily on the type of migration trajectory experienced, that it was counterproductive to wish to standardize these practices at all costs and that it would be more relevant to screen for emotional distress at least twice in the year of arrival, for example.

In 2019, the team received a grant from the Fondation de l'Ordre des infirmières et infirmiers du Québec ( Project #03 , 2019-2022 ) to implement the "ideal model" thought up and created during the action research, namely a local intervention model centered on the role of a community nurse who would work in 2 disadvantaged neighborhoods, with the help of a psychosocial team that had already been in place for years. This project (in the process of being made sustainable) has shown that the role of the community nurse is becoming a pivot in terms of access to health services and makes it possible to establish continuity and clinical follow-up within communities. It makes it possible to reach people who clearly would not have consulted before the emergency room. In the pandemic context, this role has become proactive during door-to-door sessions as well as when responding to semi-emergencies by telephone related to COVID-19 or any other physical and mental health problem.