Trauma, violence-informed primary care key to London hospital's planned clinic

A new clinic set to open later this year aims to fill a longtime healthcare gap faced by survivors of domestic violence and sexual assault in London.

St. Joseph's Health Care London announced that a primary health care clinic specializing in trauma and violence-informed care will open at St. Joseph's Hospital, with a focus on women and children affected by intimate partner violence and sexual crimes.

The Trauma and Violence Specialized Primary Care Clinic will be located on the hospital's fourth floor and open in the coming months, the hospital unveiled on Wednesday.

St. Joseph's officials are heralding it as a first-of-its-kind in Canada. The clinic is more than a decade in the making and will connect survivors to the kind of primary health care many may not have access to.

It will also "fill a significant gap in the community, particularly for racialized individuals, those with disabilities, immigrants and refugees, and 2SLGBTQIA+ people," officials said in a statement.

More than half of the people visiting St. Joseph's Sexual Assault and Domestic Violence Treatment Program have no primary care physician, said Dr. Susan McNair, the program's medical director.

"It's unique in that we are looking at trauma as an entity here, where often the outcome of difficult, traumatic events play out in different health ways," McNair said.

Instead of focusing on an individual outcome of that trauma, such as addiction, "this program is identifying individuals with trauma and responding then to the unique needs of trauma survivors," she said. 

That includes helping them understand how that trauma is linked to their current health situation. People who experience significant early-life trauma come with a significantly higher risk of addiction and chronic health conditions later in life.

"One of the things we'll study is, when we help people to understand that link and reduce some of that self-blame, does it lead to better outcomes?" she said.

Such clinics can help in rebuilding trust

While many healthcare professionals use a trauma-informed approach, having a clinic dedicated to and named for trauma and violence-informed care is an opportunity to connect with those reluctant to seek healthcare, said Chuck Lazenby, executive director of Unity Project.

The agency provides emergency shelter, housing stability, and supportive housing services to those experiencing homelessness, among them domestic violence and sexual assault survivors.

"Certainly folks who access our services, or you know, who are experiencing homelessness or are street-involved, have a significant distrust of the medical system," said Lazenby. 

"Programs like this can help rebuild that trust, especially when it's a recognition of a person's experience of trauma and violence and coming from that trauma-informed approach. It's really necessary for folks that we see to be able to access supports like that."

The new clinic is being launched with the help of $3.82 million in provincial funding from the Ministry of Children, Community and Social Services, announced in the last several weeks, which will cover the next two-and-a-half years.

Staffed with at least four physicians and two social workers, it's anticipated the clinic will serve around 600 people in its first two years, with patients initially referred from within the hospital.

Patients considered for referral would be those with no family doctor who have a history of "significant adverse childhood experiences, or significant adult events of trauma," McNair said.

Along with its role as a primary care clinic, it will also serve as a source of research regarding trauma survivors and their primary care needs — research that can be used to teach future healthcare staff and inform treatment decisions elsewhere at the hospital.