{"id":239051,"date":"2025-12-18T10:43:10","date_gmt":"2025-12-18T10:43:10","guid":{"rendered":"https:\/\/www.europesays.com\/ie\/239051\/"},"modified":"2025-12-18T10:43:10","modified_gmt":"2025-12-18T10:43:10","slug":"i-think-people-feel-safe-with-us-the-irish-times","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/ie\/239051\/","title":{"rendered":"\u2018I think people feel safe with us\u2019 \u2013 The Irish Times"},"content":{"rendered":"

The doctor and nurse crouch in front of the flap of a tent pitched in the darkness beside Dublin\u2019s<\/a> Grand Canal to talk to the 77-year-old man for whom this is \u201chome\u201d. <\/p>\n

He is a rough sleeper<\/a> with a heart condition and mental health<\/a> issues, and is well known to Dr Enda Barron and nurse Sin\u00e9ad Grogan of Safetynet Primary Care. On this chilly December evening, they have come to him in a white van fitted out as a compact, well-equipped GP room, with red seating providing a pop of colour in the clinical white interior. They want to review him, before prescribing another week of medication.<\/p>\n

But, as expected, the man will not venture out of the tent. They check his blood pressure and pulse in situ as there is no question of coaxing him into the van, which driver Se\u00e1n Fitzgerald has parked across the road.<\/p>\n

Dr Barron will return in the morning with this patient\u2019s medication, which comes in blister packaging to help him keep track of doses. He satisfied the doctor tonight that he was managing it, as he had the correct amount left from the current week\u2019s supply.<\/p>\n

Three nights a week, this mobile clinic brings healthcare to vulnerable people who live under the radar of mainstream health services<\/a>. While there are several walk-in GP clinics for the transient street community, this GP service walks up to them.<\/p>\n

\u201cWe prioritise their health when they might have different priorities,\u201d says the chirpy and affable Dr Barron, who is the clinical lead on Safetynet\u2019s primary care team and works on the evening mobile clinic once a week. \u201cSometimes, it\u2019s about catching people where they\u2019re at.\u201d<\/p>\n

Safetynet liaises with staff of services such as the Dublin Simon Community<\/a> and hostels, who point them in the direction of individuals they are concerned about. There is no knowing who or what they might encounter on any given night.<\/p>\n

\u201cEverything is a surprise \u2013 a bit like general practice lots of times,\u201d he says. But there are patterns of issues among patients they may, or may not, have seen before.<\/p>\n

\u201cIt\u2019s busy coming into this cold season because everyone has coughs, colds, flus, skin infections,\u201d says Grogan, who is manager of the homeless primary care team. \u201cWe see a lot of scabies, people sharing tents. So there\u2019s a lot of acute care needs. We\u2019re not able to do more long-term, chronic disease management because it\u2019s not really the appropriate space for it.<\/p>\n

\"DrDr Enda Barron inside the mobile health unit run by Safetynet Primary Care. Photograph: Barry Cronin <\/p>\n

\u201cWe\u2019re really just the first point of contact for people and then we try and get them into our day services for more detailed follow-up.\u201d<\/p>\n

However, the cohort is so transient, follow up is a huge piece of work in itself, she explains. They do this in partnership with other non-governmental organisations and Dublin City Council<\/a> services. \u201cIt\u2019s a lot of background work, nearly like detective work, to try and find people.\u201d<\/p>\n

Safetynet is also a point of contact for inclusion health teams working at St James\u2019s Hospital<\/a> or the Mater hospital<\/a>. \u201cIf someone discharges themselves against medical advice, or attends ED [emergency department] and leaves before they\u2019re seen, they contact us to see if we could try and find them or if we\u2019ve come across them.\u201d<\/p>\n

Both St James\u2019s and the Mater have open access clinics to which Safetynet can refer. \u201cMeeting people where they are at\u201d can be a cliche, but Safetynet is \u201c100 per cent that\u201d, says its chief executive Nicola Perry, speaking earlier from the organisation\u2019s headquarters on Amiens Street. \u201cWe subscribe to the idea that people are not hard to reach if you\u2019re looking for them in the right places.\u201d<\/p>\n

The mobile unit is just one part of services run by Safetynet, which was set up over 15 years ago with street sleepers in mind. It has since broadened its reach to anyone who cannot access mainstream health services for whatever reason. Maybe that is due to addiction or mental health; they don\u2019t have a medical card or their lifestyle is too chaotic; they are newly-arrived migrants or members of marginalised communities such as the Roma.<\/p>\n

Tonight, the van starts outside Mendicity, a charity in the Liberties that has been providing practical support to some of the city\u2019s poorest residents for the past 207 years. Its centre, off Bridgefoot Street, prioritises those sleeping outside, offering free meals and snacks, showers, laundry and other services up to 10.30pm, six days a week. A short walk away, the Liberty Soup Run is setting up for the evening on Thomas Street.<\/p>\n

\"TheThe Safetynet mobile health clinic parked outside Mendicity on Island Street, Dublin. Photograph: Barry Cronin<\/p>\n

The first two men who Dr Barron sees in the van both have symptoms of respiratory tract infections, a common winter ailment but aggravated by their circumstances. Lung health tends to be an issue among this cohort of patients, he explains, due to their living conditions and the use of cigarettes and crack cocaine. <\/p>\n

Neither man has attended Safetynet before so their details are logged in its data base, which can be accessed by relevant GPs and healthcare providers. This tracks individuals\u2019 medical history, to avoid prescription duplication and guard against adverse drug interactions. It also saves patients from having to repeat their stories. <\/p>\n

While Dr Barron and Grogan aim to treat the need that is being presented, they are also trying to cover other potential issues. \u201cThere could be other stuff going on,\u201d he says. \u201cYou\u2019re always trying to look at the bigger picture … because you don\u2019t know when they\u2019re going to see another healthcare provider.<\/p>\n

\u201cIt\u2019s so important that we have this joined-up computer system, that I can see where people are at.\u201d<\/p>\n

For instance, somebody might come in saying they can\u2019t sleep \u2013 which is a common complaint because they may be in a room with six other people, he points out. \u201cWhereas that mightn\u2019t necessarily be my priority because I see from the notes, maybe, that they\u2019re HIV positive and they\u2019re not taking ARVs [antiretroviral medication]. Or maybe they are pregnant.\u201d<\/p>\n

Then it is about trying to link them in with other services.<\/p>\n

\u201cThere is always a solution, it\u2019s just about trying to make sure that you make that solution as accessible and as easy as possible,\u201d he says. Dublin Simon\u2019s new Medical Residential Treatment and Recovery Centre (MRTRC) on Ushers Island provides both step-down (from hospital) and step-up (from community) care, to which they can refer patients.<\/p>\n

[\u00a0\u2018We are human beings too\u2019: Homeless singles react to Government housing plan prioritising familiesOpens in new window<\/a>\u00a0]<\/p>\n

One of the men he and Grogan see this evening is on a waiting list for MRTRC\u2019s detox unit. Right now he needs a dressing on knee abrasions to be changed; he is already on antibiotics. Street drinkers often come in with cuts from falls and these are liable to become infected.<\/p>\n

The man sways as he navigates the three small steps into the van. Dr Barron puts out a steadying arm and teasingly asks if he has had a drink earlier. Both he and Grogan banter with patients to help them feel comfortable and also to gauge their mood.<\/p>\n

\u201cI think people feel safe with us because it\u2019s a bit of craic,\u201d he says. \u201cIt\u2019s a non-judgmental service. You can present whichever way you want. We don\u2019t care.\u201d<\/p>\n

He\u2019s not religious but in this work he always has the sense of, but by the grace of God go I … \u201cCircumstances can have such a negative impact on people\u2019s housing and then they lose their housing. That impacts on their health and then they become, you know, despondent. It\u2019s about trying to give people hope, I think.\u201d<\/p>\n

In an ideal medical provision society, says Perry, Safetynet wouldn\u2019t be needed to try to fill gaps. About 90 per cent of its almost \u20ac3.5 million budget for 2026 comes from contracts with different branches of the HSE. A workforce of 50 operates primarily in the Dublin area but a mobile health screening unit, for example, travels to scattered International Protection Accommodation Services. It checks asylum seekers for bloodborne viruses and does chest X-rays to rule out TB.<\/p>\n

\"DrDr Enda Barron: ‘Everything is a surprise \u2013 a bit like general practice lots of times.’ Photograph: Barry Cronin <\/p>\n

Its 2025-2028 strategy recognises the increasing prevalence of people with mental health challenges amid an ever-growing homeless community. A record high of 16,700 people were in emergency accommodation around the country last month. The latest official count for people sleeping rough in Dublin, conducted last spring, was 121.<\/p>\n

\u201cThis year we set up a counselling psychology clinic that\u2019s two days a week,\u201d reports Perry. \u201cIt is there for our own internal GPs to be able to refer to. We don\u2019t have a magic wand. We can\u2019t get access into, say, inpatient or psychiatry, outpatient support.\u201d<\/p>\n

That is why they wanted one mental health service that people could attend \u201cwithout waiting for weeks or months or worse\u201d.<\/p>\n

Currently, \u201cwe do at least one involuntary admission a month and sometimes it\u2019s more than that\u201d, she says.<\/p>\n

Can there be resistance within mainstream services to referrals from their medical staff? \u201cI would say it depends on where we\u2019re going,\u201d says Perry. The organisation has excellent relationships with St James\u2019s and Mater in particular, due to their \u201cquite innovative and advanced inclusion health programmes\u201d, she says.<\/p>\n

\u201cBut if we\u2019re referring to something like, for example, cardiology, there still is, being perfectly frank, an element of discrimination\/stigma against people in addiction or with mental health [issues].\u201d There can be an attitude that, \u201cokay, we\u2019ll make an appointment but the person won\u2019t turn up and there will just be another DNA [did not attend]. <\/p>\n

\u201cAs opposed to where we\u2019d be coming from, which is, well, that is a possibility, but it\u2019s also a possibility with someone who doesn\u2019t have an addiction issue \u2013 and you\u2019re not going to not make an appointment for them.\u201d<\/p>\n

[\u00a0Alice Leahy: I have learned there is no single story about being homelessOpens in new window<\/a>\u00a0]<\/p>\n

She also mentions that all Safetynet GPs are trained to work through interpreters when necessary, which does not apply within the HSE \u201cand that instantly is just blocking people\u201d. They use three different companies who can provide interpreters trained in medical translation in a wide range of languages and are available remotely. The appointment is then conducted through a conference call.<\/p>\n

The canal bank is the last call for the mobile clinic this evening.<\/p>\n

The daytime outreach that Dr Barron will do the following morning will be without the van. \u201cI just go with a backpack.\u201d<\/p>\n

Any evening there is a particular concern about somebody who is seen, that is flagged in the handover and Grogan, as manager, sends a GP to see them the following day.<\/p>\n

\u201cSometimes, people do need to go to the emergency department, but they may not want to go for various different reasons,\u201d says Dr Barron. \u201cSo then we have to look after them. We have to follow up the next day, to make sure they\u2019re taking antibiotics and that they haven\u2019t deteriorated.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"The doctor and nurse crouch in front of the flap of a tent pitched in the darkness beside…\n","protected":false},"author":2,"featured_media":239052,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[275],"tags":[52,18,135,475,474,24081,60,19,17,167],"class_list":{"0":"post-239051","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-dublin","9":"tag-eire","10":"tag-health","11":"tag-health-care","12":"tag-healthcare","13":"tag-homeless-crisis","14":"tag-hse","15":"tag-ie","16":"tag-ireland","17":"tag-mental-health"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@ie\/115740161819861977","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/239051","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/comments?post=239051"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/239051\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media\/239052"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media?parent=239051"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/categories?post=239051"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/tags?post=239051"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}