Record numbers of homelessness across the United States continue to shine a spotlight on solutions to meet the needs of people experiencing homelessness (PEH). With nearly a quarter of the nation’s unsheltered population residing in Los Angeles County, valuable insights from people living without shelter can inform strategies on how to best meet their needs while respecting the realities of their daily lives.
PEUH come to MacArthur Park frequently, sometimes even daily, but typically have encampments spread across the city, making the park an important touch point in connecting with these individuals for their medical needs.
PEUH who come to the park are largely disconnected from primary care services and either forgo care or rely on acute care like emergency departments and hospitals to meet their health care needs, making hospitals a key stakeholder in the homeless healthcare conversation.
Nearly half of study participants have received health care in the park, and nearly all who did were satisfied with the quality of care received. They demonstrated a high level of awareness of unmet health care needs, inclusive of primary care, substance use disorder treatment, and access to screening for infections. Treatment for mental health disorders was the largest discrepancy between care desired and care delivered in MacArthur Park. This is contrary to a common narrative that PEUH don’t want help or can’t be helped.
Service providers noted wound care, mental health care, addiction medicine, and primary care services were top priorities, and despite the large number of providers, these needs aren’t being met adequately. Meeting these needs requires frequent, consistent visits from providers familiar to the patients who are comfortable practicing a wide scope of practice in a street setting, without reliance on referral to a brick-and mortar clinic.