The Interprofessional Collaboration of Indigenous Navigators in Accompanying People at Risk for or Currently Experiencing Homelessness

Odile-Anne Desroches

Impact

  • The project has contributed to the advancement of mental health knowledge and practices by identifying tangible ways of strengthening collaboration among homelessness outreach workers.

  • The goal of the project was to better support people facing complex health issues, including mental health problems.

  • The results will be shared with community and health organizations (Indigenous and non-Indigenous), to better equip them in integrating Indigenous navigators or people with experiential knowledge within their health care teams.

  • Quebec

  • Studentship

  • University of Montréal

  • Doctors of the World (Médecins du Monde Canada)

  • Fonds de Recherche du Québec - Santé (FRQS)

  • 2024-2025

  • Social Determinants of Health

  • Caregivers, Indigenous People, People Experiencing Homelessness

About the Project

In Canada, Indigenous people are over-represented among those experiencing homelessness. The paths leading them to homelessness are distinct, notably that of a higher prevalence of post-traumatic stress disorder, associated with intergenerational trauma. In addition, Indigenous people experiencing homelessness face numerous barriers when accessing care. To facilitate this access, the researcher conducted Indigenous navigation programs adopting a holistic health approach focused on individual needs.

Navigators are Indigenous people who reach out to other Indigenous people in the community, establishing trust and guiding them through their health care journeys. As an integrated part of health care professional teams, the navigators also face barriers in collaborating with their colleagues, such as the lack of understanding of their role as well as discrimination.

The project thus aimed to explore how Indigenous navigators collaborate with professionals in the teams where they work, to identify the factors facilitating or hindering this collaboration and to propose solutions to improve the support offered to Indigenous people experiencing homelessness.

Methodology

The project studied an Indigenous navigation program within a non-Indigenous Montreal-based organization in which ten semi-structured interviews were conducted, involving eight professionals (navigators, nurses and a manager). These ten semi-structured interviews were supplemented by seven on-site observation sessions. A hybrid thematic analysis was used, combining a deductive approach (based on hypotheses and a conceptual framework of interprofessional collaboration) and an inductive approach (based on data).

Findings

  • The study showed that interprofessional collaboration, when it is well-supported, facilitates access to a variety of resources, holistic care and better coordinated follow-ups. These are key elements in responding to complex needs, especially those related to mental health and to the needs of Indigenous people experiencing homelessness.

  • This collaboration was facilitated or hindered by various factors, including:

    • The uncertain work environment

    • The ambiguity of roles

    • The differing expectations among professionals

    • The cultural backgrounds shared among colleagues

  • Despite possible tensions, the positive relations and recognition of experiential knowledge (especially that of peer navigators) strengthened mutual comprehension and the collective capacity to respond to the needs of those being accompanied.

  • The findings highlighted the importance of initiatives such as diversity training, professional self-reflection and the development of a trustful atmosphere for improving collaboration and ultimately, the quality of mental health care.

  • The findings also shed light on the challenges of integrating experts with lived experience in the health care teams and on the importance of offering appropriate support spaces. For example, it is essential to offer access to psychological support for these workers, given their repeated exposure to difficult work situations.

  • The provision of cultural support space was also pointed out by Indigenous participants, for example, the ability to meet with an Elder of the community.

Project Outreach

This project consisted of a case study conducted at the local level reflecting the realities of homelessness in Montreal. The study’s qualitative and specific nature, namely the attention given to descriptive and in-depth data, allowed for the complexity of these realities to be conveyed. However, this qualitative and descriptive nature limits the generalization of the findings to other settings.

Resources Created

  • A webinar created by Siméon, J., Desroches, O A. (the researcher), entitled: Documenter la navigation autochtone : apprentissages d’une collaboration de recherche (2024). Webinar of the Research Chair in the Reduction of Social Inequalities in Health. Available online (available only in French):

  • An article written by Desroches, O A. (the researcher), entitled: Collaboration interprofessionnelle de navigateurs autochtones au sein d’une équipe communautaire dans l’offre de soins de proximité aux personnes en situation d’itinérance, (2024). University of Montreal. Supervisor: Boivin, Antoine; Houle, Janie. Available online (available only in French):

  • An article submitted for publication to the Journal of Interprofessional Care, with the goal of disseminating the findings to the scientific community.

  • A report integrating the research findings (as well as the findings of the broader research of which it was a part) is being drafted, in partnership with Doctors of the World—Médecins du Monde Canada, possibly leading to other tools for the dissemination and mobilization of knowledge.