Five years back, “Nugget” the Jack-A-Poo was in serious need of some tender loving veterinary care.
“He needed vaccinations and a few other things,” Seattle native Grace Stroklund recalled of her sidekick, a Jack Russell Terrier/Toy Poodle mix. “But I was just not in the wheelhouse financially to do any of that.”
At 23, Stroklund was struggling with her own challenges. Homeless and in need of medical care herself, she was regularly showering and eating at a drop-in homeless center run by a local church. Even so, it was Nugget's needs that were top of mind.
“I guarantee you that having Nugget and wanting to make sure he was healthy and was getting what he needed motivated me to seek care and preventive care for myself that I probably wouldn't have sought otherwise,” Stroklund said. “I think a lot of people in my position who have a pet feel that way.”
As luck would have it, both Nugget and Stroklund were about to get all the care they needed — and at no cost — courtesy of a dual purpose health care project established in 2018 called One Health Clinic (OHC). It's based at New Horizons, a Seattle shelter for unhoused youth.
“At the time in Seattle we noticed [that] so many people experiencing homelessness had animals,” said Vickie Ramirez, senior coordinator of research and evaluation with the Center for One Health Research. “And we started with the premise that they may source vet care for their animal before taking care of their own health needs.”
So the OHC was born of a need to provide better, more accessible care for people who lack housing and the animals they love, according to Dr. Alice Tin, a clinical instructor in family medicine at the University of Washington and a core faculty member at Seattle's Swedish Cherry Hill Family Medicine Residency.
Breaking down barriers to care
In a narrative published in the September/October issue of the Annals of Family Medicine, Tin, Ramirez and their colleagues describe OHC's mission as an attempt to leverage “the power of the human-animal bond to increase primary care access for individuals experiencing homelessness.”
The idea began as a collaborative effort involving the Center for One Health Research, the University of Washington and the College of Veterinary Medicine at Washington State University.
Tin recalled that unhoused youth and young adults often told outreach workers that having an animal could be a barrier to getting care. That's because animals are often unwelcome in clinics and, the young people said, they had nowhere to safely leave their pet during a visit.
“There was a lot of interest in accessing affordable veterinary care for their companion animals,” she noted.
The thinking was that if a clinic could offer free care for both people and pets alike that the animal's needs might draw owners to the clinic, where they could then tend to their own health care needs, as well.
With that in mind, OHC has provided care to homeless youth and adults up to age 26 as well as their pets, companion animals, emotional support animals and/or service animals.
Though OHC is physically connected to a homeless shelter, Ramirez said the clinic itself is entirely aimed at providing “integrated” human and veterinary care through a single health care plan that covers both two-legged and four-legged patients.
'Not your average clinic'
For patients, the menu of services includes mental health treatment, family planning, gender-affirming care, and testing for sexually transmitted infections. Injuries are also addressed, along with substance use issues, and referrals to specialists are provided as needed.
Pets, meanwhile, can get routine vaccinations, flea treatments and referrals for spay/neuter services.
After learning about OHC from a case manager at her homeless shelter, Stroklund went to one of the clinic's twice monthly open houses.
At the 4-hour-long sessions, patients and pets are seen, evaluated and given a care plan.
On her first visit, Stroklund was able to address her birth control needs, while Nugget got his shots.
Grace Stroklund and Nugget. Photo: Gemina Garland-Lewis
Between 2018 and 2021, the clinic helped 236 animals. And human patients are signaling their approval. The clinic saw a 40% rise in patients in the first year alone, and nearly half of visitors the following year were returnees.
“Everyone there is really there with the purpose of wanting to help,” Stroklund said. “So the whole approach is gentle and friendly. It's not your average clinic.”
Which is important, she said, because a lot of young people have had a traumatic experience on the street. "They need support,” Stroklund said.
Tin said clinic staffers are mindful that many patients have had poor experiences in the past and may be distrustful of health care providers. So when clients show up for the first time they are greeted by a University of Washington student volunteer who serves as a “navigator” to help ensure that the care provided to both patient and their pet is integrated and welcoming.
“The way care is offered feels like more of a nudge than you normally would find in a hard-core medical setting,” Stroklund said.
It also appears to be unique: Tin said she's unaware of any other clinic in the United States that cares for both humans and animals in adjacent clinic spaces — apart from a second OHC that is now open in downtown Seattle.
But both Tin and Ramirez suspect many other communities could benefit from the approach. The team is working with "a lot of communities" to see if they can set up similar systems, Ramirez said.
She noted that the original OHC clinic is "beyond the project phase." It's now a permanently established twice-a-month service.
As for Stroklund, despite recurring bouts of housing instability, she was so impressed by the clinic's mission that she temporarily joined OHC as an outreach consultant to help spread the word.
“We want as many people who need assistance to know about it as possible,” she said, because the clinic “is a beautiful thing.”
Learn more about the clinic at One Health Clinic.
SOURCES: Vickie Ramirez, MA, clinic and senior coordinator, research and evaluation, Center for One Health Research, Seattle; Alice Tin, MD, MPH, faculty, Swedish Cherry Hill Family Medicine Residency, Seattle, and clinical instructor, family medicine, University of Washington; Grace Stroklund, patient and outreach consultant, One Health Clinic, Seattle; Annals of Family Medicine, September/October 2022