This study is based on 12 semi-structured interviews with clients attending community-based clinics
focusing on at-risk populations, who often have very complex health needs. The interviews focused
on the clients’ experiences when seeking care in emergency room and hospital settings. Thematic
analysis of the interview transcriptions was conducted on the interview data. Research team
members initially conducted individual coding, and later met to discuss the codes and group the
codes into themes through consensus. We found the majority of participants avoid the use of ERs
and hospital settings for care until absolutely necessary. This is despite over half of them not having
a primary caregiver and thus few options for any health care access. This avoidance was discussed
in the interviews as related to poor treatment upon disclosure of histories of drug use and diagnoses
such as Hepatitis C and HIV/AIDS. The majority of participants felt their health concerns were
dismissed or trivialized by service providers once they disclosed. Participants described seeking to
be treated “like a regular patient,” not labelled by their illnesses, or generalizations. The lack of
sensitivity by service providers in these settings as to possible addiction issues was identified by
participants as problematic, leading many to consider whether to disclose their histories. Failure to
disclose their health histories to service providers led to several participants having to self-manage
addiction issues by refusing prescriptions. Overall, this research confirms there is much work to be
done creating inclusive and safe ER and hospital settings.