Hailey Shingleton, Author at Fourth Street Clinic

Healing Without Barriers

Hailey Shingleton — Fri, 01 May 2026 21:00:50 +0000

Mental health challenges, substance use disorder and homelessness are often deeply connected – and deeply misunderstood. Stigma, past trauma, and broken trust can make seeking care feel impossible, leaving many without the support they need.

At Fourth Street Clinic, we believe care begins with meeting people where they are at, building trust and providing compassionate behavioral health care and substance use disorder support that treats the whole person, not just their addiction.

At just 21, Atreyo began experiencing homelessness, cycling in and out of the prison system while battling substance use disorder for over a decade. Exhausted and ready for change, he came to Fourth Street Clinic in 2023 seeking sobriety and care. Week after week, he rode the FrontRunner from a halfway house in Ogden, determined to show up for himself.

Through behavioral health support and medication-assisted treatment, Atreyo began to rebuild. Now 34, he recently entered his third year of sobriety and has steady work, as well as a stable place to call home. He continues to meet regularly with his provider at Fourth Street Clinic, maintaining his commitment to recovery.

“You guys saved my life,” he says. “You do awesome work here and help a lot of people.”

Alabama’s story is different, but no less shaped by determination.

Creative and free-spirited, she spends her days with her dog, Ellie, crafting jewelry to sell at the Liberty Park Drum Circle. She lives with PTSD and suicidal ideation, along with a reluctance to seek care shaped by past medical trauma. As the sole caretaker of her son, who became disabled after open-heart surgery, accessing care has never been simple.

After surviving domestic violence and losing connection with her family, Alabama found herself alone and eventually homeless. “I’ve always been a mom – that’s what my whole life revolved around,” she reflects.

For Alabama, the healthcare system has not felt safe. “Every doctor I’ve spoken to about my mental health issues has only ever written me a prescription and has never done an evaluation,” she shares. So, care comes to her.

Through our Medical Outreach Street Team, Alabama’s provider meets her where she is – creating space for trust and real support. For the first time, Alabama will receive a behavioral health assessment and begin getting the care she deserves.

“I want people to remember me in a good place, and I want to get my soul back,” she says.

On May 16 Fourth Street Clinic will walk with our community in NAMI Walks, standing for mental health awareness and the belief that no one should have to navigate these challenges alone. Stories like Atreyo’s and Alabama’s remind us that healing doesn’t look the same for everyone, but with the right support, it is always possible.

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How Homelessness Worsens Health, Especially for Minorities

Hailey Shingleton — Thu, 02 Apr 2026 23:15:12 +0000

April is Minority Health and Stress Awareness Month and from 4/6 – 4/12, it is also Public Health Week! Public Health Week highlights the conditions and circumstances that shape health outcomes across communities, and homelessness remains one of the most urgent public health challenges in the US.

For minorities, the health issues associated with homelessness are intensified, due to what researchers describe as “weathering,” or the cumulative impact of repeated social and economic adversity.¹ This includes both the stress of homelessness and the ongoing strain of systemic inequities. As we know, homelessness places individuals in a constant state of survival and fight or flight, triggering harmful biological responses such as raised levels of cortisol. Over time, this can raise blood sugar to dangerous levels, increasing the risk of or escalating pre-existing conditions, i.e., Type 2 Diabetes and hypertension.

In 2025, Fourth Street Clinic served 5,754 patients, many of whom identify as a minority. Our Diabetes Educator and Pharmacist, Shideh Hafezi, PharmD, sees the correlation between homelessness, chronic stress, minority populations and diabetes every day. In March of 2023, Shideh started treating a patient who lost their sight as a result of living with untreated diabetes, which was exacerbated by three pregnancies while experiencing homelessness. Being blind and having extensive nerve damage, she also could not check her feet for diabetes sores. When this patient first came to Fourth Street Clinic, her A1C level was 13.2%, but after receiving education around diabetes and working with Shideh, her A1C lowered to 8.5% by January of 2024. She was also able to see our volunteer podiatrist, to help manage her feet and neuropathy.

Patients are the reason we are driven to provide integrated, trauma-informed and culturally responsive care that addresses not only health disparities, but the toll of chronic stress amongst minorities experiencing homelessness. Our staff is intentionally diverse, and many are bilingual, because we want our patients to see not only themselves in us, but trust that we are invested in continuing to offer a space where every patient feels supported and valued. Minority Health and Stress Awareness Month and Public Health Week serve as a reminder that improving access improves health outcomes for vulnerable populations.

Richard, M. K. (2025). Homelessness and race: the impact of structural conditions on Black, White, and Latine homelessness. Social Problems.

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Why Safe Access to Health Care Matters for Women Experiencing Homelessness

Hailey Shingleton — Tue, 17 Mar 2026 20:19:54 +0000

In partnership with Huntsman Cancer Institute, Fourth Street Clinic hosts a Women’s Health Day every quarter to expand access to essential preventive care. During this event, unsheltered women receive mammograms, cervical cancer screenings, vaccines, and early HPV detection services in a supportive and welcoming environment.

This focus on high-quality care for women experiencing homelessness is especially important during Patient Safety Week in March, a nationwide effort to reduce harm and strengthen safe care practices across the health care system. By prioritizing preventive services and patient safety, Fourth Street Clinic works to ensure that every patient receives care in an environment built on compassion, trust and respect.

According to the National Alliance to End Homelessness, women without stable housing are disproportionately affected by gender-based violence, including domestic, dating, and sexual violence or exploitation, as well as stalking and human trafficking. The organization reports that 80% of women self-report trauma or abuse as the cause of their homelessness.

For Fourth Street Clinic and our Medical Outreach Street Team (MOST), the connection between gender-based violence and homelessness among women is clear. “A lot of the women we typically see while on outreach are either in or have experienced relationships where domestic violence occurs,” says Callie Larson, Supervisor of the MOST.

Fourth Street Clinic works to ensure women feel safe seeking care by fostering an empathetic and patient-focused environment. “Every day we tell our patients that we care about them and reassure them that we’re here for them; they aren’t alone. Helping them feel safe is centered around offering support and guiding them to resources that are available, if and when they are ready,” Callie says.

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As Homelessness Grows, Care Must Too

Hailey Shingleton — Wed, 04 Feb 2026 17:24:04 +0000

From January 29–31, volunteers across Salt Lake County participated in the nation-wide 2026 Point-in-Time Count. This annual count determines how many people are currently experiencing homelessness, including those sleeping on the street, in shelters, or in places such as cars and parks. The data collected during the count informs forward-looking decision-making for homeless service providers throughout the county; in 2025, the Point-in-Time Count showed an 18% increase in homelessness compared to 2024.

For Fourth Street Clinic, the Point-in-Time Count is a critical tool for estimating the level of health care need among people experiencing homelessness in Salt Lake County, allowing us to scale and adapt both our in-clinic and outreach services so we can meet patients where they are. The need for the trauma-informed, integrated health care we provide continues to grow and, currently, we are forced to turn away approximately 25% of walk-in patients due to the constraints of our clinical space.

Fourth Street Clinic is actively working to secure the funds needed to rebuild our current site, ensuring that individuals experiencing homelessness can access the care they need. In contrast to a $1,500 emergency room visit or costly hospitalization, Fourth Street Clinic spends only $500. Therefore, the preventative care provided at our clinic is not only cost-effective, but results in huge money savings for our community. If a patient falls below 200% of the Federal Poverty Line, the most they would ever pay for a clinic visit is $4.

Without care, many patients face significantly higher risks of developing complex health conditions – many of which are either directly caused or worsened by homelessness itself.
Consider managing diabetes, asks our Medical Director, Van Aston; “How can diabetics manage blood sugar through diet changes if they have nowhere to cook fresh food and vegetables? How can someone clean a wound daily if they don’t have access to a shower? These are things many people don’t realize they take for granted.”

In addition:

Long-term exposure to the elements weakens the immune system and keeps patients in a constant state of fight-or-flight.
Infections such as strep throat or MRSA spread quickly within shelter systems, and for patients with COPD, the risk of severe lung infections increases dramatically.
Chronic lack of sleep and personal safety leads to ongoing stress, which is proven to have serious and lasting impacts on health.

“We know that quality sleep is foundational to long-term health outcomes,” Van explains. “Living on the street or in shelters means patients are always on guard, even while sleeping. The data on chronic stress is clear – it can even alter your DNA.” Our patients’ experiences have consistently demonstrated that stable resources, access to health care, and housing support are vital to healthy outcomes. Ann Schmitt, MD, recently saw David for a diabetes checkup. “He had cut his diabetes numbers in half,” she shares. “When I asked what had changed, he told me he had received reduced housing and could finally cook his own meals.”

The Point-in-Time Count makes one reality unmistakably clear: as homelessness increases, so does the demand for accessible, integrated health care. Fourth Street Clinic stands at the intersection of these needs, providing care that stabilizes health, reduces emergency room utilization, and helps patients take meaningful steps toward recovery and independence. Expanding our facility is not simply a matter of space – it is an essential investment in public health, fiscal responsibility, and human dignity.

To learn more about our Capital Campaign, click here.

Fourth Street Clinic team members and volunteers after the 2026 Point-in-Time Count.

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