Ending homelessness in St. John’s: Ten things to know

Ending homelessness in St. John’s: Ten things to know

by | Oct 17, 2019 | Uncategorized

Ending homelessness in St. John’s: Ten things to know

By Nick Falvo, Doug Pawson, and Jennifer Tipple

Photo by Erik Mclean on Unsplash

End Homelessness St. John’s (EHSJ) is the system-planning organization for the homeless-serving sector in St. John’s, Newfoundland and Labrador. In that capacity, EHSJ plays a central coordinating role and funds important initiatives pertaining to long-term planning.

In 2014, EHSJ unveiled the St. John’s Community Plan to End Homelessness 2014-2019; earlier this year, Nick Falvo Consulting was engaged to both assess that Plan and help EHSJ move forward with their next Plan.

Here are 10 things to know:

1. The 2014-19 Plan helped lay the groundwork for a range of housing and supports. These include: an Intensive Case Management program, launched in January 2016; the Homelessness Prevention and Rapid Rehousing program, focusing on prevention, launched in October 2017; and three Permanent Supportive Housing projects. Nevertheless, community members have articulated the need for more sustainable housing situations. Stakeholders in the sector have been particularly clear about the need for more supportive housing, more low-barrier shelter capacity, and more harm reduction services.

2. Exciting governance changes are happening in the St. John’s homeless-serving sector.  EHSJ historically leaned on community partners for both advisory and governance decisions. Naturally, that led to conflicts of interest that precipitated a new governance direction. Moving forward, EHSJ is transitioning from being under the umbrella of the City of St. John’s into its own non-profit—a transition that will formally take effect in 2019-20. The new EHSJ will be led by a new Executive Director position (hired in March 2019), governed by an independent board of directors, and advised by the community through its new Community Advisory Board.

3. Recent increases in federal funding for homelessness have made a very important difference to St. John’s homeless-serving sector. The federal budgets for 2016 and 2017 respectively led to Canada-wide increases in funding for the Homelessness Partnering Strategy (which has since been renamed Reaching Home). This translated into an additional $1,046,138 for St. John’s homeless-serving sector over a three-period. Put differently, for the five-year period of the St. John’s Plan, St. John’s received 30% more federal homelessness funding than anticipated at the Plan’s outset.

4. The corrections sector in Newfoundland and Labrador creates problems for homelessness. The assessment of the 2014-19 Plan uncovered that inmates in St. John’s are often discharged into homelessness. It is very difficult for a discharged inmate to go directly into housing, in part because landlords want to meet with the tenant before agreeing to sign a rental agreement. It is also very challenging for inmates to see online ads for apartments while in jail. Discharge planning in provincial correctional facilities is part of the role of a Classification Officer, but not every inmate sees a Classification Officer while inside. If an inmate requests to see a Classification Officer, it might take one month to do so. Further, the provincial government requires people to have an address before applying for social assistance, and jail does not count as an address. (Hospitals and the child welfare system also discharge people directly into homelessness, and this is discussed in detail in the forthcoming assessment of the 2014-19 Plan).

5. Once a youth has left Newfoundland and Labrador’s child welfare system, they can be quite vulnerable to homelessness. Housing secured by such youth is often shared; the youth might rent a room in a house with complete strangers. They might struggle in their dealings with housemates and a landlord. St. John’s has some supportive housing available for youth, but these options are in short supply relative to need. Prior to June 2019, youth in the provincial child welfare system could remain in the group home or under the care of a Youth Services case manager until age 18; but they are now allowed to remain in the child welfare system until 21. Local officials who work in the youth homelessness sector have welcomed these changes and believe they have the potential to reduce youth homelessness.

6. The City of St. John’s and EHSJ enjoy a very positive working relationship. The City provides EHSJ with considerable in-kind support, both administratively and operationally. This includes free office space, human resources support, legal support, support with purchasing and procurement, and financial/administrative support. It would not be unreasonable to suggest that the City provides EHSJ with annual in-kind support estimated at $250,000, in addition to an annual cash contribution of $100,000. Going forward, the City has committed to cash contributions in 2019 for $100,000 and in 2020 for $100,000. The City has also supported EHSJ in its new governance structure, supporting EHSJ in seeking the Community Entity status.

7. Service providers in St. John’s are having major challenges with software that tracks persons experiencing homelessness. Canada’s federal government created and now supports the Homeless Individuals and Families Information System (HIFIS) software. Many community agencies in St. John’s are using HIFIS 3.8 (an old version of the software), and it has recently come to light that the federal government has reduced its support for HIFIS 3.8 in order to focus on HIFIS 4. It is estimated that it will be at least another year before HIFIS 4 is available to service providers province-wide.

8. St. John’s needs more low-barrier shelter capacity. Some people are barred from all emergency shelters in St. John’s. Further, it is common for all emergency shelter beds in the city to be full. Several stakeholders also expressed concern about the reliance on for-profit shelters in St. John’s—nearly 40% of homeless shelter beds in the city are run by for-profit providers, paid for by provincial government. And some for-profit emergency housing options have no overnight staffing despite the fact that they often house high-need clients. There is also a rather formal approval process for being admitted into any St. John’s emergency shelter funded by NL Housing. Sometimes it can take up to a week for a client to gain admission.

9. Stakeholders have expressed a strong desire to strengthen Coordinated Access (CA). CA is the triage system used to refer people to housing and homelessness supports. Going forward, most stakeholders want more local organizations to make their housing units and program capacity available for direct referrals. Stakeholders also want to see the CA process become more efficient.

10. The most effective objectives and outcomes in a plan to end homelessness are tangible and measurable. The 2014-19 Plan contained six desired outcomes, some including numerical targets (i.e. provide housing and supports for 460 people) and some not (i.e. develop a coordinated homeless-serving system). The assessment found it difficult to measure progress toward outcomes without specific targets. Local stakeholders would like to see more emphasis on key performance indicators in the next Plan.

In sum. A considerable amount of progress has been made in the fight to end homelessness in St. John’s. But more work remains. That future work will be the focus on the 2019-24 Plan, which will be unveiled later this year.

Download Looking Back to Move Forward: An Assessment of Progress on the 2014-2019 St. John’s Community Plan to End Homelessness

This blog post originally appeared at the website of the Homeless Hub.

The use of homeless shelters by Indigenous peoples in Canada

The use of homeless shelters by Indigenous peoples in Canada

by | Oct 3, 2019 | Aboriginal Peoples, Alberta, Calgary, Cities, Data Sharing, Demographics, Determinants of Homelessness, Ending Homelessness, Government, Harm Reduction, Homeless, Housing, Indigenous peoples, municipalities, Research and Data, seniors, Toronto

The use of homeless shelters by Indigenous peoples in Canada

The Canadian Press recently gained access to results of analysis of the use of homeless shelters across Canada by Indigenous peoples. The results are summarized in a March 2019 slide presentation obtained by Jordan Press through an Access to Information and Privacy (ATIP) request, and are discussed in this Canadian Press article. They are based on a research project conducted by Employment and Social Development Canada (ESDC).

Here are 10 things to know:

 

  1. The analysis draws on data gathered from homeless shelters across Canada. ESDC has data on persons using homeless shelters from roughly half of the country’s homeless shelters. This includes data gathered via the Homeless Individuals and Families Information System (HIFIS) software, as well as data gathered via data sharing agreements with the City of Toronto, the Government of Alberta and BC Housing. The data used for this analysis was gathered in 2016 and is based on approximately 133,000 unique individuals (approximately 41,000 of whom are Indigenous).
  2. According to the slide presentation, Indigenous peoples in Canada are more than 11 times more likely to use a homeless shelter than non-Indigenous people. Results of the analysis are succinctly summarized in a memo prepared for the Minister which accompanies the slide presentation: “Results show that Indigenous peoples are consistently overrepresented in homeless shelters in all 46 communities examined [Indigenous peoples accounted for more than 30% of people using homeless shelters over the course of 2016, while representing less than 5% of the total population]…The degree of overrepresentation is particularly high for Indigenous women, seniors, and Inuit. Indigenous shelter users experience more shelter stays each year, and are less likely to exit a shelter because of finding a residence.”
  3. As noted in the accompanying memo: “A report is being written to expand on the results shown in the deck.” Neither the memo nor the slide presentation indicate when the report will be ready, which people and groups will be invited to provide input on drafts of the report, or whether the report will be made public. Put differently, the federal government seems to be holding its cards close to its chest on this.
  4. I was personally surprised to see the extent to which Indigenous peoples experience high episodic shelter use.  In other words, Indigenous peoples (compared with non-Indigenous peoples) tend to cycle in and out of shelters with high frequency, rather than stay for long periods of time.[1]
  5. I find it remarkable that these very important research findings had to be obtained via an ATIP request. In light of the federal government’s stated commitment to reconciliation, I would have thought it would have proactively released these findings and engaged Indigenous stakeholders in the process. This raises the following questions: To what extent were Indigenous peoples part of this analysis (beyond the fact that their data was collected and analyzed)? To what extent will Indigenous peoples be invited to discuss the implications of the analysis? Why does the slide presentation make no mention of the Canadian Housing and Renewal Association’s Indigenous Caucus?
  6. The findings pertaining to shorter shelter stays raise at least two questions. First, why do Indigenous peoples have short, but frequent, stays in homeless shelters? Second, what could be done to address this? Frequent migration between urban centres and First Nations communities may help explain this. This may also speak to the need for more low-barrier and culturally-appropriate housing options in Canada—both emergency and permanent options.
  7. The findings showing Inuit over-representation are disturbing, though not surprising. Canada’s Inuit experience high rates of unemployment, poverty, and housing need. For more on this, see: the Inuit Statistical Profile 2018, published by Inuit Tapiriit Kanatami; this Statistics Canada report from 2018; and this profile of Inuit living in Ottawa.
  8. The findings pertaining to women and seniors merit reflection. The analysis finds that, while Indigenous men are more than 10 times more likely to use a homeless shelter over the course of a year than non-Indigenous men, Indigenous women are more than 15 times more likely to use a homeless shelter than non-Indigenous women over the course of a year. Meanwhile, Indigenous seniors are more than 16 times more likely to use a homeless shelter over the course of a year than non-Indigenous seniors. Why would rates of Indigenous over-representation in Canada’s homeless shelters be higher for women and seniors than for other categories?
  9. I was disappointed to see Canada’s largest city dropped from the analysis. According to the slide presentation, City of Toronto data could not be included in the analysis because the City of Toronto lacked Indigenous status data for more than 40% of unique individuals using its homeless shelters. I hope it serves as wake-up call to the Toronto’s homeless-serving sector.
  10. Among the communities studied, Calgary’s rate of Indigenous over-representation was especially high (see screenshot below). The analysis found that, in Calgary, shelter users are about 16 times more likely to be Indigenous than are members of the city’s total population. The rate for Edmonton appears to be about half of that, with only York Region (near Toronto) having a higher rate among the cities studied. It is worth noting that the Calgary Homeless Foundation recently commissioned a research project assessing flow between Treaty 7 First Nations and Calgary’s Homeless-Serving System of Care. Hopefully that project can shed light on this matter. (Full disclosure: I’m one of the research consultants working on this project, along with Gabrielle Lindstrom, Steve Pomeroy, and Jodi Bruhn.)
In sum. Many years of work go into this kind of analysis. Thousands of people were involved in the data collection, including shelter staff and officials both inside and outside of government. Further, people using homeless shelters patiently answered questions about their lives in order for this analysis to happen. However, it is clear that much work remains. It would appear that ESDC up their game in terms of working with Indigenous peoples and groups on such research projects, and some cities clearly must do a better job of data collection. We must all work collectively to understand what specific policy measures are required to address the over-representation of Indigenous peoples in Canada’s homeless shelters.

The following individuals provided me with assistance in preparing this blog post: Jodi Bruhn, Kathy Christiansen, Damian Collins, Dan Dutton, Ron Kneebone, Diana Krecsy, Eric Latimer, Katelyn Lucas, Jenny Morrow, Jennifer Robson, Vincent St-Martin, and two anonymous reviewers. Any errors are mine.

[1] Federal definitions of chronic vs. episodic homelessness are available here.

My review of Eric Weissman’s book on intentional homeless communities

My review of Eric Weissman’s book on intentional homeless communities

by | Jul 20, 2019 | Calgary, Cities, Ending Homelessness, Government, Government Funding, Harm Reduction, Homeless, Housing, Pitching new programs to government, Policy, Social Housing, Social Policy

My review of Eric Weissman’s book on intentional homeless communities

BOOK REVIEW

Weissman, E. (2017). Tranquility on the razor’s edge: Changing narratives of inevitability. Oakville, ON: Rock’s Mills Press.

 

Eric Weissman is Assistant Professor of Sociology at the University of New Brunswick, Saint John. But he was once homeless, and has since written a very good book about intentional communities in Canada and the United States. This book is based on Eric’s PhD thesis, which in 2014 won a major national award.

Here are 10 things to know: 

  1. This book focuses on intentional homeless communities (IHC) in Canada and the United States. Intentional communities in general are communities built around specific goals. But in the case of this book, I mean small communities of housing sometimes made from discarded, donated and recycled material, and sometimes purpose-built, to address homelessness. IHCs have relatively sophisticated governance structures and are typically located on land owned by non-profits, churches or municipal government. The book argues that such communities are on the rise and that they constitute both official and unofficial responses to homelessness depending on which examples we look at. There are dozens of such communities in the United States. According to the book’s author, Homes for Heroes (Calgary) and Steve Cardiff Tiny House Community (Whitehorse) are Canadian examples of IHCs.
  2. Intentional communities are not the same thing as tent cities or tiny home communities. IHCs are legal in several American cities, where some receive government funding (though most such funding comes from non-profits and private donors). Sometimes referred to as ‘villages,’ they often have their own websites and wi-fi networks. Some have formal triage systems for determining new admissions. Many hold elections and have formal governance arrangements. Some pay liability insurance, some are legally incorporated, and some are inspected regularly by municipal officials. Tent cities, by contrast, are usually temporary, largely-unorganized and rarely sanctioned by cities. Conventional tiny-home communities reflect current tastes for micro-housing and may not be organized around any social cause in particular.
  3. The book demonstrates that who makes day-to-day housing-related decisions for marginalized persons matters. In other words, the book argues that simply having affordable housing in place with social work support (i.e., supportive housing) doesn’t cut it if we truly want to empower tenants. Rather, democratic engagement with tenants is also important. (I think Canadian housing researchers and advocates had a greater appreciation of this concept in the 1970s than they do today. For more on important innovations in the 1970s, check out Greg Suttor’s recent book on the history of social housing in Canada.)
  4. One of the book’s many strengths is that it makes readers think unconventionally about affordable housing. I came away from reading this book realizing that my own views on the topic are somewhat narrow. Until reading the book, I had not really given intentional communities much thought as a serious approach to addressing homelessness.
  5. The book embraces a research approach called ethnography. Very common in anthropology, this approach involves writing about something as you live it. Eric wrote this book based on his participation and residence in a few key intentional communities. He filmed and interviewed hundreds of residents and typed up his notes on site. Not only did he earn ‘street cred,’ he also applied it directly to his research.
  6. One of the book’s messages is that researchers may try to appear neutral, but we all have biases.[1] I can relate to this message, having personally worked 10 years as a front-line community worker with persons experiencing homelessness. Personal take-ways of mine from that work include the following propositions: don’t make it difficult for a person to seek emergency shelter; persons experiencing homelessness thrive when given the chance to engage in paid work; and persons experiencing homelessness almost always agree to live in affordable housing when it’s offered to them in an appropriate manner.
  7. The author’s own biases emerged from his own life experience with trauma, illicit drug use and homelessness. He discusses this brilliantly and powerfully in chapter three, which is arguably the best-written book chapter I’ve ever read. That chapter helped me understand both youth homelessness and illicit drug use.
  8. This would be a good book for students to read in a graduate university seminar on research methods. And chapter two itself would be a great stand-alone reading to assign to graduate students in such a seminar. However, in order to properly understand much of the book’s language, concepts and arguments, a reader would likely need to have at least one university degree in the social sciences (I personally think the book puts too much emphasis on what social theorists have said over the years).
  9. The book could have done a better job of articulating the drawbacks of intentional communities. To be fair, the author does acknowledge that the drawbacks of intentional communities can include: “drug problems, faction-led power struggles and a failure to provide adequate transitional experiences for people wishing to reclaim their role in society” (p. 300). But on the whole, the book contains very little discussion about: some of these communities lacking running water, heating and cooking facilities; how prone some of their residents are to property theft; and the extent to which such communities are vulnerable to being targeted by law enforcement officials.
  10. The book misses an important opportunity to discuss the practical ways government and the non-profit sector can support intentional communities. I was left wondering what kind of funding could be directed at such communities, and what specific services should be supported. Also, the book suggests that supporting intentional communities can be much cheaper than supporting more conventional forms of affordable housing, but no breakdown is provided as to how much it would cost to assist them.

In sum: This book, which took a lot of courage to write, doesn’t shy away from discussing the awkward. And many advocates of the tiny-house movement may find this book to be inspirational. The book also reminds me of advice I once got from a supervisor at Toronto’s Homes First Society: “When housing’s being developed for marginalized populations, people with homes shouldn’t try to tell people without homes what their housing ought to look like.” 

Eric Weissman patiently answered all of my questions via email as I prepared this review. I also wish to thank Adam Melnyk, Bernie Pauly, Marion Steele and Vincent St-Martin for their assistance.

[1] In the social sciences, positivists tend to view themselves as neutral observers, merely trying to find evidence. By contrast, interpretivists tend to openly acknowledge and embrace their biases (see this short article for more on this distinction).

 

 

Ten things to know about affordable housing in Alberta

Ten things to know about affordable housing in Alberta

by | Jun 30, 2019 | Aboriginal Peoples, Alberta, Alternative Federal Budget, Calgary, Ending Homelessness, Fiscal policy, Government, Government Funding, Homeless, Housing, Housing First, Income Inequality, Indigenous peoples, Policy, Poverty, Poverty Reduction, Research and Data, Ron Kneebone, seniors, Social Housing, Social Policy

Ten things to know about affordable housing in Alberta

People without affordable housing suffer from poor health outcomes, have difficulty finding and sustaining employment and are at greater risk of having their children removed by child welfare authorities.

Here are 10 things to know about affordable housing in Alberta specifically:

  1. The NDP government of Rachel Notley undertook important initiatives pertaining to affordable housing. In its 2016 budget, the Notley government announced the near doubling of provincial spending on housing. This represented a total of $892 million in new funding, spanning a five-year period.
  2. According to the most recent Census, 11.4% of Alberta households experience core housing need, representing more than 164,000 households. In order to assess housing need for Canadians, the Canada Mortgage and Housing Corporation uses a measure called core housing need. A household is said to be in core housing need if, out of financial necessity, they either pay more than 30% of their gross household income on housing, live in housing requiring major repairs, or live in housing with insufficient bedrooms for the household size in question (as determined by the National Occupancy Standards).
  3. Seniors living alone in Alberta face particularly high rates of core housing need. Nearly 34% of senior (65+) females living alone in Alberta were in core housing need in 2011, while the figure for senior (65+) males living alone was just under 26%. 
  4. Female lone-parent households in Alberta also face a particularly high rate of core housing need. More than 27% of these households were in core housing need in 2011. However, that figure likely dropped after the NDP government of Rachel Notley introduced the Alberta Child Benefit, a major feature of the 2016 Alberta budget.
  5. Members of Alberta First Nations also experience very high rates of core housing need. In fact, the rate of core housing need for Status Indians is nearly 25%—more than double the rate for non-Indigenous households in the province. And get this: these core need figures do not account for households living on reserve (if they did, that figure would be much greater). I should also note that more than 25% of  persons experiencing absolute homelessness in Alberta identify as being Indigenous, even though Indigenous peoples make up just 7% of Alberta’s total population.
  6. Housing typically constitutes a larger share of spending for low-income households (compared with middle- and higher-income households). And as the figure below illustrates, that phenomenon got measurably worse for low-income households in Alberta between 2010 and 2016.

    Source. Kneebone, R., & Wilkins, M. G. (2018). Social Policy Trends: Paying for the Essentials: Shelter, Food and Energy Consumption by Household Income Quintile for 2010 and 2016. The School of Public Policy Publications, 11. Retrieved from Policy School’s website: https://www.policyschool.ca/wp-content/uploads/2018/07/Social-Trends-Engel-Curves-July-2018.pdf

  7. On a per capita basis, Alberta has far fewer subsidized housing units than the rest of Canada. According to the most recent Census, subsidized housing represents just 2.9% of Alberta’s housing units; for Canada as a whole, the figure is 4.2%.
  8. Some Alberta cities have much more low-cost rental housing (per capita) than others. The visual below shows the range of private market rents paid on one- and two-bedroom apartments across Alberta’s seven major cities. The light-coloured bars show the range of rents paid on the second quintile (i.e., the second-poorest quintile) of private market rents. The next darkest bar shows the range of rents paid on the third quintile (i.e., the middle quintile) of rents, while the darkest bars define the range of rents paid on the fourth quintile of rents. Among the seven major cities, Medicine Hat appears to have the most low-cost rental housing units (per capita), and Calgary the fewest.

    Notes. Monthly rent quintiles by city in 2017. Data provided to Ron Kneebone (University of Calgary) by Canada Mortgage and Housing Corporation. The range of rents paid on the first and fifth quintiles are not reported due to confidentiality reasons.

  9. Going forward, the impact of the federal government’s National Housing Strategy will be modest. Recent analysis by Canada’s Parliamentary Budget Officer (PBO) projects future federal housing spending to actually decrease over the next decade (relative to Gross Domestic Product). The same analysis projects that total spending on Indigenous housing by Canada’s federal government will be “substantially lower” going forward. (For a general overview of the National Housing Strategy, see this analysis.)
  10. There are considerable cost savings to be realized when investing in affordable housing, especially when the tenants have serious mental health challenges. Subsidized housing for vulnerable subpopulations (including persons with mental health challenges) that is accompanied by professional staff support is referred to as supportive housing. Recent analysis in Calgary estimates considerable cost savings in the health and justice sectors attributable to formerly-homeless persons receiving supportive housing.

In Sum. For a more comprehensive look at affordable housing in Alberta, see this year’s Alberta Alternative Budget (AAB). Full disclosure: I was primary author of the chapter on affordable housing and homelessness.

I wish to thank the following individuals for invaluable assistance with the housing chapter of this year’s AAB: Meaghan Bell, John Kmech, Claire Noble, Chidom Otogwu, Steve Pomeroy, Ron Kneebone, Vincent St. Martin, John Veenstra and one anonymous reviewer. Any errors are mine.

The use of homeless shelters by Indigenous peoples in Canada

Homelessness, harm reduction and Housing First

by | May 16, 2019 | Aboriginal Peoples, Alberta, Calgary, Harm Reduction, Homeless, Housing, Housing First, Indigenous peoples, Point in time Count, Poverty, Social Policy

Homelessness, harm reduction and Housing First

I was recently invited to give a presentation at a two-day event discussing the overdose crisis and First Nations, with a focus on southern Alberta. My presentation (slide deck available here) focused on homelessness, substance use, harm reduction and Housing First.

With this in mind, here are 10 things to know:

  1. Indigenous peoples are overrepresented among persons experiencing absolute homelessness in Alberta. According to results of the last province-wide Point-in-Time homelessness count, Indigenous peoples represent 7% of Alberta’s total population, but 26% of persons experiencing absolute homelessness in the province’s seven largest cities. A similar phenomenon exists right across Canada, Australia and New Zealand.
  2. To truly understand homelessness among Indigenous peoples, it is important to understand flow between communities. Most Indigenous peoples experiencing absolute homelessness in Alberta’s major cities report not being from the community in question. In Calgary, for example, just 11% of Indigenous peoples experiencing absolute homelessness report always having lived in Calgary.
  3. A major study is about to explore factors behind the flow of First Nations people between southern Alberta communities. Specifically, it will look at those who end up experiencing absolute homelessness in Calgary. Its research team consists of Jodi Bruhn, Gabrielle Linsdstrom, Allan Moscovitch and Steve Pomeroy. More information on this project can be found in last fall’s Request for Proposals. The research is being funded by the Calgary Homeless Foundation.
  4. Traumatic events are an important factor leading a homeless person to use drugs. A 2015 Winnipeg study asked what factors made a homeless person more likely to be a person who uses drugs (PWUD). Traumatic events, especially residential school history, were found to be one of the most important factors. Other factors identified in the study as leading a person to use drugs included mental and physical health problems (i.e., people self-medicate). What’s more, a recent First Nations Health Authority report from British Columbia identifies factors that lead to substance use. They include: racism; intergenerational trauma (e.g., residential schools); and limited access to mental health and addiction treatment (which is often reported by members of First Nations).
  5. Homeless shelters do not and cannot adequately respond to the overdose crisis. A 2014 study looked at the use of homeless shelters in Atlantic Canada (it looked at all four Atlantic provinces). It found that shelters focus on providing shelter and do not have a strong mandate to fully support PWUDs. A 2018 report went further, identifying the following barriers in some homeless shelters in Canada: clients having to ask staff to access harm reduction supplies (to be discussed below); shelters refusing services to people under the influence; and rigid entry process (e.g., extensive paperwork, the need for multiple pieces of documentation).
  6. It is very challenging for staff in homeless shelters to properly engage with people who use drugs, largely because on-site use of illicit substances is prohibited. To put it bluntly, staff give out supplies but forbid the on-site use of drugs. Shelter washrooms can therefore become “de facto unsupervised consumption sites” (p. 87).
  7. Harm reduction focuses on reducing harm caused by drug use without requiring total abstinence. Harm reduction approaches include the distribution of condoms, clean syringes and safe inhalation kits. There is solid evidence supporting the view that harm reduction approaches: reduce risk-taking behaviour; reduce the risk of transmission of blood-borne diseases; prevent overdoses; reduce crime; and increase contact with other supports (including healthcare supports).
  8. Supervised consumption services are one form of harm reduction. According to this report, they “consist of providing a safe, hygienic environment in which people can use drugs with sterile equipment under the supervision of trained staff or volunteers” (p. 2). As of February 2019, 28 supervised consumption services sites were operating under an exemption from Canada’s federal government.
  9. Supervised consumption services have proven to be very effective in southern Alberta. During 2018 alone, Calgary’s supervised consumption site saw nearly 52,000 visits, resulting in more than 700 overdose reversals. Also during 2018 alone, Lethbridge’s site saw nearly 128,000 site visits, resulting in more than 1,300 overdose reversals.
  10. Housing First is an approach whereby people in need of affordable housing receive housing without having to first prove their ‘housing readiness.’ According to this study: “Harm reduction is a key principle of Housing First, where individuals are not required or expected to undergo treatment for substance use or to abstain in order to access and keep permanent housing” (p. 1). However, Housing First does not mean housing only. That is, other social supports—including drug and alcohol treatment, which may lead to reduced substance use—are crucial to the success of Housing First.

In Sum. To understand high rates of homelessness and substance use among Indigenous peoples, it is important to consider the roles played by trauma and racism. It is also important to understand flow between communities, as well as the inadequacies of homeless shelters. Harm reduction and Housing First remain important policy responses to the overdose crisis.

 

I wish to thank the following individuals for invaluable assistance with this blog post: Lorraine Barnaby, Shannon Beavis, Jodi Bruhn, Julia Christensen, Arlene Haché, Leslie Hill, Diana Krecsy, Bren Little Light, Katelyn Lucas, Adam Melnyk, Susan McGee, Katrina Milaney, Gautam Mukherjee, Bernie Pauly, Steven Richardson, Chris Sarin, Quentin Sinclair, Lorie Steer, Vincent St-Martin and Alina Turner. Any errors are mine.