Report finds insufficient daytime options for people experiencing homelessness

La version française de ce billet se trouve ici.

I’m the lead author of a recent report, commissioned by Vibrant Communities Calgary, looking at factors associated with social disorder on public transit (including social disorder involving people experiencing homelessness). My co-authors were Lee Stevens and Tessa Penich.

Here are 10 things to know:

1. Unintentional drug poisonings are on the rise in Calgary—and they are increasingly happening in public spaces, including on public transit. In fact, the rate of drug poisoning deaths per 100,000 people in Calgary has more than doubled since 2019. Perhaps not surprisingly, calls to EMS have increased very substantially during the same time frame.

2. Encampment sleeping—i.e., rough sleeping in groups—is also on the rise in Calgary. Reports of encampments via the City of Calgary’s 311 system increased fivefold between 2018 and 2023. Key factors driving this likely include Calgary’s low rental vacancy rate (1.4% as of October 2023), inadequate shelter conditions and a lack of harm reduction options.

3. In Calgary, there are limited day-time options available to people experiencing homelessness. As part of the study, I led focus groups with people experiencing homelessness. They noted that protection from bad weather was one frequent reason for accessing public transit. Some “ride the rails” on the CTrain in order to pass the time until they are allowed evening entry into their shelter of choice.

4. Calgary also has insufficient treatment and harm reduction services. And while some supervised consumption services are offered, none support inhalation, which is becoming more common.

5. People who used illicit substances often feel safer doing so on public transit than elsewhere. That’s in large part because of the many CCTV cameras available on public transit, as well as the many eyes and ears available (i.e., persons who can call for assistance in the event of a possible drug poisoning). Put differently, if a person overdoses on transit, they feel they have a better chance of survival than if they overdose elsewhere.

6. There are inadequate health care options for persons experiencing homelessness—especially if the patient has both mental health and substance use challenges. According to one service provider interviewed for the report, hospital staff will refuse to see patients who are intoxicated. Another service provider stated: “The frustrating part is we take him to the hospital to be seen by a doctor. Well the doctor looks at [the physical ailment], it’s brought on by drugs. Sorry, kicks him out, can’t really help them.”

7. There are insufficient medical respite options for vulnerable persons upon discharge from hospital. Service providers interviewed for the report provided several examples of hospitals discharging their clients quickly and not offering to provide post-discharge care.It would therefore appear that Calgary needs more medical respite initiatives, which are intended for persons experiencing homelessness who are well enough to be discharged from hospital, but not quite well enough to return to a homeless shelter. Staffed by health care providers, including physicians and nurses, their services can include case management, as well as assistance with housing searches and income assistance applications.

8. There is suboptimal coordination among organizations providing street outreach. Law enforcement officialsinterviewed for this report expressed concern about what they viewed as insufficient coordination among outreach teams. Many officers believe that outreach hours should be extended, while noting that most of these teams do not operate 24/7.

9. The report recommends greater investments in emergency services for people experiencing homelessness. This could come in the form of new facilities, the creation of more space at existing facilities, making more facilities accessible 24/7 rather than only at night, and the creation of more daytime programming. Such daytime options could include assistance with housing searches, employment and income assistance applications.

10. It makes several other recommendations. These pertain to the need for: more treatment and harm reduction options (including the creation of one or more supervised consumption facilities that allow inhalation); more medical respite options; improved coordination of street outreach; and more affordable housing.

In sum. This is a summary of a recent report commissioned by Vibrant Communities Calgary. The full report can be downloaded here.

I wish to thank Jenny Morrow and Annick Torfs for assistance with this blog post.