This blog post is part of our series which highlights sessions of the 2018 National Conference on Ending Homelessness. Hear Joanna Binch, Erin Dej, and John Ecker speak on Tuesday, November 6th at 1:30 PM. Learn more about this upcoming conference presented by CAEH.
There is a good chance if you ask a person sleeping outside or staying at a shelter if they have ever lived in a rooming house, the answer would be ‘yes’. Yet many of us working to support people experiencing homelessness may not know what exactly a rooming house is. A rooming house is a shared accommodation regulated by the municipality when there are multiple rooms in a building (e.g., four or more rooms), that are rented individually and share a bath and/or kitchen. These types of dwellings play an important role in the affordable housing market and the continuum of homelessness and housing.
How do Rooming Houses Fit Within the Housing and Homelessness Spectrum?
When we think about homelessness, we typically think of people who are sleeping rough or staying in a shelter. In fact, the Canadian definition of homelessness, developed by the Canadian Observatory on Homelessness and their partners, speaks to a continuum of homelessness that accounts for a wide variety of living conditions. The definition includes unsheltered; emergency sheltered; provisionally accommodated; and at risk of homelessness. Provisionally accommodated refers to temporary or insecure housing, while at risk of homelessness accounts for those whose housing situation is precarious, or which does not meet public health and safety standards. In light of the research to date, and hearing from those who have lived and worked in rooming houses, there is a strong argument to be made that rooming houses should be recognized as a type of homelessness.
Rooming houses are often the first attempt at housing for people leaving the homeless shelter, and many return to emergency shelters in their lifetime. Despite this fluidity, most homeless resources target the sheltered homeless and do not consider residents of rooming houses. In fact, people living in rooming houses face enormous challenges concerning health, safety, accessing basic services, and social inclusion.
What is the Rooming House Environment Like?
In a homeless shelter there is access to food, a telephone, working plumbing, heat, and toilet paper, basic needs that are often a struggle to access when living in a rooming house. In Ottawa, for example, rooming house residents are considered stably housed, and thus face significant barriers or are excluded altogether from accessing certain health, social, housing, and economic supports. This exclusion is all the more troubling when we realize the burden of illness among rooming house residents. The rooming house population is a vulnerable group with unique needs who would benefit from the resources offered to people experiencing emergency and unsheltered homelessness, such as Housing First programs, and priority for community support workers.
What Does the Research Say?
Rooming houses are the ‘lowest rung of the ladder’ without which there would be a drop into absolute homelessness. Rooming houses and single room occupancy (SROs) dwellings provide a crucial form of affordable housing in an era of low vacancy rates and an increasing shortage in affordable housing. In the Health and Housing in Transition Study (HHiT study) the authors compared the health of vulnerably housed and homeless people in three Canadian cities (Ottawa, Toronto, and Vancouver) and found it was inaccurate to divide the homelessness and vulnerably housed populations, as those vulnerably housed spent almost as much time homeless as the homeless group did. Other findings from the HHiT study revealed few differences among the two groups in relation to unmet health care needs, problematic drug use, and medication nonadherence. Differences did emerge around key health indicators:
- Hwang et al. reported that vulnerably housed individuals had slightly poorer physical health functioning and were more likely to report a larger number of chronic health conditions than people experiencing homelessness;
- To et al. found that vulnerably housed participants were more likely to report a history of a traumatic brain injury than people experiencing homelessness.
Other research shows that similar to individuals residing in shelters, rooming house residents have an increased morbidity (instances of disease) and mortality (instances of death) rate, with only a 32% probability of reaching age 75. All of this research points to homeless and vulnerably housed individuals as a large, severely disadvantaged group who regularly transition between housing states.
Want to Hear More?
Come to our session at CAEH 2018, as we engage in a discussion about how we can do more to include those living in rooming houses in homelessness research. We want to know what is happening in your communities and how we can work together!
In this bi-weekly blog series, I explore recent research on homelessness, and what it means for the provision of services to prevent or end homelessness. Read the first blog here.
At times I feel a bit dismayed when reading another descriptive research article on people experiencing homelessness. Perhaps another article on rates of mental illness among shelter occupants, maybe one on the unmet support needs of homeless families, maybe it’s the correlation between intimate partner violence and women experiencing homelessness. The ones that are the hardest to see are those on life expectancy, average age of death, or survival rates of those experiencing chronic homelessness. We know the numbers will be bad, so do we need another description of these numbers? Or do we need more intervention research that helps people find home?
Because, ultimately, homelessness is a palliative condition unless treated with housing.
This is illustrated in a recent article by Amanda Stafford and Lisa Wood out of Perth, Western Australia. The article opens with the same discouraging statistics that we see worldwide on high morbidity, barriers to health care, high use of emergency services, and poor life expectancy. At the same time, Stafford and Wood confront and contest the natural response to these statistics: provide people experiencing homelessness with more healthcare services. They query that perhaps this medical model approach is too short-sighted and downstream?
To answer the question, then, of how to respond to the poor health outcomes of people experiencing homelessness, they present three in-depth case histories of two men and one woman accessing primary care and housing support. The case histories include not just detailed health and social histories, but also service utilization and cost estimates. All three individuals scored a 14 on the VI-SPDAT (a high acuity score on this measure of acuity) and utilized an average of $100,000 of health care services.
Three clear lessons are presented through these cases:
- There is a low degree of effectiveness in treating the health needs of people experiencing homelessness then simply sending them back to the conditions that compromise their health.
- While current health services are a valuable use of money in terms of preserving life, a more comprehensive approach would involve funding better access to housing with appropriate supports, thus mitigating downstream costs of homelessness and providing enhanced quality of life.
- The personal stories of experiences of homelessness demonstrate how social policy and social conditions create risks of homelessness, at times in contrast to public perceptions of homelessness being simply an individual experience.
While the case study methodology involves an intentionally small sample, the story is very clear. Medicine is an insufficient response to the health needs of homelessness and must go hand in hand with enhanced public policy and social programs to ensure access to affordable housing with adequate supports. This is the treatment needed to reverse the palliative nature of homelessness.
In 2017, we were proud to launch the “Making the Shift Youth Homelessness Social Innovation Lab” project with funding support from the Government of Canada’s Youth Employment Strategy. Though Making the Shift is led by a partnership between A Way Home Canada and the Canadian Observatory on Homelessness, our community partners are key. It was a dynamic year of co-creating solutions to youth homelessness alongside youth-serving organizations in ten Canadian communities. Year One of MtS has come to a close, and we’re pleased to share our newly released “Making the Shift Year One Report.” At the same time, we want to showcase a key deliverable for Phase One of Making the Shift, which is an important piece of work led by our friends at MaRS Centre for Impact Investing. “Funding Services for Homeless Youth in Canada: Review and Recommendations” takes a critical look at how we currently fund youth homelessness interventions and then makes some recommendations for how we might do it differently and more effectively.
Phase One of MtS (2017-2019) involves the implementation of three demonstration projects at twelve sites across Ontario and Alberta. These large-scale demonstration projects seek to build practical knowledge and an evidence base for the following interventions focused on prevention and sustained exits from homelessness.
- Housing First for Youth (Ottawa, Toronto), Housing First for Indigenous Youth, Indigenous led (Hamilton)
- Enhancing Family and Natural Supports (Calgary, Edmonton, Fort McMurray, Grande Prairie, Lethbridge, Medicine Hat, Red Deer, Toronto)
- Youth Reconnect (Hamilton)
Most importantly, these demonstration projects provide critical services that will help ensure the best possible outcomes for young people and their families. All three interventions are designed to enhance housing stability, well-being and social inclusion, and thereby increase the engagement of young people in education, training and/or employment. As we build an evidence base on the effectiveness of these interventions, we must also think about the sustainability and scaling of this work, which requires us to ask some key questions of the role and approach of funders (government and philanthropy).
I’ve invited Duncan Farthing-Nichol from MaRS to share some of the key recommendations from the “Funding Services for Homeless Youth in Canada” report.
Thanks, Melanie. We at the MaRS Centre for Impact Investing have learned a lot over the last year. We’ve interviewed homelessness experts and funders to find out more about how governments pay for homeless youth services today and how they might fund those services in the future. We’ve heard about empowering communities to decide their priorities while strengthening their ability to deliver. We’ve heard about gathering consistent data, emphasizing prevention, shifting dollars to focus on results and coordinating funding across government departments.
We drew a few recommendations from our research. First, federal and provincial governments that fund pilot programs should mandate strong evaluation designs to learn as much as possible about what programs work, for whom and under what conditions. For youth especially, communities often lack the detailed program evidence that allows a sophisticated response.
Second, federal and provincial governments should weigh tying a small portion of community-level homelessness funding to community-level results. A small amount paid on results could channel communities toward the federal or provincial government’s goals without micromanaging on-the-ground delivery. Any scheme to tie money to results must be made in close partnership with communities. The scheme must also adapt over time.
Third and last, federal and (especially) provincial governments should test cross-departmental funds to pay for homeless youth programs. Homelessness’ causes and consequences reach across departmental boundaries, yet departments not directly responsible for homelessness often shy away from taking part in homelessness programs. By paying for programs based on results - by paying, for example, on the number of youth who graduate from high school - a cross-departmental fund might attract interest from departments keen on those results. Paying for results clarifies how ending youth homelessness can help many departments realize their aims.
Back to you, Melanie.
MtS is providing leadership in helping communities and governments move away from band-aid solutions to youth homelessness through an investment in the development and testing of effective strategies to prevent youth homelessness and to help those who are experiencing homelessness to move out of it quickly and in a sustainable way. In partnership with MaRS Centre for Impact Investing, Making the Shift is also providing cost modelling and practical recommendations for how we can more effectively fund this important work. Over the next year we will continue to support program implementation and ongoing service delivery, as well as conducting rigorous research and evaluation and sharing findings as they emerge. For Phase Two of Making the Shift (Spring 2019 and beyond), we will build new partnerships that will contribute to the long-term sustainability of these interventions, while continuing to support our Phase One partners to provide critical services to young people and their families. We will also conduct additional research and evaluation of other interventions in the areas of prevention and sustained exits from homelessness. Our ongoing work with research, evaluation, program delivery, and cost modelling will continue to inform our policy and investment recommendations, as well as provide all Canadian communities with the practical tools (resources, training and technical assistance, etc.) they need to “Make the Shift.”
Are you working in the homelessness sector and in need of program evaluation support? We’ve got an exciting update for you!
Hub Solutions is a social enterprise nestled within the Canadian Observatory on Homelessness that provides research, evaluation and design services to organizations working to end homelessness. As part of our mandate, and recognizing that preventing and ending homelessness is a shared effort, we are looking for new ways to support the sector. This is why we are excited to announce that we are giving away a FREE evaluation consultation!
What are we talking about?
This is a unique opportunity to win a free evaluation consultation from Hub Solutions! It’s also an opportunity for us to reflect and check in with our stakeholders (you!) and the homelessness sector to learn about your needs and how we can work together to prevent and end homelessness in Canada.
Who can apply for the FREE evaluation consultation giveaway?
- Organizations based in Canada who are working to end homelessness. If you have multiple programs to submit, you can even have multiple submissions.
- Small agencies, organizations and collectives who are doing really great work, but don’t always have the time to dedicate their efforts to evaluation or sustainability.
Is this FREE evaluation consultation for you?
Is your initiative making magic happen in the community? Do you need support showing how your initiative shines for that future funding proposal, community check-in or an upcoming AGM? Do you need support figuring out your initiative’s pain points and how you can do better?
If yes, then we would say this opportunity is for you!
If I get picked, what happens next?
We’ll let you know if you’ve won by December 2018 and intend to hit the ground running by January 2019. We’ll schedule a kick off meeting with our team and your team for January, where we’ll figure out the nitty gritty of your project, schedules, timelines, and all that other fun stuff. From there, the Hub Solutions team will go and do their magic!
Ready to take the plunge? Fill out this short 15 minute application and enter to win!
If you’re still not sure, check out more information here. You can always shoot John Ecker (our Director of Research & Evaluation) a message with your questions as well, and we’d be happy to answer them!
Need a hand today? The Hub Solutions team is still around to meet your evaluation needs! Contact us today!
As Talley and Timmer eloquently put it, “If we intend to address homelessness, we must not allow ourselves to mistake another problem – the creation of a dependent and controlled client population in the shelter system – for the solution.” According to the literature on homelessness, the current response to homelessness heavily relies on the provision of emergency services, such as shelters, day programs, and soup kitchens. In recent years, however, there has been a shift towards thinking about the prevention of homelessness.
Homelessness prevention is not only humane, it is also cost-effective. Studies have found that individuals who are experiencing homelessness typically have higher levels of healthcare usage, and consequently incur higher healthcare costs. Additionally, approximately $350,000 can be saved within the criminal justice system each time an individual is prevented from being homeless.
Evidence undoubtedly exists to support the argument for preventing rather than responding to homelessness. However, is academic evidence enough to promote this widespread shift towards prevention? In an attempt to answer this question, I turn to shelter staff – those directly working in shelters and operating on the opposite end of the prevention spectrum – to understand their views on shelters and its role in addressing homelessness.
At this year’s CAEH conference, I will present the results of this qualitative research project, which explores frontline shelter staff’s perspectives on the use of shelters – an emergency response – as a strategy in addressing homelessness. This qualitative study was conducted with 13 frontline shelter staff working in adult shelters across Toronto, Canada.
This session will be of most interest to the frontline staff, as well as other professionals in the homelessness sector who are working to prevent homelessness. This research illustrates that the efforts to prevent homelessness does not exclude those working in emergency response roles. Overall, findings from this study will inform homelessness prevention stakeholders on the steps needed to promote a cross-sectoral shift towards prevention.
To learn more about this study, please attend this session within the COH stream. I am very excited to be taking part in this conference for the first time as both an attendee and a presenter, and I look forward to seeing everyone there!
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The analysis and interpretations contained in the blog posts are those of the individual contributors and do not necessarily represent the views of the Canadian Observatory on Homelessness.