Calgary Homeless Foundation
December 29, 2016

On November 17, I delivered a webinar presentation for the Canadian Housing and Renewal Association titled “The Missing Piece: How Housing Policy Benefits from a Socioeconomic Perspective.”

The presentation focused on both macroeconomic factors and factors pertaining to Canada’s social welfare system in general; I argued that leaders in Canada’s non-profit housing sector should be mindful of such issues (and not just focus on housing and homelessness).  My PowerPoint presentation can be downloaded here; the entire webinar can be viewed here.

Here are 10 things to know:

  1. In the past several decades, Canada’s economy—as well as its social welfare system—has gone through profound changes. For example, since the 1980s, spending on social welfare by Canada’s federal government has decreased substantially. Likewise, since the mid-1990s, taxation in Canada (by all orders of government combined) has decreased substantially. Canada’s official unemployment rate has been considerably higher in the past several decades than it was in the first two decades after World War II, and a much smaller percentage of unemployed workers are eligible for unemployment insurance benefits today than was the case in the 1970s and 1980s.   Federal spending on housing has also seen a general decrease in the past two decades, and federal spending on homelessness is considerably lower today than it was 15 years ago.  Some social scientists refer to this broad trend as neoliberalism.
  2. Most of these changes have not been good for Canada’s non-profit housing sector. Less public spending typically means less protection for vulnerable households. What’s more, higher unemployment is usually ‘bad news’ for poverty and homelessness.
  3. It’s very difficult for researchers to know the precise impact of all these factors on homelessness. Early attempts to understand the main determinants of homelessness in the United States can be found hereherehere and here. A recent Australian attempt can be found hereRon Kneebone and Margarita Wilkins have done some research on this in Canada.  Their recent policy report—along with some policy prescriptions—can be found here.  A nice, succinct PowerPoint presentation they put together about their report can be found here. (For a general consideration of some of the challenges involved in establishing causation, however, see point #1 in this blog post.)
  4. Just because there are unanswered questions about ‘cause and effect,’ doesn’t mean it’s not reasonable to suggest many of these changes likely left a lot of people without affordable housing. In light of the challenges involved in establishing causation, researchers have little choice but to make well-researched arguments. With that in mind, I’d argue it’s reasonable to suggest that higher unemployment and cuts to social welfare programs (including cuts to affordable housing) have almost certainly led many Canadian cities to have more homelessness in the post-neoliberal era than in the pre-neoliberal era.  For example, between 1980 and 2000, the average number of persons sleeping in an emergency shelter in Toronto on a nightly basis increased by 300%. (For a consideration of pre-neoliberal vs. post-neoliberal homelessness in Toronto, see this 2010 book chapter.)
  5. The trends discussed in point #1 above are likely reversible. Indeed, other countries have gone in the other direction as Canada in the past several decades. Between 1980 and 2016, public social spending as a percentage of GDP nearly doubled in Australia, Finland and Italy. (You can see these figures for yourself at the OECD web site here.)  It’s also useful to consider the case of Japan, which currently has an official unemployment rate of just 3%.  Bill Mitchell (Chair in Economics at the University of Newcastle) attributes Japan’s low unemployment in part to increased public spending; he writes about this here.
  6. Non-profit housing leaders should pay attention to macroeconomic and social trends, and not simply think about what’s directly in front of them (namely, housing). To do this, I recommend they do the following: read every column Thomas Walkom ever writes; subscribe to the Canadian Social Research Newsletter; read the blog of the Progressive Economics Forum; read reports and blog posts of the Canadian Centre for Policy Alternatives, the Caledon Institute of Social Policy and the Institute for Research on Public Policy.  On Twitter, I suggest people follow: Miles CorakAndrew CoyneRob GillezeauSeth KleinDavid MacdonaldAngella MacEwenAndré PicardTrevor Tombe and Armine Yalnizyan.
  7. When advocating with elected officials and government staff, non-profit housing leaders should discuss macroeconomic factors as well as the broader social welfare system. Several organizations already do this. One example can be seen in CHRA’s recent submission to Canada’s National Housing strategy (NHS) consultations; another is the Calgary Homeless Foundation’s recent submission to the NHS consultations.
  8. Non-profit housing leaders should partner with researchers who are knowledgeable of macroeconomic factors and the broader social welfare system. An important example of this is the Alternative Federal Budgetexercise, which brings together a large array of advocacy organizations and researchers; together, they put forth an alternative to each year’s federal budget.
  9. Non-profit housing leaders—and researchers with whom they partner—should be honest about what they don’t know. There are at least two reasons for this. First, it’s the honest thing to do.  The late John Kenneth Galbraith reminded us of this when he said the following about economic forecasters: “There are two kinds of forecasters: those who don’t know, and those who don’t know they don’t know.”  Second, exaggerating your point may hurt you in the end.  To see how, read this blog post I wrote in August 2016.
  10. When graduate students do placements at non-profit organizations, their supervisors should have them write annotated bibliographies of existing research. They should then learn from those annotated bibliographies and become more informed on the research topic in question than any elected official, any senior staff or any academic researcher. (Here’s a little secret: one reason I know about all the homelessness studies I discuss in point #3 above is that, last summer, a graduate student wrote an annotated bibliography for the Calgary Homeless Foundation; in preparing the present blog post, I was able to quickly review the document he prepared in a matter of minutes.)  For more on annotated bibliographies, see this link.

The author wishes to thank the following individuals for assistance in the preparation of this blog post: Ron Kneebone, Tamara Krawchenko, Louise Gallagher, Brian MacLean, Marc-André Pigeon and Mario Seccareccia.  Any errors lie with the author. The views expressed in this blog post are those of the author, and not necessarily those of the Calgary Homeless Foundation. Any errors lie with the author.

This blog post has been republished with permission from the Calgary Homeless Foundation website.

Calgary Homeless Foundation
December 22, 2016

This week, the Calgary Homeless Foundation (CHF) released its updated Research Agenda.

Full disclosure: I’m CHF’s Director of Research and Data, and I co-authored this year’s research agenda along with Rachel Campbell.

Here are 10 things to know:

  1. The CHF is a non-governmental organization that disburses funding to Calgary non-profits to deliver housing and programming to persons experiencing homelessness. CHF also monitors the performance of each program it funds. More than three-quarters of the funding in question comes from the Government of Alberta. For more on CHF’s role, see this previous blog post.
  2. Over the years, CHF has partnered on a considerable number of research projects. The just-released research agenda lists every publication on which CHF has partnered since 2008 (all of those publications are listed in the document’s Appendix A). This is the first time we’ve listed them all in one place. Special thanks to my colleague, Rachel Campbell, for not only listing them all in one place, but also for writing an annotation discussing each one.
  3. Since 2009, CHF has published research agendas approximately once every two years. Previous versions are available at this link. Each research agenda is a bit like an annual report about CHF’s research.
  4. Every two years, CHF also organizes a community research symposium. The most recent one was held in April 2015. Several themes emerged at that event as knowledge-gaps requiring additional research. Key themes identified for future exploration included: marginalized populations (including Indigenous peoples, seniors, families, and youth); the causes of homelessness; patterns of ‘exit’ from homelessness; and recidivism. Our next symposium is being planned for May 2017.
  5. A major strength of CHF research is its use of data. An example of this is a 2015 study led by CHF’s Senior Researcher, Dr. Ali Jadidzadeh, looking at shelter use over a five-year period by nearly 33,000 individuals in Calgary. The report finds that, contrary to popular perception, the great majority of people who use emergency shelters in Calgary do so very infrequently and for only short periods of time. That report is titled Who Are the Homeless? Numbers, Trends and Characteristics of Those Without Homes in Calgary. The link to the report is here.
  6. The main reason CHF is able to use data stems from the fact that we oversee a city-wide database system with information on persons experiencing homelessness. When Calgary developed its plan to end homelessness back in 2008, it also decided to develop an information management system. Many of Calgary’s homeless-serving organizations enter client information into a database called the Homelessness Management Information System (HMIS). Client-level information (such as age, health status, employment status and housing status) is entered into the database. While the client is receiving services, updated information continues to be entered and updated. In the case of some programs, exit and post-exit follow-up assessments are completed. The HMIS system helps homeless-serving programs in Calgary to prioritize and refer clients to other programs. Some organizations also use the data to provide case management services to clients. Today, all Calgary non-profit programs that receive funding from CHF must use the HMIS. For more on Calgary’s HMIS system, see this previous blog post, as well as point #8 in this previous post.
  7. This year, CHF co-organized the First Annual Canadian Homelessness Data Sharing Initiative. In May 2016, approximately 40 people attended the event (which was co-sponsored with the University of Calgary’s School of Public Policy). A major goal was to bring together persons with access to various forms of homelessness data. Those attending included government officials, researchers and students. This will become an annual event, with the next one currently being planned for May 2017. For more on the first event, see this previous blog post.
  8. CHF likes to partner on research that has an impact on both practice and policy. We discuss several such examples in the research agenda, one of which is a project in which we developed standards of practice for case managers working in Housing First programs. This research led to a mandatory accreditation process for all CHF-funded agencies; and in 2013, we learned that the American Case Management Association had begun using this research as part of their curriculum for accreditation of case managers.
  9. Some of CHF’s best research involves persons with lived experience with homelessness. The Homeless Charter of Rights project has used a participatory action research approach to examine the barriers to service faced by persons in Calgary experiencing homelessness. This project, which is ongoing, has involved persons with lived experienced at all stages.
  10. CHF research is developing an international reputation. After reviewing a draft version of the current recent research agenda, Professor Thomas Byrne (Boston University) noted: “I can’t think of a single community here in the United States that is as engaged and thoughtful about conducting research (specifically to inform their practice) as the Calgary Homeless Foundation.”

Click here to view the CHF Research Agenda.

This blog has been republished with permission from the Calgary Homeless Foundation.

A Way Home
December 14, 2016

I’m a sucker for the holidays as it is: the beautiful twinkling lights, holiday carols, and even cheesy holiday rom-coms. This holiday season is even more special somehow, and reflecting on the first year of A Way Home Canada is an important part of that. What I’m most grateful for is the approach we are taking to making a real impact on the issue of youth homelessness known as Collective Impact. Now I know I’ve written about Collective Impact in previous blog posts, but it is fundamental if we want to prevent and end youth homelessness in communities while simultaneously shifting the policy and funding context to support those communities.

Key to our Collective Impact approach is working with funders as partners. The Catherine Donnelly Foundation, who I lovingly refer to as “the radical nuns from the prairies,” are convening a table of corporate and philanthropic partners to contribute to A Way Home’s strategy, funding base, government relations efforts, and to even start working toward shared outcomes and specific funding streams that focus on prevention. This is innovative stuff! One of the funders at the table, the Ontario Trillium Foundation, has even embarked on an ambitious program to support local and provincial Collective Impact initiatives.

Photograph from the event on Parliament Hill with a few of the attendees.
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Here’s what these kinds of relationships can look like in action. On November 15th one of our partners in this Collective Impact approach, the Home Depot Canada Foundation, hosted a reception on Parliament Hill to report that they achieved their initial 3-year investment goal of $10 million to support national and local efforts to end youth homelessness and to announce an additional $10 million commitment over the next 2 years. This event attended by more than 60 Members of Parliament from across party lines and associated meetings with elected and senior officials in Ottawa with A Way Home, the Home Depot Canada Foundation, and the Canadian Observatory on Homelessness provided a critical forum to release the results of Without a Home - the largest national study on youth homelessness ever done in Canada. Guess what? The results of the study point overwhelmingly to the need to prevent young people from ever becoming homeless, and if they do become homeless, ensure it is brief, rare and one time. We were able to walk into those events and meetings as a unified front comprised of the community sector, researchers and the corporate sector with an invitation to all orders of government to join us in our shared vision.

So what does 2017 and beyond look like for A Way Home? We’ve named five strategic priorities upon which to focus our collective efforts as a coalition:

  1. Identify, develop, research and build evidence in policy and program models that support the shift to prevention and appropriate models of housing and supports.
  2. Develop partnerships to integrate policy and program model learnings into other youth focused systems of care (Child Intervention, Youth Justice, Mental Health and Addictions).
  3. Support and facilitate systems planning (communities, regions and provincial/territorial) (processes must include those that can influence the systems that drive young people into homelessness).
  4. Service provider/sector shift to prevention (led by the National Learning Community on Youth Homelessness hosted by A Way Home).
  5. Knowledge mobilization, public engagement and government relations to inform sound public policy and investment.

Just to circle back, how can we deliver on such an ambitious agenda? We will do it together, and Collective Impact provides a frame to support and guide our efforts.

I hope your holidays are filled with rest, love and joy. 

This post is part of a monthly series that follows A Way Home's progress as we create real change on the issue of youth homelessness. On the second Wednesday of every month, join us for an update from A Way Home's Executive Director, Melanie Redman. 

December 13, 2016

Introduction

In the first blog post in this series, Dr. Alina Turner gave an overview of the Haven’s Way program model – a Foyer supportive housing program for youth in Calgary. See full report on the program here.

It is important to complement the research perspective with of those of people ‘living’ Haven’s Way: the staff and youth residing in this home. In the second blog post, Heidi Walter, current Manager of Youth Housing at Boys and Girls Clubs of Calgary and former House Parent at Haven’s Way described what she feels is the essence of Havens Way to better convey why it works.

In this blog post, Ange Neil -who was a youth participant and current Alumnae of Haven’s Way describes her experience and thoughts on the program.

Haven’s Way – What is Home?

Haven’s Way is more than a program that used to help me. It’s more than a house I used to live in. It’s more than a service for at-risk girls experiencing or who are at risk of homelessness.

Haven’s Way is a lifeline in the darkness; it’s a raft that comes in the middle of the storm and doesn’t stop fighting for your life no matter how bad you flounder.

The Start

Ange with the sign "I kept living because.."
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Five years ago, I was 18 years old and stuck between a rock and a hard place. I couldn’t go home, I couldn’t live where I was living anymore, and I couldn’t afford to finish school and pay for the basic needs of life all at the same time. I didn’t want to drop out of high school, but what choice did I have? Food and shelter are very real needs when it comes to survival. Besides the basic needs of life, I was lacking mental wellness, my willingness to live, relationship skills, and holding a plethora of adversity in my back pocket. 

You don’t get to Haven’s Way because everything in your life is going well. You get here with a suitcase full of trauma, stories no one wants to read, and walls stronger than the ones surrounding a maximum-security prison system. And this is exactly how I arrived – angry, beaten, scared, and lost.

My first memory of Haven’s Way was painting my room blue and teal during the days leading up to moving in. I picked the colors; my bedding was purple and yellow. We had a family dinner that first night, the same way we did every time another new girl moved in. I was told the rules, given the official house tour, and painted my room. I went to sleep that night feeling scared, angry about where my life was at, and a little bit hopeful. I cried the first night and the house parent living at the house hugged me, tucked me in, and told me morning would be different. I didn’t know if I believed her but I liked her. She was gentle, kind but didn’t tell me what to do.

Fast-forward six months of fighting love, mental-health episodes gone awry, and a lot of unpacking my dirty emotional baggage something began to shift. I began to realize these people weren’t throwing me away like the garbage I felt I was. They didn’t give up on me or stop loving me.

Why does it work?

I think one of the reasons this program works so well is because it’s rooted in love. That interwoven strand of love wraps through every room in the house, every relationship that enters the front door. It’s not about a paycheck or a doing a job for 12 hours. The house parents live in this home just as equally as each girl who lives in the upstairs bedrooms.

Three years passed while I lived at Haven’s Way. During that time, I painted a lot of canvas until 3am, ate family dinners, celebrated every holiday and several birthdays, and filled every inch of my blue room with posters and various forms of art. I learned how to live with roommates that became like sisters. I formed communication skills and stopped acting out my internal pain with risky behaviors. I learned to use my words to transmit whatever was going on inside of me.

I didn’t just spend six months in a residential program working to stabilize me. No, I was welcomed into a family and given a home. I was given safety and a chance to succeed but also fail. See, when I learned how to fail I ended up learning how to succeed. Making mistakes is common at Haven’s Way, being alienated and punished is unheard of. We learn consequences but we learn without being punished. Through my normal late teen-early 20’s mistakes, I participated in my journey of life at a level that I never dreamed possible for me.

Looking Forward

I’ve told you some of the lessons I learned at Haven’s Way; some of my successes include entering recovery and leaving behind the drugs and the alcohol for 2½ years now, staying out of the psychiatric ward by taking responsibility for my mental health, not being controlled by my trauma, being an employable member of society, graduating a university diploma program, and currently working towards my degree at the University of Calgary. I share my lessons and successes with you to point out the important role Haven’s Way has when intervening in the lives of young women. I could not have done these things if Haven’s Way hadn’t found me. I needed a safe place to grow up and find myself and I did that at Haven’s Way.

I fell a lot during my time at Haven’s Way but I stood up every single time because I had my Haven’s family beside me.  And as I now form my adult life outside of Haven’s Way I continue learning and growing. But I know I can always come home to my Haven’s family. I can call any of them and I know they will show up for me. I graduated Haven’s Way but I didn’t graduate from this circle of community I am now forever a part of.

Haven’s Way is more than a program; it’s home.

Homeless Hub
December 09, 2016
Categories: Ask the Hub

“What are the statistics on homelessness and mental health in Toronto?”

This question came to us anonymously through our latest survey.

Over the years, the Homeless Hub blog series has written extensively on the links between mental health and homelessness in Canada, however, we’ve not yet focused on any specific location.  As Canada’s largest and most ethnically diverse city, Toronto has the greatest number of people experiencing homelessness with 5,253 people counted on the 2013 Street Needs Assessment (SNA). The Toronto count in 2013 found that 79% of those surveyed were staying in shelters, 8% on the street, 6% in correctional facilities, 3% in violence against women (VAW) shelters, and 4% in health care or treatment facilities. A study on health care access for homeless people found that among Toronto’s homeless population, one third identified as an immigrant, 45% identified as belonging to a racialized group, 22% identified as Black and 9% as Indigenous.

Toronto’s SNA is used to estimate the number of people experiencing homelessness staying outdoors, or in a number of facilities on any given night. While the SNA offers important information, it does not provide an exact number of people experiencing homelessness in a community. For example, those disconnected from agencies serving the homeless population or who are couch surfing are likely not to be counted. However, a point-in-time estimate, such as Toronto’s SNA, does yield important information that would otherwise not be known.

Back in 2013, Isaac Coplan wrote a blog entry highlighting some of the findings in Toronto’s latest SNA, and I revisited the report to compile some data in connection to mental health, along with other statistics found in two other Toronto-focused studies on health and homelessness.

Mental Health & Homelessness in Toronto

The 2013 SNA highlights that 43% of respondents indicated that addressing their health needs was important. While only 2% indicated that mental health supports was most important to finding housing, 32% of respondents expressed an increased need for mental health services. Those who have been homeless for 2 years or more were two times more likely than those experiencing homelessness for a shorter period of time to indicate that mental health services was most important in finding housing. In contrast, 80% of women staying in VAW shelters indicated that help in addressing health needs was important to them, compared to 43% for all respondents. VAW shelter respondents were also 8% more likely to indicate the importance of mental health supports. Lastly, 49% of all respondents were on a subsidized housing waiting list and of those, 19% indicated having an application with the Coordinated Access to Supportive Housing system which provides access to housing catering to those with mental health and related needs. 

While the 2013 SNA doesn’t provide further information beyond this data on mental health, it does provide a glimpse into the profile of homelessness in Toronto, and the rising needs for services required to better serve this population.

Media Folder: 

The Street Health Report 2007 reveals a similar picture of homelessness in Toronto based on a health survey for homeless adults in the downtown core. The findings in this study include:

  • 35% of respondents had been diagnosed with at least one mental health condition in their lifetime.
  • 12% said that they had mental health supports in the past but could no longer get help.
  • The major reasons for not being able to obtain mental health care included:
    • 38% did not have a doctor or didn’t know where to get care
    • 29% saw a doctor but were not offered mental health care
    • 24% were not able to get a referral to a specialist
    • 24% did not have a health card
  • 58% with a mental health diagnosis had been prescribed medication but:
    • 28% said that the side effects were not explained to them
    • 35% felt that they did not have a choice or say in their treatment plan
  • 26% had been hospitalized with an average of 5 times for an emotional or mental health problem. Of this group:
    • 70% said their most recent hospitalization was voluntary
    • 30% were forced to go against their will
  • 47% of respondents hospitalized in the past year of the study did not get help filling prescriptions when they were discharged from the hospital.
  • 32% are unable to obtain medication due to the added expense, not having a benefit card or drug benefits not covering the prescription.

More recently, the Mental Health Commission of Canada conducted the At Home/Chez Soi study. The national study included demonstration sites in Vancouver, Winnipeg, Toronto, Montreal and Moncton and was the world’s largest trial of Housing First. The project aimed to develop evidence on effective services and interventions for people who are homeless and living with mental health conditions and ran from October 2009 to June 2013.

The Toronto participant sample covered a wide range of demographics: 68% were male, over 54% were between the ages of 35-54, 54% were born in Canada, 70% were single, 28% had children, 49% had less than high school education, 4% had prior military service and 95% were currently unemployed despite 68% having previously been employed for at least one year with the same employer. Findings from this group include:

  • Of the 575 participants followed for two years, 67% met the criteria for two or more mental illnesses or addiction, of which 37% had a psychotic condition.
  • 43% of participants had two or more hospital admissions for a mental illness in any one-year period in the five years before study entry.
  • 5% of participants reported having been hospitalized for mental health at least once for more than 6 months in that time period.
  • 30% reported symptoms consistent with moderate to high suicide risk.

Toronto has a large network of mental health services for individuals who are both housed and homeless including inpatient/outpatient services, case management, crisis programs and ethnoracial-focused agencies, yet there is a great need for an integrated approach to better serve this population. In our section on systems approach to homelessness, we emphasize the need to utilize an inter-agency collaboration, individualized programming and community-based service provision. The At Home/Chez Soi study demonstrated that with coordinated support systems under a Housing First framework, people who are homeless and have a mental health condition can live independently in the community, and the majority indicated that they would prefer to do so.

Media Folder: 

Overall, the mental health status of people experiencing homelessness in Toronto is alarming. Many report extremely high rates of mental health symptoms and suicidal ideation. However, it’s important to note that unlike the common stereotype of the homeless person suffering from psychosis, the most common conditions are depression and anxiety.

While quantitative methods reveal critical figures required for policy development that directly impact Canadians, people’s experiences and realities cannot be measured in numbers alone. Both The Street Health Report 2007 and the At Home/Chez Soi study used qualitative methods, including narrative interviews to reveal their experiences with mental health, homelessness, coping strategies and resilience. Qualitative data such as stories help us better understand the reality in unique ways that statistics simply cannot do.

Services in Toronto

With research increasing in the area of mental health and homelessness so are the programs available in Toronto, which include but are not limited to:

  1. Street Health is a non-profit agency providing physical and mental health programs in the Dundas and Sherbourne area. Their community mental health program supports people access health services and has nurse practitioners who provide care at their drop-in centres and shelters.
  2. Anishnawbe Health Toronto operates a 24/7 mental health crisis management service.  They offer care from many disciplines including Traditional Healers, Elders and Medicine People, ancient ceremonies and traditions, intrinsic to Indigenous Peoples’ health care model.
  3. Sistering provides basic services to women who are homeless and under-housed. Among their services, they offer crisis intervention and prevention support for women dealing with trauma and abuse.
  4. Fostering an Inclusive Shelter Environment for LGBTQ2S Youth is a new mandatory training curriculum for Toronto’s shelters staff on topics of LGBTQ2S youth homelessness and the high rates of suicide and mental health.
  5. CATCH is a program offered by St. Michael’s Hospital, CAMH, and St. Joseph’s Health Centre designed for people experiencing homelessness and needing care. The program provides referrals to patients and remains connected with them to ensure that they are receiving the care they need.

While these are just a few initiatives, advocates call on the need to integrate mental health care and homeless services as featured in CAMH’s Nowhere to Go film that focuses on LGBTQ2S experiences in the shelter system. There are also gaps in the literature and further research is required to shed light on the experiences and needs of key populations through an intersectional framework. This would enable service providers and policy-makers to better understand the specific needs of homeless individuals living in Canada’s most diverse city.

More Toronto-Based Resources

Image Credit: The Street Health Report 2007 and 2013 Street Needs Assessment (SNA)

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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.