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Ending Homelessness in London If it can happen elsewhere, why not here?
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By Haydn Jensen

Perhaps you have heard about Medicine Hat, Alberta and their recent success in helping almost all of its homeless people get off the street and on their way to a healthier, stable and sustainable future. How does London compare? Our efforts towards ending or reducing homelessness aren't attracting media attention the way Medicine Hat's efforts have. What does this say about our situation? Well, first we should take a look at what's happening in Medicine Hat and compare that to London.

A city of 61,000, Medicine Hat has helped 875 homeless people (including 280 children) find secure lodgings in supportive or subsidized housing since 2009. They are doing it within a 10-day waiting period. In a November 2014 count, they listed 64 people as homeless. Of these, only five were "sleeping rough" and the rest were either in an emergency shelter or short-term supportive housing. Those are impressive numbers coming from a part of Canada where the old-west values of hard work and self-sufficiency run deep. As Medicine Hat’s mayor Ted Clugston describes the attitude, "...if you want a place to live, you pull yourself up by the bootstraps. You go get a job."

Clugston says he used to share that mindset, but a new approach has convinced him that this way of thinking may actually be a hindrance to helping individuals and families facing homelessness. The new approach is to assess an individual or family's situation, and respond first with appropriate housing, followed closely by appropriate supports. The "housing first" or "housing with support" model challenges conventional wisdom which expects people to be sober, mentally healthy, and gainfully employed in order to "earn" a place to live. If a person is homeless while struggling with mental illness, or in the grips of an addiction, or faced with trauma or unemployment without adequate support relationships in place to help them get on their feet again, then being able to get a job to pay for rent and food etc. is even more difficult, if not impossible.

Here's a quick explanation of how Medicine Hat is applying the "housing first" model. Based on a ten-day plan, if a person becomes homeless, some sort of permanent residence is made available within ten days (and not simply an emergency shelter). They have a Community Housing Society which is a multi-disciplinary social services agency that works with people according to assessed needs. They have ways to offer subsidized or geared to income rent as needed. They can also help provide treatment for mental health and addictions, as well as access to employment resources and income assistance.

It's easy to see how providing stable housing needs to happen before any progress can be made in overcoming challenges like unemployment, poor mental health, and so on. From a financial perspective it all makes good sense too. Experts estimate caring for a person on the street can cost up to $100,000 a year. Housing a homeless person only costs $20,000.

So, if "housing first" seems to be working well there, what about here in London? Sure, we're in a different part of Canada, our city is larger, and our economy is different. And yet, we also have people in our community without homes or with the same basic needs. We often share that same anti-handout "get a job" mentality. We also would like to see everyone in our community--especially children and families--living in secure and safe environments. What would it take for us to even approach the kind of progress Medicine Hat seems to be making? I took the discussion to some London agencies working directly with those facing homelessness to get their viewpoint.

In general, the feedback on how London is doing is fairly positive in that improvements are being made--slowly but surely. However, matching Medicine Hat's example of finding permanent housing for a person or family within 10 days is not presently realistic here. London is almost six times bigger than Medicine Hat.

Gordon Russell is Director of Shelters for Mission Services of London. He says that somewhere around 30 days is more realistic, but even longer waits are not abnormal.

Executive Director for the Salvation Army Centre of Hope, Nancy Powers agrees and adds, "We will get there, but a larger ship takes more time than a canoe to turn itself around." She says, "We believe that people should be living in their homes and that emergency shelters should be used as a place to stay during a crisis--not be used as a solution to housing."

Gord Russell talks about two distinct groups of single people facing homelessness. One group is the chronically and persistently homeless and the other group consists of those who face a brief period of homelessness. The chronically and persistently homeless represent a small proportion of Mission Services clients and yet they account for the majority of bed nights at a shelter over a given year. Gord says that the vast majority of clients they serve at the Men's Mission are the second group--those who stay briefly but get back on their feet again and never return. Those who are chronically and persistently homeless are understandably facing much more serious and often more complex challenges and so will require a greater investment of supports.

Nancy Powers at the Salvation Army adds that the chronically and persistently homeless also put additional pressure on police and EMS services. So, a greater investment of supports to help these people towards independent living can pay off in reduced demands on police and EMS response. It also takes a lot more support to help them get to stable independent living the longer they live in shelter. Gord says that people develop habits around living in shelters and on the street; developing habits that allow them to live in a home requires work also.

One good reason for optimism in London is a growing alignment on the municipal, provincial and federal levels. All follow a housing and people first approach to homelessness. As well, there is growing awareness of the need for better coordination among London's local agencies and services working directly with our homeless population and those at risk of homelessness. It's been noted that the services someone receives can vary depending on where the person or family accesses the service system. With agencies using different assessment tools and eligibility criteria of different programs, the result can be fragmented, uneven and inefficient. Individuals or families have not always been directed to the most appropriate programs or services. This is not uncommon for larger urban centers like London.

To help address this, The City of London in 2013 published a Homeless Prevention System as a three-year implementation plan. This also focuses on the "housing first" or housing with support philosophy. The Homeless Prevention System's goal, together with agencies, programs and funding is to assist individuals and families experiencing homelessness or at risk of homelessness to achieve housing stability. Support needs are assessed for the individual or family and implemented once the housing crisis need has been stabilized. London's Homeless Prevention System aims to deliver "actionable and measurable solutions in purposeful and strategic ways with community-level results, consistent service delivery and information management." It lists four primary focus areas:
  • Securing Housing
  • Housing with Support
  • Housing Stability
  • Emergency Shelter Diversion

The effort is to use a clear strategy to offer phased-in approach over several years to increase capacity and competency and help our now relatively fragmented system improve enough that homeless prevention becomes the main approach.

Although the clear focus is on a personal response to the personal crisis of not having a place to live, the matter of finances inevitably requires a great deal of attention. Low-income programs like Ontario Works combines with Rent Geared to Income programs in a complicated funding formula that too often does not meet the financial needs. A current lack of affordable housing also makes it difficult to find adequate housing at market rates. Various federal, provincial and municipal financial assistance through loans and some grants are attempting to be helpful, but resources are too often stretched and still found wanting. Efforts are being continually being made to reassess and improve funding structures and supports but it’s clearly an evolving process.

There are growing local efforts towards greater partnership to streamline supports and services, along with some interesting initiatives. Agencies are working at increasing their numbers of housing crisis workers, housing selection workers, and street outreach workers. The London CAReS (Community Addiction Response Strategy) was initiated in 2008 by the City of London and is a highly collaborative community-based Housing First service aimed at improving the health and housing outcomes of individuals experiencing homelessness in London. The Unity Project originated in 2001 when a group of youth activists and homeless individuals formed a tent city in a downtown park to raise public awareness. With private and city of London support they have since purchased and operate their own facility in East London where they offer social services to help thousands of men and women approach stability and restore wellbeing. The London Homeless Coalition is an open network of individuals from agencies, government, mental health, addictions care etc. all seeking to advise, shape and coordinate community responses to homelessness, and related needs to the London area.

Clearly, a growing number of people and agencies in London are working hard at improving things. In comparing ourselves to Medicine Hat, yes there is a size difference and a difference in the kinds of resources we have available here. Gord Russell of Mission Services believes the political will is there and would like to see more improvement in our structure of support. For example, there is an ongoing effort to create a centralized intake network. This could be a big help in improving efficiency and hopefully improve each agency's ability to redirect people away from an emergency shelter. Even the basic ability to count the number of people seeking emergency shelter or other supports in the city can be difficult because people will move from agency to agency. A rough estimate according to London Homeless Coalition Director Abe Oudshoorn is that about 2,000 people in London are homeless on a given night. So, centralized system would provide more accuracy in determining what supports are needed for specific numbers of people.

Overall, there seems to be a growing need for awareness and commitment from the community--essentially we all need to own homelessness in our community as our problem since we are impacted either directly or indirectly. This can mean involvement from Londoners as individuals and as church communities. Gord Russell shared an interesting perspective this is a good way to finish off this discussion. He reminds us that people struggling with homelessness are vulnerable in many ways because of their isolation. He says, "If we don't pay attention to that, and operate like our culture generally does in keeping to ourselves, we're not helping that much." He adds, "Loving your neighbour will cost you something and involves risk. Philosophically we must be prepared for cost." With that, he also points out that we should also be prepared to receive.