Research Matters Blog
Housing First has now been lauded far and wide as the most effective solution to homelessness in developed nations. This model focuses on rapidly moving people into independent and permanent housing regardless of where they are in their own personal journey. This in contrast with past models that required people to be at a certain phase of recovery, be accessing treatment for mental health challenges, or move through a step-wise process of increased independence. Research has now demonstrated that the best outcomes are grounded in access to housing. However, there are a number of tough questions that have been raised in this model that I would like to address in this post.
1) Does Housing First put women second?
Last year ‘Homes 4 Women’ released a critical white paper titled “Housing First, Women Second?” The paper highlights the lack of a gendered approach taken at the national level of implementing Housing First priority for project funding. With this there is a risk that best practices around women’s homelessness, particularly that take into consideration the ubiquitousness of violence in women’s experiences, will be lost. We know that women’s and men’s experiences are not the same, and this paper highlights important differences such as the more hidden nature of women’s chronic homelessness.
So does Housing First put women second? I would suggest that only if we let it. The core principal of housing as the most important foundation for ending homelessness holds true across gender lines. However, where this will play out is within program implementation. The needs of women will be secondary if the programs themselves do not include the decades worth of best practices already developed. It is important to note that Housing First is inclusive of different types of housing, with the concept of ‘independent’ living being more fluidly defined. Secondly, it is housing with support, and these supports can vary as well. Therefore, Housing First won’t inherently put the unique needs of homeless women second as long as we continue to bring those needs to the forefront.
2) Isn’t independent housing dangerous for women recently leaving a violent partner?
This question builds closely on the previous one of women’s needs. If all Housing First programs mean a rapid move to a single, private residence, this will indeed put women leaving violence at risk. There are high rates of ex-partners finding women who have left violence, which makes the safety planning that comes with congregate living much more effective. However, Professor Stephen Gaetz highlights that there is no need to abandon transitional models that have proven effective with certain sub-populations, such as women. Indeed, researchers and leaders in the women’s movement note the lack of “Third Stage” housing, which is essentially permanent housing with supports. A Housing First model would mean maintaining second stage housing where effective, but not forgetting that third stage housing is the ultimate goal. Again, this comes down to a matter of proper implementation.
3) Why are there so many deaths in Housing First programs?
I am part of a research team evaluating the health outcomes of the first group of individuals enrolled into London CAReS. All of these individuals are those identified as chronically homeless, and the vast majority have experienced chronic addiction. In this case, when I speak of chronic addiction, I mean persistent and high use of substances, including mouth-wash addiction and significant IV drug use. We have seen a noticeable number of deaths of participants enrolled in the program. This has also been noted by workers in the sector, and raised some questions about Housing First programs in general and risk to participants.
Some of the deaths seen are those that would already be anticipated with this particular sub-population of significant substance users. However, I would hypothesize that there is another phenomenon at play as well. Many of these individuals overdose on a consistent basis during their homelessness, but this occurs in the context of an agency where other residents or staff are present. They are then taken to hospital and revived. Moving an individual who continues to use high levels of substances into a more independent living arrangement puts them at higher risk of overdosing undetected. The difficult bind is that this independent living, permanent affordable housing, is the desire of the individual. Therefore, we don’t want to deny them that, we absolutely don’t want to force people to stay in shelter long-term, but we also have to be aware of, and make the resident aware of, the risk that comes with using substances privately.
4) Isn’t the Foyer Model a better one for homeless youth?
The Foyer Model of transitional housing for homeless youth is popular in Europe, and has seen some implementation in Canada. In essence, this model is a more long-term model of transitional housing, rejecting the common 364 day limitation, that incorporates wrap-around services inclusive of education, employment, and life skills development. Arguing the Foyer Model against Housing First is where we get into the semantics of these models. If the Foyer Model is implemented with no move out date, then it is indeed permanent, independent, affordable housing with supports; it’s just a particular degree of support. If a move out date, for example 3 years, is indeed enforced, then a conversation needs to be had about rethinking programs and services to entail truly permanent housing. However, this doesn’t mean we through out the great best practices that have been developed in Europe, but rather we can work to integrate them with Housing First.
5) Sure Housing First is great, but what if there is no housing?
To either divert people from shelter or rapidly move them out of shelter requires affordable housing on hand. In communities across Ontario we face 2-20 year wait lists for social housing, and many communities have vacancy rates below 2%, disincentivizing the market to add more such housing. However, local examples show that there are innovative ways to increasing the housing stock. The first way is to take advantage of private sector housing in communities where vacancy rates mean rentals are available. In London this means a rent subsidy of approximately $200 to move an individual from the OW housing allowance of approximately $375 to $575, which puts them into average market rent. Although this investment in housing means no capital increase for the Housing Division that you would get from a new build, the $200 cost is far less than the municipality pays to keep an indvidual in shelter (approx. $1230 per month).
A second way to look at increasing affordable housing stock is innovative ways to boost the overall available stock through new builds. Also in London right now we are in the process of developing a Housing Development Corporation (HDC). This HDC will increase projected new affordable housing units from 450 to 1000 over next 10 years, without necessarily requiring further municipal investment. This is done by leveraging funding across all government levels hand-in-hand with both charitable and investment funds from the private sector. This is a sign that ambitious targets for new affordable housing are obtainable while still investing in immediate short-term solutions, such as rent supplements.
6) Can individuals with chronic addictions really stay permanently housed?
When London CAReS started enrolling the most chronically homeless in our community for permanent, independent housing, many within the sector were sceptical to say the least. These were individuals that they had tried to re-house many times, but had seen them cycle back time and again to shelter. How could London CAReS do any better? Well, time has been the test, and the majority of individuals rostered with CAReS have maintained their housing against the odds. This is proving that those with chronic addictions can remain housed, but is requires the right supports. In this case the right supports includes intensive case management, one worker per ten participants, which is costly in terms of operations, but pays big dividends across both health and social systems, and of course in terms of outcomes for the individual. Anyone who wants to be housed can be housed. (And research of 200 homeless individuals with mental health challenges in London showed that 100% desired housing.)
7) How come individuals in Housing First programs still access high levels of other services?
In anticipating the benefits of Housing First, there is a predicted decrease in use of health, social, emergency, and corrections services. The decreases have been seen in health, emergency, and corrections services, but individuals enrolled in Housing First programs still frequently use high levels of social services. For example, they may still access drop-in services and food programs on a daily basis. This continues to strain limited resources in the social service sector, but is not necessarily a bad thing. Recall that Housing First means housing with supports. What is happening here is individuals are defining what their supports are, and these are most often the services they are familiar with through their period of homelessness. If these services are working for the individual, then they are still of great value.
However, ultimately the goal would be that people would integrate into communities. In my mind this is the current fore-front of work on ending homelessness. We have been able to move people from shelter into housing, and keep them housed, but we have seen limited results in terms of then integrating people socially, and recreationally. Although having a social network of other street-involved individuals is better than an alternative of social isolation, best long-term outcomes are seen when people have a sense of belonging where they live, and have more diverse social networks. So until we are better at helping people integrate socially, we should continue to anticipate (and allow) high use of homeless services by people who are now housed.
This post was republished with permission from Abe Oudshoorn's Blog.
This week’s Infographic Wednesday post is on the subject of unmet requests for domestic violence services, as per the National Network to End Domestic Violence’s (NNEDV) Domestic Violence (DV) Counts Census infographic and its corresponding report Domestic Violence 2013: A 24-Hour Census of Domestic Violence Shelters and Services, which are both supported by the Avon Foundation.
On September 17, 2013, the NNEDV performed for its “eighth consecutive year,” its “National Census of Domestic Violence Services (Census), a one-day, unduplicated snapshot of the number of individuals who accessed domestic violence services, the types of services they requested, and the stories and experiences of survivors and advocates.” The snapshot took into account 1,649 of the 1,905 “domestic violence programs and shelters identifiable” across the United States (including its territories) and found that on this date, 66,581 adults and children accessed “services from domestic violence programs.”
The NNEDV noted that on the Census Day:
- 98% of local programs offered “Individual Support or Advocacy” services.
- 84% of local programs offered “Children’s Support or Advocacy” services.
- 77% of local programs offered emergency shelter services.
- 58% of local programs offered “Court Advocacy/Legal Accompaniment” services.
- 58% of local programs offered transportation services (i.e. many victims fleeing domestic violence lack transportation, especially those residing in rural areas).
- 53% of local programs offered “Group Support or Advocacy” services.
While many survivors were able to get the assistance they required, 9,641 service requests regretfully went unmet (which were largely requests for shelter) “due to a lack of resources.”
NNEDV noted that:
- “42% of unmet requests were for emergency shelter.”
- “18% of unmet requests were for transitional housing.”
- “40% of unmet requests were for non-residential services.”
Typically, when survivors flee an abusive situation, finding safe refuge is the most immediate concern, and it continues to remain important as service users shift from first needing emergency shelters to requiring transitional housing, which the NNEDV explains as: “[T]emporary accommodation designed as a stepping stone between crisis and long-term safety and self-sufficiency.”
Unfortunately, since there exists a severe shortage of affordable housing, achieving long-term independent housing “can take 6 to 10 months or more,” meaning that in the absence of transitional housing and other supports (i.e. being able to stay with friends, family members, etc.), many survivors, especially those from “isolated or marginalized communities,” are left with two extreme and undesirable options: (1) Return to the abusive situation, risking further violence; or (2) Become homeless. In fact, the NNEDV’s Census report noted that “When asked what most often happens to survivors when programs are not able to meet their requests for services, 60% of local programs report that victims return to the abuser, and 27% said that they become homeless.” Additionally, 11% noted that “victims end up living in their car.”
Clearly there is a link between domestic violence and homelessness, so, why were there nearly 10,000 unmet domestic violence services requests? According to the participants in the Census:
- 27% believed unmet requests were due to “Reduced government funding.”
- 20% noted organizations being understaffed as a cause, given that “1,696 staff positions were eliminated in the past year,” of which most were “direct service providers, such as shelter staff or legal advocates.”
- 12% identified a decrease in private funding.
- 10% referenced declining individual donations, which covered costs such as hotel/motel stays when local shelters have reach capacity – due to funding cuts, “149 programs had to eliminate these services.”
Due to the reasons just stated, many programs have been left with no option but to reduce services, while some have even had to permanently close down. Even more troubling, perhaps, is that along with this decline is an increase in the demand for domestic violence supports in general. Essentially, if we are to combat the issue of unmet domestic violence service requests, a multifaceted approach involving “funders, policy makers, victim advocates, social service providers, law enforcement, courts, and communities” is needed – “don’t let the conversation end here”!
Obtaining a high school education is an expectation in Canadian society, established by way of both societal norms and governmental policy. In most provinces, youth are required to be enrolled in school until at least the age of 16. Beyond high school, the expansion of the ‘knowledge economy’ has resulted in a push for post-secondary education as the pathway to gainful employment.
Individuals who lack formal education are at a higher risk for unemployment or underemployment than their educated counterparts. Barriers are often created in obtaining employment, or even accessing services, for those with low levels of literacy or who speak English/French as a second language. For many people (especially youth) their homelessness caused them to leave the educational system. Obtaining a GED is a potential option for a homeless individual who doesn’t have a high school diploma but challenges of preparing for it, having the needed identification and being able to afford the test present barriers to achievement.
Homeless youth in particular are an overly vulnerable population with respect to the acquisition of formal education. Many homeless youth struggle to gain continuous access to education, and most do not have a high school diploma. For instance, in Ottawa and Toronto, “between 63% and 90% of homeless youth have not graduated from high school despite being of age to have done so” (Canada Mortgage and Housing Association, 2001). Many factors contribute to their absence from formal schooling including: interruptions to regular attendance as a result of instable housing, practical issues related to shelter life, including proximity to schools and health issues including (but not limited to) stress. Other homeless youth are unable to remain in school for financial reasons, as monetary income takes precedence over school attendance.
Educational challenges also exist for children in families experiencing homelessness. Sometimes families are required to move to family shelters or motels that are a great distance from their home school. This results in a change of schools or intensive efforts on behalf of the family to travel back and forth to the child’s old school.
Meeting the educational needs of people who experience homelessness is a challenge that must be addressed by researchers, policy makers and service providers.
In reference to this story of a man experiencing homelessness who was attacked in Cape Breton my friend Stephanie H. posted this on Facebook.
“My blood pressure has gone up significantly. Where do people get off feeling like they are so superior that they can commit such an act? My heart aches when I read stories like this...I just don't get how people feel that their life is any more significant than someone else's. Why could that person not just have carried on their business? Ah people just don't make any sense to me sometimes.”
While I assumed she meant this as a rhetorical question, I do have some thoughts for her.
Stephanie, I find people are afraid of what they can’t control and what they fear becoming. It seems so easy to pick on people who we (as individuals or a society) view as “less than”. People who hold the power (or feel that they do) take out their fears (and often their own personal, unrelated frustrations) on someone they feel superior to. This is common with bullies – bigger kids picking on little kids, people being picked on because of appearance, race, sexual orientation etc.
I noticed this happening even when I worked in shelters and drop-ins; people would pick on others. Newcomers were called “bugs” until they earned tenure and status. Then they would perpetuate the cycle. This is common in society. Children who are abused sometimes grow up to be abusers. It’s what they follow as an example. Kids learn from their parents, media, schools etc. When they see certain segments of society or groups of people constantly being demeaned or discriminated against, they follow along.
I think, like the many cases of gay-bashing caused by internalized homophobia, people who hurt or bully people experiencing homelessness are afraid it could happen to them. So many Canadians live just one paycheque away from homelessness, or exist in cases of extreme housing need. It scares them and they lash out.
People who experience homeless are more likely to be victimized than housed people. They’re more likely to be physically assaulted, and for women especially, sexually assaulted. Violence is common, murder isn’t rare. There are lots of examples – I’m more familiar with the cases in Toronto such as Paul Croutch and Bly “California” Markis – but they exist everywhere. Even things like Bum Fights or the Calgary Creature Hunting/Sightings videos show the utter disregard that some people have for the homeless and indeed, can lead to more violence.
There is also a perception, that “no one cares” about people living on the streets. Gary Ridgway, aka the Green River Killer and Robert Pickton in Vancouver, both killed large numbers of sex workers and street-involved women. It took significant effort for the “trend” of missing women in both locales to be recognized and taken seriously by police. The hundreds, if not thousands, of missing Aboriginal women and the Highway of Tears, clearly show that this continues. If 500 young, employed, housed, white women went missing in the same stretch of time there would be intense police action. Even if 100…50…25…1…
So what do we do?
There is a great trend, started by a Canadian student Josh Stern of a type of pay it forward concept called #FeedtheDeed. It was based on the trend of tagging of people in social media to post pictures or videos of themselves doing something stupid. Instead, this student (there is a great article in this month’s Reader’s Digest about it) decided to start doing nice things instead. Videos, photos, posters with the #FeedTheDeed hashtag help promote a cycle of good.
These types of stories, like the guy who gives a homeless person a “winning” lottery ticket, and later crowdfunds him a house, or 17 year old Hannah Taylor who founded the Ladybug Foundation as a child or 12 year old Robby Eimers serving food to the homeless in Detroit show that we can change the way homelessness is viewed.
But it’s really up to all of us. Those of us who recognize that people are usually homeless because of structural barriers or system failures rather than personal issues or failures need to educate others. We need to speak up and speak out. We need to point out the injustices that exist. We need to stop the bullying and we need to demand action and justice. And we need to end homelessness. We need to recognize that being housed is an inherent part of human dignity.
Doing good can change the world – Eric (the homeless man helped in the first lottery and home videos) pays it forward himself for another person experiencing homelessness.
Image from Wikimedia Commons.
This post is part of our Friday "Ask the Hub" blog series. Have a homeless-related question you want answered? E-mail us at email@example.com and we will provide a research-based answer.
A common misconception that pervades discourse about causes of homelessness and poor households is the belief that individuals live in poverty because they choose to be unemployed. Time and time again, research has shown that this is simply not the case. Perhaps a more important question to ask is: does poverty persist in households where individuals are employed?
The infographic above, published by the Citizens for Public Justice, answers this question. A job alone does not guarantee freedom from poverty. In fact, in 2012, at least one member of the household was employed in a staggering 44% of all poor households. Even in situations where an individual is employed, there may still be the need for income supplements, as well as educational and employment supports.
This is partially because of the monumental changes that have occurred in the Canadian marketplace. The growing trend that continues to emerge is precarious employment: a decline in the number of well-paid jobs, and an increase in both lower-paying jobs and temporary employment. The infographic provides an example of how an individual working part-time, at minimum wage, falls below the poverty line. Temporary employment, by its very nature, often results in incomes that are unpredictable, making households more prone to suffering from fluctuations in income. In households where families and individuals are living paycheque to paycheque, these trends are direct contributors to family poverty.
Income supplements are essential to lifting families above the poverty line. While the idea of implementing guaranteed annual incomes (GAIs) has been around for decades, it has recently resurged as a result of the rising costs associated with dealing with the symptoms of poverty rather than its causes. GAI refers to various proposals that look to implement a guaranteed minimum income for Canadians, related to the concept of a negative income tax. GAIs will provide struggling Canadians with some security from income shock. The most common criticism associated with GAIs is that such models would act as a disincentive to work. Emery, Fleisch and McIntyre argue that this doesn’t mean a GAI scheme for Canada should be rejected, instead this only means that the uncertainty over GAIs should be “used to guide a phased-in introduction of a GAI with the intent of determining the extent of the ultimate coverage of the scheme."
Educational and employment supports work hand in hand to support communities across Canada. Educational supports can help provide individuals with specialized skills that are easier to market. Employment supports, in turn, can help these same individuals improve their chances of finding a well-paid stable job.
It's important to keep in mind that employment percentages on their own are unlikely to be a clear indicator of what causes homelessness. Details about the nature of employment, and the income generated from employment are far more useful metrics. A recent paper, published by the University of Calgary's School of Public Policy, posits household food insecurity as a useful consumption-based indicator of both poverty and lack of insurance against income shocks. Just as the causes for poverty in Canada are multidimensional, solutions in turn have to be multidimensional and have to account for more than just one metric.