Research Matters Blog
In towns and cities across North America, individuals living in homelessness interact with more than just the local emergency shelters. They also interact with healthcare service providers, the justice system, and social services. It can be difficult to keep track of what services are most commonly used, and what the costs associated with services for people who are homeless might be. Accordingly, cost studies of homelessness are a tool of critical importance if we want to learn more about the cost of homelessness. Recently, the largest and most comprehensive cost study of homelessness in the USA was completed in Santa Clara County, California. Santa Clara is home to both the “extreme wealth of Silicon Valley and the highest percentage of homelessness in the USA.” This week’s infographic, produced by Destination: Home program of The Health Trust, takes a look at some important findings from a report published on the six-year study.
Together, the costs per year of providing services for homeless residents in the county amounted to $520 million a year. Over a third of the study’s participants were involved with the criminal justice system; common charges included felonies, infractions, misdemeanors and drug offences. Over half of all costs associated with the county’s services for those experiencing homelessness came from healthcare. Healthcare services used most often were outpatient healthcare, emergency room services and mental health services.
The report and the infographic establish that the costs of homelessness in the country were heavily skewed towards a small number of frequent service users. Homeless residents with costs in the top 10% had average costs of $67,199 per year, accounting for 61% of all costs. (For comparison, the average cost per county resident experiencing homelessness was a little over $5,000.) All individuals belonging to this top decile, who were housed through a permanent supportive housing initiative, had post-housing costs of just $19,767. This amounts to savings of over 70% when we compare the cost of pre-housing with post-housing!
Geography plays an important role for municipalities in determining the cost of homelessness. Resources, political willpower, local infrastructure all play into experiences of individuals struggling to find housing. Accordingly, the cost-savings in Santa Clara County may not be congruent with other communities in the USA and Canada that opt for a similar approach. It should be noted, however, that recent research suggests that the cost associated with homelessness remains high in Canada: an estimated $7 billion annually.
The study does contribute to a large body of research that identifies homeless prevention and permanent supportive housing as two cost-efficient approaches we have at our disposal in the fight against homelessness. This body of research includes several studies focused on homelessness prevention that were completed in Canada. Providing individuals living in homelessness with permanent housing and wrap-around supports is sustainable and leads to improved short-term and long-term outcomes.
Discrimination refers to intentional or unintentional actions that negatively affect people, based on biases and prejudices. People may experience discrimination because of their race, ethnicity, sexual orientation, gender, age and/or income. Discrimination is linked to homelessness in several ways. The experience of discrimination in employment, housing and access to services can result in inadequate opportunities, education, income and compromised health, all of which can increase the risk of homelessness.
Research shows that certain marginalized populations (racial minorities, Aboriginal Peoples, sexual minorities) are overrepresented amongst the homeless. At the same time, the very experience of homelessness and extreme poverty can result in discrimination through restricting people’s access to necessary services and supports, and to housing and employment. People who are homeless and who are racial minorities, Aboriginal or sexual minorities face multiple forms of discrimination.
In addition, people who are homeless often experience restricted access to many of the spaces and places that domiciled individuals typically enjoy, including both public (parks, streets, etc.) and private spaces (restaurants, stores and malls, for instance). One negative consequence is that many homeless people are forced, then, to live in dangerous and undesirable environments, which further impairs their ability to move forward with their lives.
This week’s question comes from Olusola O., who asked: What can be done to minimize double counting among street homeless people?
Knowing approximately how many people are homeless in a community is important to assess the extent to which homelessness is a problem in a given area; and to monitor progress in reducing homelessness.
One popular method is point-in-time (PiT) counts, which helps us learn how many people experience homelessness during a period of time. In terms of how they work, Jesse Donaldson, our PiT count coordinator, explained this in her blog post a few weeks ago:
Over a single point in time – usually a night - communities deploy volunteers to the street to locate, and survey, individuals who are experiencing homelessness. During that same period, volunteers are deployed to shelters, and other overnight facilities, to count and survey those that are staying the night.
At the end of the PiT Count, communities have two types of information: first, estimates of the number of people that are sleeping outside and in shelters; second, information about those that were surveyed. This includes information such as gender, age, veteran status, length of homelessness and service use.
Double counting occurs when someone is counted more than once, thus skewing the data of the PiT count. Inaccuracies are somewhat common, largely because there hasn’t been a consistent framework for PiT counts. Though PiT counts are valuable, they are not mandatory and are inconsistently implemented across Canada.
This is why the Canadian Observatory on Homelessness has developed a PiT count toolkit, in support of the HPS Coordinated PiT Count occurring in 2016. If you’re part of a team responsible for PiT counts, I highly recommend you review the whole toolkit. In the meantime, here are some guidelines from the toolkit to help you avoid double counting.
1. Count at night
People generally have other commitments during the day or will be using other services. Counts done during the day run the risk of double counting because volunteers may encounter the same person at multiple locations. Our toolkit recommend counting at night because “volunteers are more likely to encounter individuals at their chosen sleeping location for the night.”
2. Combine known locations with full coverage
Known locations are shelters, parks, anywhere people experiencing homelessness are known to frequent. Full coverage requires counters to explore the city. The toolkit recommends a combined approach – with very clear boundaries for volunteers to cover – for the most accurate count.
A guide to counting by the British Columbia government also stresses the importance of clear mapping. Preventing overlap is key to avoiding double counting.
3. Screen/ask questions
The toolkit recommends using a survey method, which includes screening questions and informed consent. This determines eligibility for being counted and gives volunteers the opportunity ask participants if they’ve been asked the same questions that night.
4. Count sheltered and unsheltered people on the same night
Our toolkit recommends counting people in the unsheltered, provisionally sheltered and provisionally accommodated categories (with exemptions). A guide from the U.S. Department of Housing and Urban Development recommends this be done on the same night, when shelters are most full, to ensure the most accurate count.
In 2016, communities across Canada will participate in the HPS Coordinated PiT Count. It’s a significant step towards a national picture of homelessness in Canada. The strategies within the COH PiT Count Toolkit, including steps to reduce double counting, will ensure that the coordinated PiT Count is implemented successfully.
This post is part of our Friday "Ask the Hub" blog series. Have a homeless-related question you want answered? E-mail us at firstname.lastname@example.org and we will provide a research-based answer.
The infographic states that 70% of survey respondents, all of whom had experienced homelessness in San Francisco in the past year, had been forced at least once to move from a public space. Of the survey respondents, 91% who had been asked to move remained in a public space, but moved down the street, walked around, or went to a different neighbourhood. The other 9% moved indoors. (It is highly likely that even these 9% returned to a public space shortly after being asked to relocate.) Simply put, more often than not there is nowhere else to go for these individuals.
The infographic also states that referrals and services commonly provided by police officers reinforce punitive practices. Results from the survey show that only 11% of police interactions resulted in a referral to another service. Due to a lack of shelters, drop-in centers and affordable housing options, officers can offer little, “except a ticket and threat of arrest”. The absence of adequate supports for individuals living in homelessness may actually heighten existing tensions between people experiencing homelessness and law enforcement.
It’s clear that the criminalization of homelessness in San Francisco is doing nothing to actually address the problem. Rather than solving homelessness itself, criminalization wrongly targets individuals who are living in homelessness.
Research shows that how we discuss police interactions with individuals experiencing homelessness, especially those with mental health issues, matters. A recent study, conducted using four Vancouver police department reports, found that such reports call for increased investment in police presence and linked people with mental health issues with violence and danger. Policies that criminalize and frame homeless people as grave threats to public’s wellbeing marginalize those who are homeless, and simultaneously erode whatever trust homeless people have with law enforcement authorities. These policies are often informed by myths about homeless people, rather than actual research and evidence. It’s no wonder that the Coalition on Homelessness in San Francisco calls for department-wide training for police officers to improve police interactions with the homeless. Recently, Emma published a great post on the Hub that outlines what else can be done to improve police interactions with homeless populations.
Unfortunately, recent years have seen increased criminalization of homelessness in the United States. San Francisco is only one of many cities in the USA to have these policies in place. However, we need not look far to find examples of the criminalization of homelessness here in Canada.
Looking at the Criminalization of Homelessness in Canada
The Ontario Safe Street Act (SSA), passed in 2000, provides us with a clear example of how individuals living in homelessness are being targeted here in Canada. While the act was intended to curb aggressive forms of solicitation, the reality has been considerably different. A review of tickets handed out by Toronto Police under the SSA indicates that up to 80% of the tickets were handed out for non-aggressive acts. These tickets can potentially lead to incarceration. We have to consider the impact such tickets can have on individuals living in homelessness who are facing tremendous challenges to begin with. Accessibility to education supports, housing subsidies, and food assistance can all be negatively impacted by involvement with the criminal justice system.
Fifteen years after the SSA has been passed, it’s clear that the Act is an inappropriate way to deal with the province’s problem with homelessness. The Coalition for the Repeal of Ontario’s Safe Streets Act was formed to address this injustice. We invite you to sign the petition to repeal the SSA.
One of the challenges in understanding homelessness and responding to it is that it is often framed as an urban, inner-city issue. There are several important reasons for this, including the fact that it is often in large cities where big investments have been made in homelessness infrastructure, including the building of shelters, drop-ins, housing etc. Additionally, the vast majority of the Canadian population lives within two hundred kilometers of the American border.
However, the factors that lead to homelessness exist not only in big cities, but can also be found in rural areas, small town and areas of Northern Canada. This includes inadequate housing, poverty, discrimination, violence and substance misuse. At the same time, these areas typically lack the resources – and in some cases the will – to invest in infrastructure and services that may prevent or reduce the worst outcomes of homelessness.
Several factors make homelessness in the North a more complex issue. First, there is a lack of infrastructure and services to prevent or reduce the worst outcomes of homelessness (this is also true for rural communities). Second, the degree of poverty in the North means that there are increased pressures on individuals, families and communities. Third, the cold experienced during the winter makes the possibility of surviving without shelter impossible.
As a result, when people in rural areas or northern communities face homelessness, they may choose to temporarily stay with friends or relatives, or in some cases endure unbearable situations (including abuse or living in poverty), and thus become part of the “hidden homeless” population. A lack of services and supports means that many are otherwise forced to leave their community and move to a larger urban area in order to access services. This may mean escaping one set of problems, but can lead to many others. Rural and northern homelessness present important challenges for those who seek to end homelessness. Currently, there is a need for more research in this area.
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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.