Shelters are a key component of many homeless service systems. However, the risk of victimization and overdose are serious issues that can lead people experiencing homelessness to feel unsafe in shelters and avoid them altogether. A team of researchers conducted a systematic review to better understand the factors that contribute to safety, victimization, and overdose in shelters.
In this blog, we will summarize the findings of the review. We will also provide five recommendations for reducing victimization and overdose risk in shelters.
What Contributes to Safety in Shelters?
The most common factors that shape how safe people experiencing homelessness feel in shelters are concerns about violent and non-violent victimization (e.g., theft). Lack of privacy within traditional congregate shelter settings is another factor that could undermine safety for some people experiencing homelessness. In contrast, shelters that have private rooms with lockable doors were perceived as safer options.
We also found that shelter staff had the potential to positively or negatively affect the safety of people experiencing homelessness. In other words, when the relationships between staff and individuals accessing the shelter were grounded in trust and consistency, this could be stabilizing and empowering. However, staff who were seen as less empathetic and welcoming could be viewed as a threat to the safety of the individuals accessing the shelter.
Other aspects of the shelter environment that have been found to make these settings feel unsafe for some people experiencing homelessness were:
- Unsanitary conditions
- Loitering near shelter entrances
- Intoxicated individuals
- The presence of drug use and selling
Recommendation 1 – Create safer shelters through the use of hotels:
Shelter hotels offer an alternative approach to traditional congregate shelter settings that may improve the sense of safety. This is achieved by providing service users with access to their own rooms with keys. Research on the use of shelter hotels during the COVID-19 pandemic has also highlighted the acceptability of this model for service users, including those who were previously experiencing unsheltered homelessness.
Recommendation 2 – Gather and provide timely information on critical events in shelters:
The establishment of standardized methods to collect and report data on critical incidents, including violence and overdoses, in shelters is recommended for enhancing accountability and advancing service safety. This could be achieved through the development of public dashboards that are similar to existing monitoring mechanisms on the number of individuals using the shelter system on a daily or monthly basis.
Recommendation 3 – Increase sectoral funding to address safety issues in shelters:
Increases in sectoral funding are key to reducing systemic discrimination against people experiencing homelessness. Additional sectoral funding is also needed to facilitate the development of interventions that are sufficiently resourced for improving safety in shelters.
What Contributes to Overdose Risk in Shelters?
Our review found that various factors contributed to overdose risk in shelters. However, one important factor was whether the shelter had policies in place that discourage or prohibit substance use. Shelters that had a policy of this nature were perceived to increase the likelihood of concealed and rushed drug use, which increased overdose risk.
In contrast, designated drug use spaces in shelters facilitated a sense of safety among people who use drugs. A participant in one study in the review described the benefits of these spaces:
“It’s easier to relax, to do your drugs. And it’s just you feel safe and comfortable … They have everything that you need all the time and just the staff is right on top of everything, you know? And they try to help everybody out the best that they can, and they’re just very helpful.” – study participant
Two evaluations of shelters that implemented safer supply programs, with accompanying harm reduction supports, also found no fatal overdoses while these services were in operation.
Recommendation 4 – Expand the use of harm reduction supports in shelters:
Implementing shelter-based harm reduction supports, including onsite overdose prevention sites, is crucial for reducing overdose risk. Shelter-based safer supply programs are another promising approach for preventing overdose among people experiencing homelessness who use drugs.
Who is At-Risk of Shelter-Based Victimization?
Of the articles included in the review that examined groups at-risk of shelter-based victimization, almost all of them focused on members of the 2SLGBTQ+ community. The findings clearly demonstrated:
- 2SLGBTQ+ service users experienced abuse and discrimination in shelter settings related to their gender identity and sexual orientation.
- Service providers who did not respond to homophobia or transphobia or did so by relocating 2SLGBTQ+ service users to another area of the shelter reinforced their feelings of marginalization.
Recommendation 5 – Strengthen staff training and supports for equitably intervening on critical events in shelters:
More supports for shelter staff to develop trusting relationships with service users and respond to critical events in the workplace are needed. This includes staff training on how to prevent and equitably intervene in homophobic and transphobic violence, especially in youth shelters where 2SLGBTQ+ individuals are overrepresented. The development of evidence-based sectoral core competencies for shelter staff could be beneficial for advancing these goals.
Collaborators and Acknowledgments
The research team was comprised of Nick Kerman, Sean Kidd, Joseph Voronov, Carrie Anne Marshall, Branagh O’Shaughnessy, Alex Abramovich, and Vicky Stergiopoulos. This work was made possible through funding from the Canadian Institutes of Health Research.
For more information about the study and its findings, please contact Nick Kerman at Nick.Kerman@camh.ca.