The Root Causes of Homelessness in Canada

Sociologist Rob Rosenthal wrote an excellent paper (Rosenthal, 2000) exploring the simplistic perspectives in the public discourse of homeless persons as being either deserving or undeserving of aid.  This is based on whether homeless persons are conceptualized as victims of their own irresponsibility, simply lacking in capacity, or victims of circumstances beyond their control.  When we think about the causes of homelessness, it is helpful to hold the agency/structure dialectic, as proposed by sociologist Anthony Giddens (Giddens, 1984), in mind.  Giddens defines ‘agency’ as being able to act freely, unconstrained by external forces, and ‘structure’ as the social institutions and norms that influence human relationships.  Therefore, in looking at any individual case, we need to recognize that both personal agency and social structures play a role in one’s current housing status.

At the 7th International Conference on Urban Health, Jim Frankish broke down the agency/structure dialectic further in looking specifically at homelessness, and proposed four sets of factors that contribute to homelessness: societal factors, organizational factors, interpersonal factors, and intrapersonal factors.  Societal factors include: access to social assistance, funding for shelters and other resources, social assistance rates, availability of affordable housing, crime and drug policies, and housing policies.  Organizational factors include: agency availability, resource availability, location of services, design of service provision, and availability of service providers.  Interpersonal factors include: family issues, cultural issues, social network problems, and interactions with providers.  Lastly, intrapersonal factors include: biological problems, lifestyle choices, knowledge, addictions, criminal activity and beliefs.  These categories are similar to the findings of the Mayor’s Homelessness Action Task Force (Golden, Currie, Greaves & Latimer, 1999) out of Toronto, Ontario.  The Task Force defined the four essential causes of homelessness in Canada to be increased poverty, a lack of affordable housing, mental health care deinstitutionalization, and social factors such as violence, abuse, and social network alienation.

Of the causes identified, much of the recent focus has been on public policy in the housing realm.  Various organizations have promoted educational campaigns suggesting that homelessness is a housing issue.  This intuitively makes sense, as extremely comprehensive supportive, supported and subsidized housing programs would hypothetically assist all individuals regardless of their personal constellation of agency and structure challenges.  It has been found that having stable housing increases the likelihood of leaving social assistance, finding employment, leads to better outcomes for children, and decreases morbidity and mortality (OMSSA, 2005).  And, the increase in homelessness in Canada over the last few decades has been termed by David Hulchanski as a ‘dehousing process’, suggesting that the dismantling of national and provincial affordable housing programs has caused the current crisis of homelessness.  Therefore, ‘housing first’ models of assistance have been suggested, meaning that to assist homeless persons, we must first provide them with stable housing.

Although housing is an important public policy realm that can point to both causes of and solutions to homelessness, I believe that the push to refine public policies should not be exclusively limited to housing.  Shapcott, in a submission to the UN special rapporteur on adequate housing (2005a), provides an excellent synopsis of the step-by-step dismantling of the national and provincial housing programs, but also recommends increasing social assistance, enhancing social services, and increasing dollars for outreach and support (Shapcott, 2005b).  Similarly, the “Pathways into Homelessness” Report mentioned above found that 45% of primary causes of homelessness were financial, but also found 26.7% to be related to interpersonal conflict and abuse, 17.7% due to drug and alcohol use, and 3.7% due to mental illness.  Therefore, using the factors that contribute to homelessness proposed by Jim Frankish, it can be suggested that in addition to housing policies, we need to consider health policies, social assistance policies, and other relevant public policies.

So, coming full circle, let us again consider what the root cause/s of homelessness is/are in Canada.  Both inter/intrapersonal factors and public policy play a major role in causing homelessness.  However, I would suggest that statistics from nations such as Norway (with a homelessness percentage estimated at 0.11) demonstrate that with strong enough public policies, almost all constellations of inter and intrapersonal factors can be accounted for, and homelessness can be averted.  Therefore, I would suggest that the ultimate root cause of homelessness in Canada is problematic public policies.  More comprehensive health, social and housing policies would lead to provision of adequate shelter for all Canadians, regardless of health status, employment status, or income level.

Defining Homelessness

Although defining the word ‘homeless’ appears at first to be a simple task, there is an underlying complexity in terms of who counts and who doesn’t.  That is, being homeless simply means to be without a home, but there are many ways that this is lived out within a Canadian context.  So how you define the phenomenon will determine the statistics that you obtain on it.  Although there is no disagreement that someone sleeping in a park, under a bridge, or in an alley is homeless (sometimes referred to as absolute homelessness, or sleeping rough), the following scenarios are less clear-cut: living in a shelter for homeless persons; living in a building not considered a home, such as a shed or abandoned building; living temporarily in someone else’s abode for which one may or may not be paying a rent (sometimes referred to as couch-surfing, relative homelessness, or proto-homelessness); living in a halfway house or substance treatment centre; or living in an apartment or house that one owns or pays rent for, but does not meet the minimal codes for an inhabitable shelter.

Another level of complexity is how quickly and how often these housing statuses can change over time, which is why many services also include those considered to be ‘at risk of’ homelessness’ within their scope.  This status-over-time dimension is why the Canadian Library of Parliament chooses three labels of ‘chronically homeless’, ‘cyclically homeless’, and ‘temporarily homeless’ to refine their definition of homelessness.  However, it seems somewhat disconcerting to label a person based on their past housing history in such a way that presumes what their future will be, such as cyclically versus temporarily homeless.

Defining homelessness can be a very political act, as how one defines the phenomenon will thus determine its scope.  And, it is often the quantitative scope of a problem that is used as the primary indicator of whether a reaction is necessary, rather than the qualitative nature of the experience.  Thus, if one wants to make an argument for the requirement of more services, one simply uses a broader definition, and vice versa.  A striking example of this was when Statistics Canada in their Census 2001 found that at the time of the census 14,145 persons were living in shelter.  However, this was a telephone survey of service providers, only covers those persons living in shelter, and only provides a figure for a single moment in time.  In contrast to this number, in the following year it was found that 31,985 people stayed in shelter at least once in the city of Toronto.  With Toronto representing 16% of the Canadian population at the time, and with only one of the living situations considered, one can begin to understand how the statistics can vary drastically both based on definition and methods of data collection.

For my own purposes, I use a definition of homelessness that includes both those who are absolutely homeless and those who are couch-surfing, in shelter, or any other situation that does not include owning or renting a place to live.

On ‘Trauma-Informed’ Services

There is an excellent post at homelessness.change.ogr by Joy Eckstine entitled “Hey Homeless Services, First Do No Harm“.  The article explores the issue of trauma and homeless persons, and how to provide services that are appropriate to persons who have experienced trauma.  In providing services for persons experiencing homelessness, one of the major challenges is determining how to deal with behaviours deemed to be ‘difficult’.  Are disciplinary measures appropriate?  How much?  How do we balance the Giddensian agency/structure dialectic in a way that is most respectful of our patients/clients/residents?

Eckstine suggests that there is room for setting limits, and for confronting people around rules and regulations, but that we can do so without becoming jaded, or losing the “drive of service and compassion” that leads us to this sector.  She points to this excellent website that provides information on best practices for health care providers in doing trauma-informed care.  Hopefully our practice in working with people who are traumatized and at times challenging can be based in good evidence, rather than intuition (which at times is more reflective of frustration).