I have been involved in community consultations for a local organization that looks at public health. In the last consultation, we were tasked with identifying policy priority areas around 6 main areas, including ‘Alcohol and Substance Misuse’. At the end of the day we had to pick two top priorities, which ended up being 1) Exploring safe injection in London, and 2) Educating health providers about addictions to decrease stigma.
At today’s event, the goal is to take the 2 action priorities for the 6 areas, and start evolving them into explicit policy directions. You can imagine my surprise in looking through the workbook for today when I noticed that safe injection had disappeared from the priority list for ‘Alcohol and Substance Misuse’. It was replaced by the priority we had ranked 3rd, a public education campaign to address city-wide stigma around addictions.
So, here I had been sharing with friends and colleagues that London was poised to get ahead of the curve in addressing substance use, and this was going to be led by a very large and very credible public health organization. However, it appears that the priority was too hot to handle. What is most diappointing to me from a process perspective is that although the events were called community consultations, the outcomes were vetted and are again going to be agency driven rather than community driven.
The Senate Committee on Social Affairs, Science and Technology released a report at the end of 2009 titled “In From the Margins: A Call to Action on Poverty, Housing and Homelessness”. The committee was chaired by Art Eggleton, who is not working to put some ‘legs’ to the report. This involved him coming to London this week at the invitation of MP Glen Pearson to talk about the report. I was invited to be on part of a panel the responded to the report, which also included Mayor Joe Fontana and Andrew Lockie, the Executive Director of United Way London.
The full report is available on Senator Eggleton’s site here. My response to the report included highlighting points that I felt were particularly important, and outlining some areas of concern. These are my comments in a nutshell:
Items of Note
The requirement of people to drain their assests before receiving social assistance is part of what traps people on social assistance, and is poor long-term planning.
Social assistance rates are below every measure of poverty in Canada.
Proactive poverty reduction saves money.
Affordable housing stock is abysmal, with waiting lists for London being 8-9 years on average.
We need a national housing strategy (like Bill C-304 which has stalled on the 3rd reading).
The Homelessness Partnering Strategy funds have not increased in value since they were designated 10 years ago.
Homelessness is the most expensive way to manage extreme poverty.
Not-for-profit agencies are in a lot of ways filling the gaps in services that should be the Government’s responsibility.
Items of Concern
The report does not mention the number of individuals who qualify for social assistance but do not receive it do to systems that are designed to keep people out.
Affordable housing (defined at 80% of market rents in London) is the only option proposed, with no mention of rent-geared-to-income, which is more affordable housing.
There is a recommendation to address physical health needs of people experiencing homelessness, but no comments on what this looks like or where it lives. This is a challenge as until we have a plan, the hardest to serve groups will continue to be under-served.
Harm reduction is a model that we know is crucial to promoting the health of people who are experiencing homelessness. In a nutshell, harm reduction is focusing on reducing the harm of certain behaviours, rather than demanding immediate abstinence. This is most often put into practice as the distribution of clean needles and promotion of safer injection. The idea is that although we ultimately want people to get clean, that involves making sure they stay healthy enough to get to that point.
The South West LHIN is currently taking some steps towards harm reduction in London, with consultations on a managed alcohol program (MAP). MAPs focus on reducing the harm of alcohol, usually by providing housing support that includes access to small amounts of alcohol on an hourly basis. These programs exist in Toronto, Ottawa and Hamilton, and focus mostly on supporting those who consume non-beverage alcohol (ie. Listerine). I had an opportunity to participate in the consultation, and hope that this does indeed come to fruition in London. Those who face the most barriers to health in our community are those who are homeless and addicted.
I was recently exposed to another aspect of harm reduction and homelessness, which is the idea of housing first as a form of harm reduction. I read about this on a post from Bernie Pauly, which talked about a report out of Victoria, BC. Housing first is a model that has taken precedence in work on homelessness, and is the idea that before we think about addictions, mental health, poverty, food security, etc., we need to make sure people have a safe place to stay. The link between harm reduction and housing is that housing prevents much of the harm of homelessness.
You have likely heard of the It Gets Better video series, which focuses on bullying of LGBT youth. The original Canadian video is here. As you are likely well aware, LGBT youth experience homelessness at a disproportional rate, and identify family violence in the home as the primary cause of their homelessness. When I heard a friend was making a video for It Gets Better London, including a supporters video, I jumped at the opporunity. I wanted a chance to let LGBT youth know that although they may end up homeless for a time, it does get better. Youth either reconcile with their family of orgin, or are able to find a new network to call family, and home. Here is the video:
My apologies for having been absent from the blog, I am in the final throes of my dissertation, and am quite busy with revisions. The good news is I will have a lot to share from this soon.
Many of you are probably familiar with cheque cashing/payday loan businesses. These businesses prey upon those with limited resources with the offer of ready cash. In particular, cheque cashing is used frequently by people experiencing homelessness who are refused bank accounts but given social assistance cheques. In this way, these businesses are making money of the very poorest in our communities. This businesses and their challenges are actually well documented in this wikipedia article.
This issue recently hit the news in London, Ontario when one such business was opened in the same building (The Market Tower) as the Ontario Works (social assistance) offices. To add insult to injury, this business is owned by the husband of our former mayor (who I supported), Tim Best. There was good coverage at the time of the opening, but with no real response from Mr. Best, the London Homeless Coalition decided to take action and write a letter to the London Free Press, Mr. Best, and Downtown London. You can see the Free Press coverage here.
I’m glad that the predatory/exploitative nature of these businesses is getting coverage. I am dismayed by the lack of interest Mr. Best seems to be taking in addressing our concerns. I should note that we sent a letter to Mr. Best, but the Free Press got to him before our letter (having received theirs by email), so his comment is quite simply that he hasn’t heard from us. Hopefully this will lead to continued dialogue of the issue in the community.