The Charitable Impulse: Part 1

In the summer of 2010, I saw a talk given by James Shelley that started to erode my basic assumptions of how to make the world a better place.  The challenge is that somewhere along the way I’ve picked up the desire to change the world, which is a fire you can’t put out, and which demands action.  This was simple and straight-forward through my twenties, as I assumed we could change the world by simply providing more resources to those who have less.  However, James changed that, and the basic assumptions I held of what was required of me began to crumble.  Here is the talk:

In this talk James talks about some of the basic assumptions of international charity, highlighting that charity can actually impede development.  Here’s my favourite line from the talk:

“Just because an idea is driven by really good intentions, does that make it a good idea?”

Continuing to explore what charity means in an international context, I have been exposed to the critical exploration of volunteer international health work based on studies by my colleague Oona St Amant.  Volunteer health work, where health professionals go into less developed nations to help bring medical care to those in need, is rife with the same problems that James identifies in his talk: If done as charity rather than development, more harm can be done to the community in the long run.

In this series of blogs I will critically explore the charitable impulse and what this has meant in terms of addressing poverty and homelessness in our community.  This will not be a conservative treatise on why not to give, but rather an exploration how we as decision-makers in our community need to focus on the long-game, treat root issues, and make lasting change.

The man at the curb

A man stands at the curb in front of your house. His beard is too long; his skin is too tanned, starting to wrinkle like a crumpled piece of paper; his hands look sticky from beer spilled from crushed cans; his nails are black. The man bends down and digs through your recycling bin, retrieving a wine bottle and adding it to the precarious pile growing in his shopping cart. Passing dog-walkers are careful not to look at him. Passing motorists show frustration that his cart is on the road.

What separates you from the man at the curb? Is it a series of poor life decisions, or a series of unfortunate events?  What if you had been abused as a child, and hadn’t dealt with those demons? What if you were genetically inclined to alcohol addiction? What if you had your leg crushed in a car accident? What if your job was downsized? What if your Employment Insurance ran out? What if you yelled at your spouse and they left with the kids? What if your depression went unmanaged and you couldn’t escape the dark place? What if your home was foreclosed, your car was impounded, your family became ashamed of you?

The man at the curb is just like me, but not as lucky.

Recycling

The Power of a Key

Power of a KeyI was reminded in watching this video that when considering homelessness, there are few symbols as powerful as the house key. When speaking to people with lived experiences of homelessness, the transition that is most meaningful, or that which they most desire, is a space of their own, and a key to lock it to be safe. Yes, food, mental health, recovery, and clothing are all crucial in terms of human needs, but safe space is essential.  It is humanizing.

A key symbolized more than a place of one’s own, it also means:

  • Safety, particularly for women escaping violence
  • Control, I will let in or keep out who I want
  • Hope, I am no longer labelled ‘homeless’
  • Self-worth, I deserve my own space in the world
  • Dignity, I no longer have to live out private functions in a public venue

This last point came up frequently in the interviews I conducted for my doctoral dissertation.  People spoke to having no place to live out intimate relationships, struggle with substance use, catch up on rest, feel down or ill, that wasn’t public and exposed.  Then in living out these human functions they would be punished, deemed inappropriate for public spaces.

There is so much power of a key.

It’s Everything

The following is a powerful video created by the Calgary Homeless Foundation on the idea of housing first, which is a nice follow-up from my previous post.  I particularly like the comment around poverty and income support, with the idea that we will always need more social housing as long as we continue to provide people with an inadequate income to meet this basic need.

The video ends with a poignant quote from a woman living in housing first, when asked what housing first is: “It’s everything. Without home it’s, it’s nothing.”

 

Framing Housing First from Calgary Homeless Foundation on Vimeo.

Managing Information – HIFIS Comes to London

One of the challenges we face in addressing homelessness in London, like in many municipalities, is the lack of information sharing across the many agencies involved.  From an administration perspective, this means difficulties in budgeting, in collaborating, and in creating a clear advocacy message.  From a service user perspective, this means having to complete the same intake forms and answer the same questions at every agency you access.  We have moved into a digital age, but our information systems and processes are not particularly advanced.

This concern parallels some of the work I have been doing around health and homelessness in London, and the lack of information sharing that can lead to poor health outcomes.  With this concern eating at me, I was quite pleased to see THIS report from the City of London highlighting that the federal government is going to support our adoption of the HIFIS 3 system (Homeless Individuals and Families Information System).  The system will be utilized for sure by our emergency shelters, and other services will have the opportunity to opt-in.

There is always some skepticism about information collecting and information sharing within social services.  A question many ask is why we need to be collecting personal information on individuals who are simply seeking shelter.  And, those more prone to conspiracies, wonder about the information governments have about us.  Additionally, when it come to sharing information across agencies, people wonder if negative relationships with a staff member at one location will negatively impact care at other agencies.

However, if we keep in mind the goal is to always optimize services to end homelessness, then good information, and information sharing, are a part of the direction in which we need to be heading.

Why Affordable Housing?

Affordable housing is not cheap.  At up to $145,000 per unit, and with 3005 families on the wait list, it would cost over $400M to meet London’s affordable housing need.  That said, the system-wide costs of not housing people are exponentially greater than this investment.  From 2010 statistics, housing an individual in shelter costs $1,450 per month, jail costs $140 per day, psychiatric acute care costs $650 per day, and acute care inpatient over $885 daily.  That means that for every homeless person who spends a year in psychiatric care, we could build almost two units of housing.  The local economic gains of building housing are also extensive.  Short term gains include job creation, development fees, and matched funding from the province and feds; long term gains include assessment growth, community revitalization, and urban intensification.

Apart from the economic argument, there is the value in terms of optimizing our social systems.  All the research that has been coming out in the past 15 years on addressing homelessness has been pointing to the essential role of ‘housing first’.  This means that the best outcomes for people with multiple vulnerabilities are achieved when people are moved first into housing before dealing with addictions, education, employment, health care, etc.  In a municipal context with an average affordable housing wait list of 8.2 years, and ‘fast-track’ list of 1.3 years, we are far from being able to make housing first a reality.  This means that we are knowingly working in a sub-optimal system trying to deal with complex health and social needs for people who do not have housing stability.

Lastly, and most importantly, is the human argument.  Homelessness is not only a housing issue, but it is always a housing issue.  In the past number of years in researching and working in the area of homelessness, what has been most dismaying for me is that with an issue that is so complex, the solutions are so simple and within our grasp.  We could eliminate homelessness tomorrow with two steps: 1) create an adequate stock of affordable housing, and 2) provide supports to help people maintain their housing.  They have done this in Norway, and have a per capita rate of homelessness that is less than 10% of ours, representing those who are simply in transition between housing.  And, unfortunately, where are government has relinquished its responsibility to provide for those in need, citizens and non-profits have needed to step in and fill the gap.  This is happening in London, with faith communities, social services, developers and others engaging in building affordable housing, but we are currently only on track to build 500 units of our 1200 unit goal over the next 4 years.  Something needs to happen in London, or the problem will only grow.

Breaking the Cycle

Last week at the Grit Uplifted issue #2 launch, a number of the writers took time to read their work.  I was struck by the story of Serenity, who spoke to being born homeless, before she had any idea of the sense of that word.  She said she didn’t fully understand until she, as a teenager, bore a child into homelessness herself.  I was very impacted by the cyclical nature of her story, that sense of not understanding one’s own past, until one replicated it.  Serenity’s story was particularly powerful in that she has found strength and has been able to move herself to a much better place, escaping homelessness, and finding hope.

After the readings I interviewed her briefly, apologies for the poor quality from my Blackberry voice recorder:

Interview With Serenity

The Risks of Knowing Too Much

In refining our health and social services for people who are experiencing homelessness, we have been talking a lot about better information sharing.  Individuals who access services are forced to complete the same forms and answer the same questions from one agency to another, to another.  This leads to what Jodi Pfarr calls ‘agency time’, the time people in poverty devote to just being a part of the system.  It would seem far more efficient if all agencies were linked through common databasing, so that a housing worker at the shelter would, for example, know if an application was already submitted for an individual by a housing worker at Ontario Works.

However, with any system refinement, we have to think of the unintended consequences.  In this case, I’m wondering about the unintended consequences of limiting access to services.  So, for example, much of what service users access where they are getting the same thing in multiple places in considered redundancy.  However, it might also equate to people getting what they need.

Let’s take food for an example.  I just learned the other day that the London Unemployment Help Centre has a food cupboard.  This finalizes it, every service in town has an emergency food cupboard.  So let’s take an individual, we’ll call her Jane Doe, and look at how she acquires food.  She might go to the Hospitality Centre for breakfast, access the food cupboard at InterCommunity Health for lunch, and go to the daily bread program for dinner.  The next day she might do the shelter for breakfast, a church for lunch, and Mobilizing Hope van for dinner.  If every agency charted her access of their food cupboard, her multiple uses might be seen as a redundancy.

So, the big risk of sharing information, is how is it used?  People experiencing homelessness have developed ‘work arounds’ so that they can meet their immediate needs.  Will information sharing close the door to these work arounds without also ensuring that needs are met?

A House is not a Home

So if 1/3 of homeless people are in shelter, and only less than 1% sleep rough, who else is homeless?  The bulk of people we would consider to be homeless are the ‘hidden homeless’, but what does this mean?  The hidden homeless are those who might have a bed and a roof, but it is not their own, and it is temporary, precarious, or down-right dangerous.

Take for example a person who is in an acute care psychiatric facility for an extended stay, and has no place to be discharged to.  They have a bed, heat, food, and a roof, but not a home.  Or, take a sex worker who is living with her pimp.  She has a space, food, even some income, but not a home.  Or, take a 16 year old who is kicked out of their house and crashing on a friend’s couch, they have the couch, a ride to school, and a Playstation, but not a home.  So, because people have a place to stay, does not mean that they have a home.

Next question, is this conceptualization useful, or is it simply a way to ‘stack’ the stats to make homelessness look like more of a problem than it is?  This is a fair question, because each interest area wants to find more funding, which requires public concern.  However, the reason that this definition is helpful is because research shows us that those who are the ‘hidden homeless’ encounter the same health and social concerns, and have the same negative trajectories as those who are ‘absolutely homeless’.  Therefore, we need to have adequate programs for all those who are homeless.

And, what is the first step in terms of programs?  It’s to make sure that everyone has a home.  This starts with enough buildings and units so that everyone can have a space of their own, with a lock and a key.