Picture yourself homeless. Perhaps you’re mentally ill and need to take certain medications at set times to avoid spiraling down to a dark place. Perhaps you’re surviving by prostitution and regularly cycle through the courts. Perhaps you’re addicted to alcohol or drugs and chasing your next fix. Imagine trying to overcome any of those challenges, let alone all three, when you don’t even have a place to keep yourself – and your essential belongings – safe.
Facing Homelessness: At Homeless Connect, an event that offers a range of services for locals experiencing homelessness, Trevor Boller took portraits. Kathy Anderson and Shane Dowling are pictured here.
Photographs by Trevor Boller
Anne Smith, United Way’s CEO, recalls confronting such a scenario as part of a mayoral initiative that brought together leading citizens to the table with the audacious mandate of finding a way to eliminate homelessness in 10 years. “Our approach has always been ‘You can’t get into a home until you deal with your issues,’ but I realized you can’t deal with those issues until you’re housed,” Smith says. “That was an ‘aha’ moment for me – more like a ‘duh’ moment. It really is common sense.”
Such common sense led Mayor Stephen Mandel to announce a Committee to End Homelessness, which is chaired by committed Edmontonians Eric Newell and Linda Hughes, to propose a paradigm shift in how we respond to the city’s seemingly unstoppable upward trend in homelessness. The resulting 10-year plan, “A Place to Call Home,” calls for a “Housing First” approach in which we first help people find permanent homes and then surround them with the supports they need to battle their demons and join community life. City Council unanimously endorsed the plan in January 2009; just two months later, the Government of Alberta adopted its own 10-year, $3.3 billion plan to support housing first initiatives in the province’s seven largest cities.
Housing First was born in New York City in the ’90s and has since spread to Toronto, Vancouver and elsewhere, helping thousands exit the streets. As the paradigm spreads, the evidence builds that this approach costs just a third as much as sticking with the status quo. People without homes not only need shelters, but are disproportionately high users of ambulances, emergency rooms, hospital beds, court time, prison cells and social services. None of those come cheap.
“The economic argument is critical,” says Smith, who now chairs a Homeless Commission of leading citizens set up by city council to champion Edmonton’s plan to fight homelessness. “It doesn’t make sense to do anything else.”
Even before Edmonton’s Housing First plans took shape, frontline agencies such as Jasper Place Health and Wellness Centre and Bissell Centre were following a similar philosophy, scrambling to find affordable apartments and the wherewithal to keep people in them. Boyle Street Community Services did the same for people in the tent city that sprang up near its offices during the boomtime summer of 2007.
Smith sees the tent city as a tipping point that galvanized community-wide desire to stop homelessness. For years, the numbers were swelling. The tally had tripled since 1999, when concern about this issue led to Edmonton’s first homeless count. The number of homeless people in the city topped 3,000 in 2008 – not counting those hidden in the shadows. But it was when the tent city hit the headlines that the numbers gained a human face. “All of a sudden it was so visible and so real,” Smith says. “People said it’s not right in our city to have this travesty.”
Noreen Jackson along with her grandchildren.
Photograph by Trevor Boller
Soon after, Mayor Mandel launched the Edmonton Committee to End Homelessness, giving outrage an outlet. Three years later, Edmonton has not only a focused strategy and millions of dollars a year from multiple levels of government, but enthusiastic support from many quarters, including some previously aloof to the issues of homelessness. That’s as it should be, Smith says. “If we’re truly going to get at some of these really wicked issues, we have to do it together.”
Co-ordinating the charge is Homeward Trust, created in 2008 by amalgamating the Edmonton Housing Trust Fund and the Edmonton Joint Planning Committee on Housing. “When the plan to end homelessness was announced, we hit the ground running, building the bridge as we walked across it,” says Executive Director Susan McGee. Government funding, capital project proposals, landlord relations, staff training, client referrals, strategic planning and outcome tracking – all flow through this office in downtown Edmonton.
The frontline work of connecting people with homes and support is done by dedicated teams at agencies that had already earned the trust of homeless people. “For these organizations that have for years identified the inability to house somebody as a real problem, this is an incredible opportunity – but also a big responsibility,” McGee says. “It’s a harm reduction model, and there are tensions around that; people intuitively think somebody needs to be clean and sober before they can have a home. But it’s been demonstrated over and over again that the alternative doesn’t work.”
Two years into the 10-year plan, teams have successfully housed more than 1,300 individuals. (Across Alberta, about 4,000 people have been helped under the Housing First banner.) Potential clients are screened to see if they’re capable of learning to live independently and willing to have a support worker visit once a week. They move into neighbourhoods of their choice, with their first month’s rent paid and subsequent months topped up so that housing eats up no more than 30 per cent of their income. They set their own goals, which might include reconnecting with family, conquering addictions, finding employment, learning to budget or simply keeping their place reasonably clean. And they’re connected with resources for meeting those goals. More than 85 per cent of clients are staying housed, a number that’s better than the norm in Housing First initiatives.
It’s very exciting to move to a place where we’re saying we have to stop managing homelessness and end it.
The intent is to provide the right support for the right person at the right time. That’s particularly complex when serving aboriginal people experiencing homelessness, who hail from numerous tribes and are at various stages of identifying with their culture. A top-down ‘this is what you should do to get from here to there’ approach has proven to be utterly ineffective. Instead, support needs to be constantly available and provided in a manner that demonstrates respect for the client.
People who are chronically homeless and need direct access to considerable clinical care and support (often due to mental health issues coupled with addictions and other health problems) receive “wraparound services” from a multidisciplinary Assertive Community Treatment (ACT) team. To date, there are two ACT teams: DiverseCity Housing for people experiencing homelessness embroiled in the justice system and the Boyle McCauley Health Centre’s Pathways to Housing Program.
Bob Haubrich leads the Pathways team, which includes social workers, a psychiatrist, a medical doctor, nurses, an occupational therapist, recreational therapist, and expertise in supported employment, addictions and leisure skills. “We have 47 clients now, and they average a history of well over seven years of living on the streets,” he says. “While three have left the program, and a few others haven’t been able to live on their own, we’ve had some really incredible stories. Ninety per cent of our clients are no longer homeless and have maintained their home, 20 of our clients have been housed for well over a year. We have people who were homeless for 25 years who are doing quite well.”
Abdi Ali
Photograph by Trevor Boller
People who want a home but need less clinical support work with one of six Intensive Case Management (ICM) teams. Based at Bill Rees YMCA, Bissell Centre, Boyle Street Community Services, E4C, Hope Mission and Jasper Place Health and Wellness Centre, these teams provide case management services connecting clients with needed services in the community. A key challenge is finding professionals willing to make time in their caseloads for clients who’ve lived the hard life of the streets. A clinical assessment team at the George Spady Centre promises to help fill that gap with onsite expertise and connections to experts.
Team leaders meet every two weeks. “Those individuals really are the driving force behind this work,” McGee says. “By capturing their learning and innovation, we’re starting to build a community of practice.”
Providing clinical and support work on an outreach basis is hard work. “We’re always on the go with lots of driving because our clients are housed throughout the city, in areas of their choice, and none of our clients have chosen to remain in the inner city where our office is,” Haubrich says. “And when they’re first housed, they have many complex needs to be dealt with. They’ve been in survival mode, not taking their medication, not worrying about that pain in their side – or drinking it away. Now that they have a home, these other needs surface and require attention. Having their medication stabilized and their wounds dealt with will pay off eventually, but it requires support and services to get to that point. Recovery isn’t linear. It’s often two-steps-forward one-back, so that creates extra work and time for both the clients and staff.”
All teams track their work in a central web-based system, building up the capacity to spot trends and best practices. As the learning expands, so does the work, tapping community networks. For example, a Welcome Home program is emerging to counter the loneliness and isolation clients experience in their new neighbourhoods. At the initiative of Archbishop Richard Smith, a member of the Homeless Commission, 100 leaders from 23 faith traditions have signed a commitment to ending homelessness and are building the Welcome Home program. The program partners volunteers with the newly housed in order to build companionship and a sense of community, and both Enbridge and United Way of The Alberta Capital Region have pledged their support for the program.
That’s just one of the ways United Way is working behind the scenes to advance the battle against homelessness. “We’re a resource mobilizer,” says CEO Smith, “and we’re trying to model the whole concept that ending homelessness will take all of us.” Besides carrying the Housing First story to workplaces and other potential partners, the organization is helping to pilot a new ID bank for those who’ve lost their identification – and United Way is hugely invested in Homeless Connect, a one-stop bonanza of essential services that takes over the Shaw Conference Centre twice a year. “We’ve always been very involved in supporting people who are homeless,” Smith says. “It’s very exciting to move to a place where we’re saying we have to stop managing it and end it.”
Rob Sterling with son Ethan and daughter Grace.
Photograph by Trevor Boller
A full 80 building owners and property managers have also joined the efforts to end homelessness, renting 400 apartments all across town to Housing First tenants. Boardwalk Rental Communities, winner of a 2011 ROOPH (Recognizing Outstanding Organizations and People in Housing) award for housing partnerships, is not only adding more units to the 200 dedicated to this cause, but offering rent reductions.
Even so, there are not enough units available to meet demand – and as the economy heats up again, that gap could widen. “There are certainly bottlenecks around affordable housing, and the common denominator among the homeless is poverty,” McGee says. “We’re working with the City to leverage dollars for affordable housing that will be available for the long term no matter what the fluctuations in the market are.”
Requests for housing are also outstripping frontline staff’s ability to respond. “If we had staffing capacity, we could easily be four times bigger than we are today,” says Matt Ashdown, whose team at the Bissell Centre is supporting 80 adults and cannot take any more until current clients graduate to needing less support. His team refers complex cases to Pathways, where Haubrich is sifting through nearly 300 referrals knowing he has capacity for just 33 more clients.
The intake bottleneck is exacerbated by a dearth of places for people who need more support than a standalone apartment can provide, Haubrich says. “We offer a really good approach for people who have the capacity to recover and reintegrate. But there are a lot of people on the streets, sadly, who can’t do that.”
Ashdown agrees. “Housing First was designed to work with 85 per cent of homeless people,” he says. “It’s a good way to drastically reduce homelessness. But to end homelessness, we need places for the other 15 per cent. A lot of us have put a lot of energy into working with that 15 per cent, but it eats into our capacity to find homes for the people we’re set up to serve.”
Clearly, considerable work remains to meet the audacious goal of eliminating homelessness before this decade ends. Yet the people of Edmonton are succeeding in turning the tide, with the numbers shrinking for the first time since homeless counts began. The latest count, in October 2010, found 2,421 people without a permanent home – 658 fewer than in 2008, or a 21 per cent drop. True, that’s still 1,585 more than in 1999, but cause for rejoicing, nevertheless.
“I’m really proud of what’s happening in Edmonton,” Smith says. “We’ve moved further and faster than anybody ever expected, and we’ve gained appreciation for what real collaboration looks like. Most of all, I’m just so proud of the people who’ve been housed. There are amazing stories of success – people you would never have thought could get to a point where they’re comfortable in a home wanting now to give back, get employed, make sure others are housed. So it’s a really heartwarming story of what happens when a community comes together and says we’re not going to tolerate this anymore.” 
SHARING STORIES
A homeward trust initiative helps aboriginals experiencing homelessness share their stories
About 40 per cent of Edmonton’s homeless are aboriginal – eight times more than demographics would predict. That’s a sobering reality, and one Homeward Trust is aiming to change through Housing First.
Within two years, 585 aboriginal individuals have found a home with the support of Housing First teams. That’s 47 per cent of the people housed through the initiative, a glimmer of hope that, over time, aboriginal homelessness could be wrested down to five per cent of Edmonton’s homeless, on par with the aboriginal presence in our overall population – or even down to zero.
But as aboriginal elders teach us, the proof is not solely in the numbers. So Homeward Trust hired a team of researchers to hear the stories of aboriginal clients who’ve found housing through Housing First. “We were looking more for meaning than for measurement,” says Ralph Bodor of the Blue Quills First Nation College Research and Program Evaluation Team. Begun with a ceremony involving an aboriginal elder and the people whose stories would be heard, the study will close with a celebration and sharing circle to give the findings back and seek wisdom in response.
Besides drafting a 140-page report, the team commissioned playwright Matthew Mackenzie to blend bits from the interviews into a sharing circle of four voices representing the physical, spiritual, mental and emotional aspects of the medicine wheel, Bodor says. “My hope is that people who have not been exposed to this population could say, ‘I understand their story better. I can hear the passion and wisdom and awareness of these folks. They sound like people I’d want to meet.’”
