Talking Social Inequalities around Addiction

The observance of World Social Justice Day offers us a chance to reflect on the institutional inequalities that prevent people from accessing basic needs like food, water and housing, and to look back on the hard work of previous generations of activists that got us where we are today. For Alpha House, working with individuals experiencing active addiction, we see firsthand some of the barriers and inequities that they face. We also see the pushback attached to efforts to challenge these inequities. Public sympathy for addiction is low and drug policy often lags behind the needs of the population we serve. Globally, we are facing unprecedented challenges related to social inequalities and overall economic wellbeing particularly for already stigmatized and underserved populations. Today we’re focusing on the history and current situation around harm reduction and how it has worked to bring those struggling with addiction towards improved wellbeing.

Harm Reduction formed as a result of grassroots advocacy among communities of people who have used drugs or know someone who is/has experienced challenges with substance use, and is a movement that has been foundational to Alpha House’s work in the community.

Harm Reduction found its roots in the latter half of the 1900s. The modern harm reduction movement started in the 1980s as a response to the HIV-AIDS crisis, most often attributed to the needle exchange programs put in place to mitigate the spread of disease during that time. These needle exchange programs weren’t always government supported, rather, the public took it upon themselves to create safe injection sites to tackle the situation while the government lagged behind in policy. Despite the lack of support from policymakers and law enforcement, needle exchange programs demonstrated the benefits it would bring to the public’s health, and were the stepping stones for many amazing programs we have today.

Alpha House also found its footing in the 1980s, with our shelter and detox services opening in 1982 as a pivotal innovation for street-involved individuals publicly experiencing addictions to alcohol or other drugs. Our agency began as, and continues to be, a safe and caring environment for individuals experiencing homelessness and active addiction, offering the community an alternative to criminal justice and law enforcement practices like holding cells.

Harm Reduction Practices

North America’s first legal supervised consumption site, Insite, opened in Downtown’s Vancouver’s Eastside in 2003 in response to drug prevalence increasing across the country and, following the success of Insite, Supervised Consumption Sites (SCS) began opening in cities like Calgary, Toronto, and Edmonton across Canada. Supervised consumption sites not only prevent overdoses, but act as a point of connection for caseworkers to connect with clients on key points like housing, healthcare, and addiction treatment services.

In 2005, 2 years after Insite opened in Downtown Vancouver, Alpha House launched our pilot program, the DOAP (Downtown Outreach Addiction Partnership) Team (now known as the HELP Team), a 24/7 outreach program dedicated to assisting the unhoused population in Calgary who are in active addiction. Working closely with Emergency Medical Services and the Calgary Police Service to reduce unnecessary and inappropriate uses of emergency systems, and to connect individuals with the programs and services that they need to improve their well-being. A Social Return on Investment (SROI) study was conducted in 2013 and found that for every dollar invested into this program, there is a social return of $9.43.

Around this time, harm reduction supply also became more widespread in an attempt to reduce disease related to substance use. Easier access to supplies like sterile needles, bubbles, and stems reduce the risk of overdose, infections, and bloodborne disease for individuals who would have already engaged in substance use with supplies that would have already been used or unsanitary due to other reasons.

Despite the improvements seen since the inception of safe consumption sites, they still remain highly contested and debated to this day. Alberta and Ontario are among the provinces that report the highest number of opioid-related deaths, highlighting the need for advocacy and policy change in this space.

Safe Supply and Decriminalization

As the drug crisis continued to spiral in North America, another harm reduction strategy entered the conversation. Safe supply programs were introduced to provide regulated alternatives to street drugs, thereby reducing overdose deaths in the community. Safe supply programs generally operated through clinics, pharmacies, and community health organizations and offered prescription drugs like hydromorphone to those at a high risk of overdose. Providing a safer alternative to unregulated street drugs, safe supply programs have shown, through research, that individuals that make use of these programs experience fewer hospitalizations, reduced involvement in the criminal justice system, and an overall improvement in their wellbeing.

The distribution of naloxone kits also started to pick up steam— a life saving medication that reverses opioid overdoses, which has now become readily available through pharmacies, outreach programs, and emergency services. Being able to hand out naloxone proactively to those who might experience or witness an overdose was a major milestone in the sector.

Decades of advocacy against the criminalization of drugs takes us to 2023, where British Columbia launched a three-year pilot program that temporarily decriminalizes small amounts of select illicit drugs in an attempt to shift the focus from punishment to support, a milestone that many advocates in the sector have fought for[1].

Where We Are Today

Despite the progress we’ve seen in harm reduction advocacy over the last half-century, there are still challenges to overcome. Fentanyl entered Canada’s illicit drug market in the early 2010s, a synthetic opioid, promising effects up to 100 times that of other opioids like morphine or heroin[2]. Based on numbers from January 2024 – June 2024, most accidental apparent opioid toxicity deaths involved fentanyl at 79%, with 21 deaths per day on average[3]. Some of the factors that play into the current drug crisis in Canada:

• Due to its high potency, even small amounts of this drug can prove fatal; illicit drug dealers have taken to mixing in Fentanyl into other substances like heroin to “increase the effects”, thereby contaminating the drug supply and causing many fatalities as a result.
• Extended use of opioids, like fentanyl, can lead to an individual developing tolerance, meaning a higher and/or more frequent dose is required to feel the same effects. Stopping the use of opioids results in the individual’s tolerance for the drug to drop rapidly, meaning that taking a similar dosage to what was previously used can prove to be fatal.
• Stigma towards substance use disorders only exacerbates the problem, discouraging substance users from seeking help and being open about their ongoing addiction challenges.

From the late 2000’s to now, Alpha House has focused on strengthening our housing and outreach programs to recognize some of the main gaps in reducing homelessness, helping individuals manage and overcome addiction, and increasing social equity for historically underserved or highly stigmatized populations. We’ve:

• Opened 7 Supportive Housing buildings, operating 161 housing units for individuals exiting homelessness and looking to find long-term stability
• Piloted a Scattered-Site housing program which now manages 180 market rental units for low acuity individuals
• Launched a Needle Response team that works to clean up needle debris around the city, supporting safe and clean communities while reducing stigma around public substance use
• Expanded the Encampment program to provide rapid response to unhoused individuals who lack emergency shelter access

All of our programs and services strive to work within harm reduction practices and, subsequently, housing first, building off of all of the hard work and advocacy done in the past to bring these ideas to the forefront of the sector. According to the National Harm Reduction Coalition, harm reduction is a flexible practice where interventions and policies are designed to match individual and community needs, meaning that there is no universal definition for harm reduction, however, there are core tenants that guide any harm reduction practices:

• Patient Centered Care
• Judgment Free Care
• Sharing the Voices of Those with Lived Experience
• Advocacy

These core tenants are inherently linked with advocacy and support for equity deserving groups, providing compassionate supports for individuals who need it and advocating for systematic change for current and future generations. Instead of punishing those struggling with substance use, harm reduction seeks to support them in improving their wellbeing while respecting their rights as an individual to make their own choices. In an ideal world, following the tenants of harm reduction, individuals would not be denied supports like housing, financial help, and healthcare due to their substance use or housing status.

For homeless serving agencies, like Alpha House, harm reduction is a philosophy that shapes how our services are delivered. At our core, we look to create opportunities for our clients to engage with healthcare and mental health supports with the end goal of stable housing. Harm reduction can continue to evolve to meet the everchanging needs of modern-day society, but we as a population, policymakers, and law enforcement have to be willing to adapt in a way where we can fill these gaps in the system and support our most vulnerable. Further work is needed to address the contaminated drug supply, lack of housing, and the lack of access to appropriate services and supports for individuals in active addiction before we can see this crisis managed.

 

[1] https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-20336-9#:~:text=Background,g%20of%20select%20illicit%20drugs.

[2] https://myhealth.alberta.ca/alberta/pages/fentanyl-frequently-asked-questions.aspx

[3] https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/

 

Let’s talk about camping! May long weekend is here, and we’ve got some thoughts to share as everyone gets ready to enjoy a weekend of family, fun, camping, BBQs, or other traditional long weekend activities.

Encampments and the challenges they pose for communities, the public, law enforcement, and governments has been an ongoing topic of discussion in Alberta these past many months and Alpha House is jumping into the conversation once again to talk PERSPECTIVE.

“Camping” is often thought of as a fun, mostly short-term activity that couples, families, and individuals partake in when they want a break from work or responsibilities and desire a reconnection with nature, fresh air, or simplicity (or maybe just an open area where their kids can run wild). But there is a lot of food for thought in the way we talk gleefully about an upcoming camping trip—about the pleasures it will bring—while simultaneously speaking ill of those for whom rough sleeping is a constant (often necessary) reality.

The pleasures and joys of camping—solitude, an inexpensive getaway, open country and fresh air, living by the land—are stated easily in casual conversation and accepted unquestioningly by most. Yet, the most frequently asked question when we talk about people who rough sleep or camp continuously rather than access shelters, is why on earth would someone choose to sleep outside?

The conversation is often – ‘there must be something wrong with shelters if someone is choosing to sleep outside instead.’ Speaking as an agency who meets people where they’re at without judgement, we know things are more complex than that. Shelters are an emergency response to (ideally) short-term crisis. They were neither created for nor expected to be for long-term comfort. Some people choose to stay outdoors because they feel more comfortable doing so because of trauma, anxiety, mental health, or simply personal preference in a choice that’s the lesser of two undesirable options.

Choosing to sleep outside, at least, if nothing else may be, is a relatable aspect of those who are about to head off to a campsite this summer and those individuals or couples who just setup a tarp and tent in the field near your house.

Camping can provide freedom and solitude and, when you have access to the tools and supplies you need, be relatively relaxing. Except, of course, when it feels like the only option on a seemingly endless road of being homeless; when staying warm with a fire is risky, when you haven’t showered in a few days, when you haven’t eaten anything hot in a week, when you’ve outstayed your welcome in the area and you have to pack up all your belongings and lug them off to find yet another temporary spot.

The reality is that what is challenging about camping – the preparation, the packing, the setup, the maintenance, the waste, the lack of access to things easily accessed in a home – is made more so by the circumstances of a person’s homelessness.

And what is rewarding about camping – the fresh air, the peace, the getaway, the freedom, is often made irrelevant by the circumstances of a person’s homelessness.

Encampments are not a solution to homelessness; they are a reality for those for whom going to a shelter is a challenging or upsetting prospect. We wish to see anyone who rough sleeps supported into housing that suits their needs and we wish to see camping become nothing but the hobby it’s about to be this summer for so many of you.

As we enjoy this May long weekend, our wish is for people to remember that rarely is anything as straightforward as it may seem. There is always room for perspective.

The City of Calgary’s Housing Strategy: ‘Home is Here’ outlines 98 action items to ensure Calgarians have an affordable place to call home. One of the main tactics for addressing both the shortage of houses available to those who need them and the need for different types of housing options in the city is to increase the supply of housing.

Scarcity of housing means a lack of housing affordability – pushing groups with more income to capture the part of the market previously accessed by lower income groups, whose options are further reduced to co-habitation with friends and family or living in spaces that are unsafe or unhealthy. Scarcity of housing, for the same reasons, forces individuals into units that don’t adequately meet their mental, physical, or psychological needs. For many, including Alpha House’s clients, this doesn’t just mean being housed in a smaller unit (1-bedroom vs 2-bedroom for example), it could mean:

• an inability to be housed in a certain community where they have connections
• an inability to be housed with caseworker supports due to a lack of supportive housing options
• an inability to be housed where mobility challenges are supported
• an inability to be housed in a neighbourhood with a familiar culture

…and many other needs that may not be met due to a lack of diversity and choice around our housing options.

Therefore, on top of the affordability barrier, a second challenge that currently impacts Calgarians is an inadequate spectrum of housing options. Different types of housing options could include single-detached, rowhouse, townhouse, apartment, and semi-detached. Historic data shows single-detached housing as making up 58.3% of housing type in the city, which generally favours certain socio-economic groups. To increase the number of 1-bedroom or 2-bedroom apartments available for clients in our Community Housing program, for example, would mean supporting an increase in developments like rowhouses, townhouses, and apartments complexes. An increase in the availability of these units will lower the prices of these same units due to an increase in supply; the idea being that these price decreases will make renting/owning a rowhouse, for example, more accessible for someone who is living in smaller or shared accommodations and wants to move into a bigger space. As these individuals move into bigger spaces, the availability of 1-bedroom apartments increases thereby making them more affordable for those with lower incomes.

One of the main reasons for the constrained supply of housing and housing diversity is that the current land use districts (zones) in approximately 60% of Calgary’s residential areas do not allow for a choice of housing beyond single-detached or semi-detached homes. Allowing for diversity in housing structures within each community better suits the wide array of individual and family needs within the city, and a mixture of rental and ownership properties at market and non-market (subsidized) rates offers people at all income levels access to safe and stable housing options.

Alpha House sees firsthand the need for diversity in types of housing to meet the unique needs of the clients we serve and, as a result, we whole-heartedly support the City of Calgary proposal to “rezone all residential parcels that currently only allow for 1 or 2 units, it will be easier for property owners to add additional housing varieties across the city, without having to go through the additional steps of a Land Use change Amendment application.” This application process can take upwards of 6-months to process, maybe longer if there are other issues to be resolved with.

Rezoning will not solve all our housing-related problems, but it is a significant step forward in supporting affordability for Calgarians through increased housing supply and increased diversity in housing supply.

The City of Calgary Council’s recently passed strategy has five main points:

• Increase the supply of housing
• Support affordable housing providers
• Enable the City’s housing subsidiaries to improve service delivery
• Ensure diverse housing choice
• Address the affordable housing needs of Indigenous people.

This strategy was adopted on September 16, 2023 with implementation plans stretched out over 2024-2030. The current public hearing about the specific rezoning amendment is April 22, 2024. If you are someone who has asked themselves how you can support reducing homelessness in the City of Calgary, we urge you to write to your councillor and tell them you support re-zoning efforts.

The City of Calgary has an excellent frequently asked questions page for those concerned about what re-zoning could look like in their neighbourhood. https://www.calgary.ca/planning/projects/rezoning-for-housing/faq.html

Harm Reduction

The social services sector evolves with the needs of the people that it serves; harm reduction has become a leading framework for those working with individuals facing homelessness and substance use challenges because of its effectiveness in minimizing risk in situations involving physical health, mental health, and/or substance use.

Understanding Harm Reduction

First off, what is harm reduction? Harm reduction is a non-judgmental approach that seeks to reduce the health and social harms associated with an action that is inherently risky. In the social services and addiction sector, we seek to reduce the harm associated with substance use, without requiring individuals that use substances to immediately abstain. We often refer to this as ‘meeting people where they are at’ instead of placing a moral judgement on their behaviour ⁱ. The goal is to reduce harm in the immediate while supporting conversations and options around what reducing harm can look like long-term.

Why Not Abstinence?

For many people, substance use is part of recreational activities, and risk of long-term substance use disorders is minimal, but for others it can develop into an addiction that significantly impacts all other areas of that individual’s life ⁱⁱⁱ. A common misconception about harm reduction is that it is an enabling action and that abstinence isn’t an option within a harm reduction model. Harm reduction is about giving individuals the power to make decisions for themselves, and that can mean anything from continuing to use substances, reduced substance use, choosing abstinence, and everything in-between. This framework is here to support individuals in improving their circumstances over time with a non-judgmental approach, and, ultimately, to help people lay the foundation for lasting change in their lives.

Harm Reduction in Practice

Harm reduction in practice can look very different depending on its application and doesn’t only apply to situations involving substance use. People engage in harm reduction practices every day, often without realizing it; for example, putting on sunscreen to reduce the harm of sun exposure, wearing a seatbelt when driving a car to reduce the risk of serious injury in the event of a car accident, and using oven mitts when cooking are all examples of harm reduction measures.

In the realm of substance use, overdose prevention sites are part of reducing harm due to toxicity or quantity. Overdose prevention sites have considerable positive impacts on those in active addiction. These sites reduce the harm of illicit drugs by providing a safe and clean environment where people are monitored by medical professionals to ensure quick, life-saving action in the event of an overdose. These sites are known to reduce costs for the healthcare system, prevent illnesses, and most importantly prevent overdose fatalities ⁱⁱ. Other examples of harm reduction practices and services relating to substance use might be:

• Outreach programs
• Safe supply
• Needle exchange programs
• Opioid replacement therapies
• Drug testing kits/services
• Use of naloxone kits

 

Harm Reduction and Homelessness

Alongside the need for shelter, unhoused individuals face many challenges that compound experiences of homelessness. We know that individuals living on the street are at a higher risk of mental illness, physical health issues, and basic hygiene challenges; in some cases we see substance use become a coping mechanism for individuals on the street as a response to struggling with the challenges (and trauma) of experiencing homelessness. Unhoused individuals often experience barriers to health care on top of not having access to basic hygiene supplies, resulting in a higher number of negative health outcomes such as infections, Hepatitis B and C, and HIV. This is why ensuring unhoused individuals have access to safe supply like sterile water, needles, and glass pipes is essential to ensuring the safety of unhoused folks.

Harm reduction is a practice related to substance use as one example, but other health interventions are harm reduction practices that are equally important. Access to clean clothing, for example, reduces harm by removing dirt, bacteria, fleas, and other irritants which helps reduce the occurrence of infections, rashes, and disease. Access to showers, as another example, reduces the harm of infestations like scabies, fleas, and head lice which individuals on the street are at a higher risk of due to infrequency of washing supplies ^iv. Once the immediate safety of the individual is addressed, there is room for support, referrals, and goal setting towards other improved circumstances.

The overall goal of harm reduction is to minimize the negative consequences involved with an inherently risky action (such as substance use) while recognizing that each individual’s circumstances are different and require a unique, non-judgmental approach.

If you want to learn more about the root causes of homelessness, harm reduction, and practical strategies on how you can better navigate interactions with this population, we offer a free 90-minute workshop twice a month at the carya Village Commons. You can learn more about the workshop and available dates here.

References

1. Thomas, G. (2005) Harm Reduction Policies and Programs Involved for Persons Involved in the Criminal Justice System. Ottawa: Canadian Centre on Substance Use.
2. Mental health. CMHA Ontario. (n.d.). https://ontario.cmha.ca/harm-reduction/#:~:text=What%20are%20some%20examples%20of,for%20people%20who%20inject%20drugs.

• Harm reduction. Harm Reduction | The Homeless Hub. (n.d.). https://www.homelesshub.ca/about-homelessness/substance-use-addiction/harm-reduction

1. Thelwell, K. (2020, October 24). Struggles obtaining convenient access to showers. The Borgen Project. https://borgenproject.org/access-to-showers/

 

National Housing day exists in Canada to remind each of us of the importance of affordable housing for all. If you are lucky enough to never have had to worry about shelter for you and your family, it can be easy to overlook the barriers faced by so many and the critical nature of having safe, affordable housing.

 

National Housing Day aims to provide more advocacy for people experiencing homelessness within Canada, and serves to remind us that there is much to be done to make sure that all Canadians have access to affordable and safe housing. Current estimations suggest 235,000 Canadians may experience homelessness in a given year. Many people experiencing homelessness have multiple barriers to gaining affordable housing, such as lack of consistent or adequate income, mental or physical health issues or substance use addictions.

 

It has become more and more clear over the past decade that Canada is facing a housing crisis. Growing costs of housing and a strong demand with insufficient supply has led many Canadians, unable to afford market prices, to become entrenched in unsafe or inadequate housing units, or to become unhoused. In Calgary, the average house price is $553,300, and market prices for apartment rentals are currently averaging $2,178. These prices are often unaffordable for so many and, as a result, it becomes more and more likely that individuals, couples, and families will be forced to stay in unsafe housing situations, places that don’t meet their needs, or risk becoming unhoused.

 

Alpha House Society works alongside other homeless-serving and housing agencies in Calgary and within the Calgary Homeless Foundation’s Housing Strategist programs to transition people experiencing homelessness into housing. Alpha House offers two different types of housing programs: permanent supportive housing (PSH) sometimes called Place-Based Housing (PBH) and Community (Scattered-Site) housing. Alpha House’s PSH program is made up of seven different apartment buildings throughout Calgary. Each offers individual case management and goal setting, as well as group programming case, supporting each resident to improve their circumstances by learning new skills, reducing harm related to substance use, and establishing and creating community for everyone.

 

Alpha House’s Community Housing program supports clients to transition towards independent living. Clients in the program are housed within the community with their own units and sign their own leases. Caseworkers support clients with intensive case management to help with basic short and long-term needs and reduce the likelihood of re-entry into homelessness.

 

There is a vast array of needs when it comes to housing and, to ensure stability, it is critical to meet those needs with a spectrum of housing options; matching needs with services. In the homeless-serving sector, housing options are critical to reducing barriers for individuals who are rough-sleeping, struggling with mental or physical health challenges, and dealing with substance use addiction

 

Alpha House believes foremost in a Housing First approach to solving homelessness –  without barriers and without exception – providing housing regardless of an individual’s personal circumstances and, as an agency, our continuum of programs work to meet individuals where they are at, determine what type of housing would suit them best, and support them in transition.

 

National Housing Day exists to remind Canadians that every person deserves a home, four walls and a roof. Many Calgarians are feeling firsthand the impacts of the housing crisis. aware of how the housing crisis. The City of Calgary Council recently passed a strategy with the goal of ensuring every Calgarian has an affordable place to call home. This strategy has five main points: 1) increase the supply of housing, 2) support affordable housing providers, 3) enable the City’s housing subsidiaries to improve service delivery, 4) ensure diverse housing choice, and 5) address the affordable housing needs of Indigenous people. This strategy was adopted on September 16, 2023 with implementation plans stretched out over 2024-2030.

 

Federally, Canada has also implemented a national housing strategy which includes investing 40 billion dollars into different housing strategy targets, such as a 50% reduction of emergency shelter stays by those chronically homeless, 385,000 community housing units protected, and another 50,000 units created through an expansion of community housing. Alpha House knows the importance of safe, supportive, and affordable housing and we stand with all agencies, government bodies, and developers who are working towards Housing for All.

 

Written by Alpha House Staff (Amy Sutherland)

 

Government of Canada. (2017). Canada’s National Housing Strategy: A place to call home. https://eppdscrmssa01.blob.core.windows.net/cmhcprodcontainer/sf/project/ placetocallhome/pdfs/canada-national-housing-strategy.pdf

 

City of Calgary. (2023). Home is here, the City of Calgary’s housing strategy 2024-2030. https://www.calgary.ca/communities/housing-in-calgary/housing- strategy.html#:~:text=Home%20is%20Here%2C%20The%20City%20of%20Calgary’s%20 Housing%20Strategy%20was,office%20conversions%20to%20support%20students

 

Alpha House. (2023). Housing Program. https://alphahousecalgary.com/how-we-help/housing- program/

 

Homeless Hub. (2021) How many people are homeless in Canada. https://www.homelesshub.ca/ about-homelessness/homelessness-101/how-many-people-are-homeless-canada

 

Average house price in Calgary. (2023, October 16) The Canadian Magazine of Immigration. https://canadaimmigrants.com/average-house-price-in-calgary/ #:~:text=The%20average%20house%20price%20in,over%20year%20in%20September%2 02023

In the homeless-serving sector, we operate on a principle of Housing First. Housing First means providing affordable, supportive housing to individuals/families experiencing homelessness as quickly as possible without expecting them to meet certain requirements (such as ‘sobriety’) before being allowed a home. In our experience, housing gives people the opportunity to work on other aspects of their lives without being constantly displaced. But housing is not the only solution or supports that people need. We sat down with some of Alpha House’s Community Housing Caseworkers to hear their thoughts on what comes next after ‘Housing First.’

 

We know about some of the barriers individuals face when trying to transition from homelessness to housing – lack of income, issues with obtaining ID/bank accounts, unmet medical needs etc. What are some of the barriers you see when it comes to someone newly housed remaining housed?

Most newly housed folks need to learn/relearn basic household and hygiene skills. Emergency Shelters do not always have the capacity to allow clients to learn how to perform these tasks so it can be a struggle when someone is newly housed.

Many folks also struggle with feeling as though they don’t fit into their new community, they may feel they are being targeted due to their appearance or behaviors and rarely feel comfortable asking for support from neighborhood support systems. It often takes months or years for a client to build a sense of community and belonging. This can lead to struggling with boundaries around things like guest management with clients inviting their (still unhoused) friends to stay, as that group of people is where they feel most comfortable.

 

What do Alpha House’s caseworkers do to reduce these barriers for clients?

From the perspective of learning/relearning basic household and hygiene skills, caseworkers are able to assist with basic chores, provide insight and information, and work off their rapport with clients to support skill building and overall confidence.

For community integration, caseworkers are able to do tours of the community, provide lists of community supports and events, and provide encouragement and supports to help clients reintegrate within their community.

The importance of having someone you trust cannot be overstated here. Rapport with clients is critical to supporting their needs and helping them gain confidence and feel more comfortable.

 

How big of a part does a neighbourhood/community play in helping individuals stay housed? Are there things we can do better as a community to prevent re-entry into homelessness?

The neighbourhood and community play a big part in a client’s successful housing. When clients feel like they are part of a community, we often see greater success in housing stability. We all play a part in our communities to help people feel welcome and that is no different when it comes to those we house. Simple things like smiling and saying hello or introducing yourself make a huge difference. More involved engagement like having a coffee with the individual and taking the time to get to know them is very beneficial to the success of housing programs. Those we serve have often been experiencing homelessness for a long period of time and feel alienated from society, so reintegration and kindness are key.

If our clients feel welcomed and understood by their neighbors, they are more likely to integrate quickly and to show a sense of pride in their housing, which promotes hope and is crucial to long-term housing stability and overall wellbeing.

As a community, we can help prevent re-entry into homelessness by understanding that everyone deserves a chance and has a unique story. Greet your neighbours regardless of their past or appearance.

Society as a whole could be more open to seeing unhoused individuals as people that are worthy of interaction and compassion.

Anecdote: I live in the deep SW and one day stopped to fill up with gas, an Alpha House client was in the parking lot asking for money to get on the bus. When he asked me, I showed him my employee ID badge and he immediately held out his hand to show me a possible broken hand with cuts all over it. He only needed to get on the bus to go get medical attention and had no money to do so. Everyone else that he approached walked away from him as fast as possible when he really just needed help and support.

 

Can you share some thoughts on the importance of landlord relationships when it comes to housing stability for clients? How do you go about building those relationships and reducing stigma that can come with housing previously homeless individuals?

Landlord relations are incredibly important as not all individuals have an easy or seamless transition to independent housing.  With a patient and understanding landlord/lady, it is easier for individuals to be successful in their housing. One critical piece is establishing a landlord-tenant relationship where the landlord addresses concerns they are having with a client themselves in a direct and gentle approach. If a landlord/lady requests Alpha House discuss all concerns with a client it does not build a client’s capacity to have these discussions and overall, it reduces their accountability. All of our clients are their own lease holders and need to attend the lease signing with the landlord; we also encourage clients to call their landlord for small fixes and concerns just like a non-program tenant would. This builds capacity and self-advocacy as well as relationships. Forming a relationship helps the property owner see a client as a person who deserves housing, and not just someone who used to be homeless or has an addiction.

 

What about neighbour relations? How do you encourage clients to integrate into their community?

In inner city areas it is easier to integrate and not feel so targeted as opposed to in suburban communities.  Alpha House never wants to make a client feel bad about their appearance or experience so when working with clients we tend to focus more on being a good neighbor and what that means. We talk about not having a lot of guests over at any one time, using appropriate garbage cans, keeping the apartment a good level of cleanliness etc. Overall, integration into community is not something that can be easily achieved without society as a whole becoming more open minded towards our clients.

 

Where are there gaps (both in the homeless-serving sector and overall as a society) when it comes to housing stability? What things are we missing as a collective group to prevent someone losing their housing or to be more inclusive and well rounded in general?

To help the client succeed and maintain housing stability, communication is key. When housing someone from homelessness into housing, the transition period is very hard for the client. We often see clients who sleep on their balconies, or have their bed in the living room. As a collective, we all need to be patient and communicate the struggles that the client is facing at the time and work together to ensure adequate supports are provided.

Additionally, the Homeless Serving sector could do a better job at educating society about the variety of reasons individuals become homeless. So many non-aware people assume that it is just based on drugs and alcohol, rather than seeing the trauma that so often leads to substance use as a coping mechanism.

 

We typically see studies that show prevention is more cost effective than reactionary programs – this is true in terms of crime prevention, injury prevention etc. Besides the humanitarian reasons to provide affordable housing to all and prevent homelessness, what do you see as the economic benefits of housing stability? (i.e. client interacts with police less often, fewer medical issues, less substance use etc.)

We often see a reduction in overall emergency services use, such as CPS and EMS interactions, as clients are housed and able to attend general medical appointments on a regular basis and address underlying health concerns.

Often times we see a reduction is substance use as a result of decompression. When clients are homeless their bodies go into a fight or flight mode. When they are housed we often see them decompress and they are able to relax, not having to constantly be looking over their shoulders.

We also often see mental health concerns stabilize as individuals are able to take care of themselves, stick to a medication regime, get better sleep and eat better, which all contributes to a positive state of mental health

 

Alpha House operates from a Housing First perspective meaning individuals are better able to work on other aspects of their lives if they have shelter security and a place to call home. In the context of “housing first, what’s second?” – what would you say comes second after housing?

Some of the most common ‘seconds’ we see are mental health, overcoming trauma, reconnecting with family or dealing with physical health concerns.

In addition to the above pieces, community reintegration and purpose, along with a sense of dignity and self-worth for the client are important. We help clients set goals and support their plans for the future. Having something to work towards and having hope for the future is critical.

Overall, we know that support needs to come second; it is about supporting clients in whatever way they need so they can find stability.

 

What types of philosophies do you follow as caseworkers to support your clients? Do you have any rules of thumb or best practices?

1. Be honest to yourself and to the client
2. Everyone deserves to be treated with dignity and respect. We work with people and not just numbers. Client choice is also very important. Every client has their own unique story, with underlying trauma as a big factor in why they were homeless. We support clients, no matter the choices that they make. As long as they are safe, and given the tools to remain safe in their homes.
3. Harm reduction principals and to meet a client where they are at. We cannot move faster than them and for individuals who have been homeless or institutionalized most of their lives, it takes longer to feel comfortable being housed than someone who has been only episodically homeless.
4. Celebrate the small successes with your clients and encourage self-sufficiency