Helter-Shelter: Security, Legality, and an Ethic of Care in an Emergency Shelter

Book Review by Jeannette Waegemakers Schiff of Helter-Shelter: Security, Legality, and an Ethic of Care in an Emergency Shelter written by Prashan Ranasinghe

Rural Homelessness in Western Canada: Lessons Learned from Diverse Communities

"Until recently, there was little acknowledgement that homelessness existed in rural areas in Canada. Limited research and scarce data are available to understand the scope and dynamics of rural homelessness in Canada. As suggested in our previous work, there is a need for rural homelessness research to examine themes from a provincial perspective. The aim of this research was to contribute to expanding the knowledge base on the nature of rural homelessness at a provincial level in the Canadian province of Alberta. In order to understand the dynamics of homelessness in rural Alberta, we conducted interviews with service providers and other key stakeholders across Alberta. We examined homelessness dynamics and responses to rural homelessness in 20 rural communities across the province. Across all of the communities in the study, homelessness was reported however, the magnitude of the issue and its dynamics were distinct depending on the local contexts. We also identified several themes which serve as descriptors of rural homelessness issues. We note a number of recommendations emerging from this data which are aimed at building on the experiences, capacities, and strengths of rural communities." (author's abstract

Housing First - Where is the evidence?

n the last ten years a radical transformation has occurred in the attitudes and practices guiding housing programs that provide emergency and long-term housing for homeless people. This shift evolved from linear or step-wise models of either coupling housing with treatment, or of requiring treatment prior to obtaining permanent housing (Treatment Continuum – TC) (Padgett, et al., 2006), to a priority placed on housing without treatment expectations (Brown, 2005). The latter approach has been labelled housing first (HF) and has rapidly acquired wide-spread adoption by communities with 10-year plans to end homelessness in Canada and the U.S. (e.g. Calgary, Toronto, Minneapolis, San Diego, New York) and by mental health service providers seeking housing stability for clients (Newman & Goldman, 2008). Fuelled by some scientific evidence (Atherton & McNaughton Nicholls, 2008), and increasingly made popular by press and housing authorities developing “10 year plans” to eradicate homelessness, housing first has emerged as an increasingly popular approach to addressing homelessness. (The HF approach was embraced by all levels of government in Canada, as evidenced by the Streets to Homes initiative in Toronto and the housing initiatives in Calgary). Despite the rapid uptake of this approach, there is the absence of “best practice” evidence to support this. “Best practice” is commonly understood to imply evidence-based techniques or interventions that have been demonstrated to work well with most persons and have the least potential for adverse results. To the extent that there was some, but not conclusive, evidence that HF was effective for those with mental illness and co-occurring mental illness, the Mental Health Commission of Canada (Mental Health Commission of Canada, 2010), introduced a large, multi-site study of HF in five Canadian cities (referred to as the At Home/Chez Soi project). This project is examining the approach in various political contexts and with differing target populations, thereby including the multi-cultural dimensions essential to Canadian adoption of this approach. Although early results are promising, conclusive answers will not be available for several years. In the interim, adoption of the HF approach is rapidly growing

A Review of Peer Support for Suicide Bereavement as a Postvention Alternative

Peer support is acknowledged as a cornerstone in recovery from mental illness and addictions; yet its applicability for survivors of suicide has not been explored. Most postvention programs consist of professionally led individual and group counseling services. Alternatives to traditional professional counseling interventions are reported in the mental health peer support literature. We examine the postvention literature and the related mental health literature on peer support programs to determine their relevance and applicability. This report considers peer support provided as a postvention option or supplied in tandem with conventional professional services. Finally, we examine this as an intervention that also needs to be documented by quantitative and qualitative methods so that the presumptions and hesitations about its efficaciousness with suicide survivors can be documented

A Critical Look at Participation of Persons with Mental Health Problems in Training Mental Health Professionals within University Education

Involvement of persons with mental health disorders, with or without addictions (persons with MHA), within mental health education is becoming more common in some parts of the western world, in particular, the United Kingdom. What does involving persons with MHA entail and what are the benefits and challenges in involving these individuals in education? In this paper, we take a critical look at involvement of persons with MHA within the literature and provide a case study of a Canadian inter-professional mental health and addictions course where persons with MHA were included in some aspects of teaching. We present the evaluation of the course, and offer implications for involvement of persons with MHA in university courses

Developing an Estimate of Supported Housing Needs for Persons with Serious Mental Illnesses

A rich body of literature attests to the importance of affordable accommodation and support services necessary, appropriate, and acceptable to persons disabled by a mental illness. However, there is a little which provides a means for housing and service planners to determine the gap between available supportive housing and need. Such understandings are needed to prepare strategies and develop the resources needed to accommodate persons with a disabling mental illness in the community. While housing studies that examine shelter needs of the homeless acknowledge that a sizable proportion has a disabling mental illness, these numbers underestimate need in the cohort that experiences disabling mental illnesses. This underestimate exists because many of those who are disabled by mental illness and in need of supportive housing are among the hidden homeless: doubled-up, couch-surfing, and temporarily sheltered by friends and family. Thus, little is known about the size of this cohort or their supportive shelter needs. The present analysis examines two approaches and offers one methodology as most feasible and parsimonious which can approximate housing need and may be extrapolated to other urban locations

Developing an Estimate of Supported Housing Needs for Persons with Serious Mental Illnesses

A rich body of literature attests to the importance of affordable accommodation and support services necessary, appropriate, and acceptable to persons disabled by a mental illness. However, there is a little which provides a means for housing and service planners to determine the gap between available supportive housing and need. Such understandings are needed to prepare strategies and develop the resources needed to accommodate persons with a disabling mental illness in the community. While housing studies that examine shelter needs of the homeless acknowledge that a sizable proportion has a disabling mental illness, these numbers underestimate need in the cohort that experiences disabling mental illnesses. This underestimate exists because many of those who are disabled by mental illness and in need of supportive housing are among the hidden homeless: doubled-up, couch-surfing, and temporarily sheltered by friends and family. Thus, little is known about the size of this cohort or their supportive shelter needs. The present analysis examines two approaches and offers one methodology as most feasible and parsimonious which can approximate housing need and may be extrapolated to other urban locations.Peer Reviewe

Strength in the Face of Adversity: Perseverance and Resilience of Racialized Staff in the Homeless Sector During COVID-19

The emotional toll that individuals experience while working in the homeless sector ranges from traumatic stress and burnout to depression and decreased job satisfaction. Recent evidence highlights significant levels of post-traumatic stress symptoms among homeless service providers in some regions of Canada, which are higher than those reported prior to the Coronavirus disease of 2019 (COVID-19) pandemic. This study seeks to examine the impact of gender and ethnicity on work-related stressors among frontline staff in the homeless sector. Utilizing data from a survey on mental health stressors and needs completed by a robust sample of 566 frontline workers in the homeless sector across Canada, we investigate traumatic stress, burnout, post-traumatic stress disorder (PTSD), compassion satisfaction, and resilience between three key staff groups including Black, non-Black racialized, and Caucasian. Quantitative analysis revealed key themes related to 1) workplace traumatic experiences reported, 2) lived experience of homelessness, 3) lifetime traumatic events, 4) rates of traumatic stress symptoms, and 5) PTSD scores. Overall, Black staff demonstrated significantly fewer traumatic symptoms and lower burnout, and fewer on-the-job traumatic events, while non-Black racialized persons report slightly higher traumatic stress, burnout, and traumatic events, including traumatic experiences reported on the job. Non-Black racialized staff also report the highest PTSD Checklist (PCL) scores, indicating qualification for PTSD diagnosis. Caucasian staff reported the highest levels of lifetime traumatic events, traumatic events on the job, and burnout. Overall, racialized staff demonstrated lower levels of traumatic stress, and greater overall perseverance and resilience compared to their Caucasian counterparts. While areas such as coping practices and race-specific differences require additional research, the implications of this study can be used to inform institutional and organizational change and address mental health needs for racialized staff within homeless-serving organizations

Counting the Undercounted: Enumerating Rural Homelessness in Canada

Until recently, homelessness in Canada was largely considered to be an urban phenomenon. This assumption has been reinforced by homelessness interventions that primarily focus on urban areas. The past decade has seen a steady increase in research and reports on rural homelessness, using primarily qualitative methods. Recently, there have been some efforts to develop enumeration methods to measure and describe the scale and scope of rural homelessness. These enumerations have resulted in unprecedented availability of quantitative data on the number and characteristics of people experiencing homelessness in rural Canada. In this article we report on research which collected and analyzed data from Canadian rural homelessness enumerations. Significantly, these reports show per capita rates of homelessness in rural communities that are higher than those seen in Canada’s largest urban centres. These enumeration reports also show that a significant percentage of persons experiencing homelessness (PEH) in rural Canada are unsheltered and fall into the category of absolute homelessness. This research provides a snapshot of rural homelessness that is contrary to the dominant narrative of predominately “hidden homelessness” in rural communities. We suggest adjustments to policy and funding of homelessness programs that consider this evolving knowledge about the scale and scope of homelessness in rural Canada

A Critical Review of Research and Policy in Youth-Focussed Housing First

The Housing First approach is a social policy directive for addressing homelessness, but there is a lack of clear evidence of its effectiveness with youth experiencing homelessness. At the community level, service providers are implementing “youth-focussed Housing First” without the research support to evaluate the efficacy of this approach in providing stable housing that promotes a positive transition to adulthood. This comprehensive literature review includes ten of the most widely used social services databases, confirming a deficit of diverse perspectives and research evidence such as evaluative studies and peer reviewed articles validating the Housing First approach with youth. A comprehensive review of grey literature was also completed to determine what is known about youth-focussed Housing First and the most significant gaps in research. This article sets out directions for future research and produces social policy recommendations for all levels of Canadian government that will support Housing First programs that meet the unique developmental needs of youth. At the grassroots level, communities are adapting the Housing First approach to youth; this needs to be recognized and supported by research that evaluates the impact these programs are having in the lives of young people in order to inform scalability efforts to work towards eradicating youth homelessness. The hope is that youth-focussed Housing First develops a robust discussion in academic research.RésuméL’approche Logement d’abord est une directive de politique sociale visant à lutter contre l’itinérance, cependant, son efficacité n’est pas clairement démontrée auprès des jeunes en situation d’itinérance. Au niveau communautaire, les fournisseurs de services mettent en œuvre un programme « Logement d’abord » pour les jeunes malgré le manque d’études pour évaluer l’efficacité de cette approche afin de fournir aux jeunes un logement stable qui favorise une transition positive vers l’âge adulte. Cet article de revue détaillé inclut dix des bases de données de services sociaux les plus utilisées, ce qui aide à confirmer le manque de perspectives variées et de données de recherche telles que des études d’évaluation et des articles examinés par des pairs afin de valider l’approche « Logement d’abord » pour les jeunes. Une analyse détaillée de la documentation parallèle a également été réalisée afin de déterminer ce que l’on sait des programmes Logement d’abord pour les jeunes et les principales lacunes de la recherche. Cet article conçoit les orientations des futures études et présente des recommandations de politique sociale à tous les niveaux du gouvernement canadien, qui soutiendront les programmes Logement d’abord afin de répondre aux besoins développementaux uniques des jeunes. Au niveau local, les communautés adaptent l’approche Logement d’abord aux jeunes. Cela doit être reconnu et soutenu par des études qui évaluent l’impact de ces programmes sur la vie des jeunes afin de guider les efforts d’extensibilité visant à éradiquer l’itinérance des jeunes. Le but est de susciter une discussion animée en matière de la recherche universitaire quant au programme Logement d’abord pour les jeunesMots clés: Jeunes; logement d’abord; logement d’abord pour les jeunes; article de revu