An Examination of the Shelter Industry in Canada & the Efficacy of Program Delivery as It Impacts Client Outcomes.

A REPORT of FINDINGS from Angels of the Road

16 Months of Living with Canada’s Homeless by Bonny L. Cameron

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Prolog Initially it was my intention to present these findings to you as a formal research paper, however I find myself uncomfortable using that format. I will submit this report written in the first person because I lived it in the first person, and I funded it in the first person. My only responsibility here is to the truth, good or bad. I will not waste valuable space listing my credentials; for more information than you could possibly want to know about me, please go to my website www.AngelsOfTheRoad.com and click the ABOUT tab. You will find my resume, biography, philosophy and a brief synopsis of “the journey” (as I like to call it). This study is meant as a qualitative analysis of program delivery to Canada’s homeless and indigent population. No hard statistics have been kept… those are available through any number of government departments and stakeholder organizations. The study makes no mention of individual facilities, unless they stand as a strong example (good or bad) for other agencies to use as learning models. In no way should this document be taken as an indictment of the shelter industry. Almost everything I experienced indicates good people doing the best they can with the limited resources & information available. It is my sincerest hope that the shelter industry, social planners, and researchers in this field will use these finding to guide the evolution of service delivery to Canada’s homeless; resulting in shorter shelter stays with improved recovery and reintegration for all client populations.

The content of this document and the Angels of the Road website / blog site is copyrighted to the author / researcher Bonny L. Cameron and must be credited accordingly in any reproduction or distribution of these documents in whole or in part. The free (and wide) distribution of these copyrighted materials is encouraged; however if anyone profits (financially) from the use of same, an appropriate compensation to the author can be made by email to [email protected] Yes I trust you. Please direct any questions, requests or comments to [email protected]

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Table of Contents Abstract …………………………………………...

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Methodology…………………………….………..... Page 4 Demographic Information……………….………..… Page 5

Shelter (sleep) Programs.……………….…………… Page 7 Meal Programs ..……………….…………………. .. Page 10 Skills Development & Education………………… .. Page 13 Recreational Programs……………………………... Page 15 Counseling Services…………….……………...….. Page 17 Outreach Services…………….……………..……... Page 19 Management / Staff Relations..….………….……… Page 21 Staff / Client Relations..….………………………… Page 24 Summary……………...….………………………… Page 26

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An Examination of the Shelter Industry in Canada & the Efficacy of Program Delivery as It Impacts Client Outcomes. Abstract: This observer/participant study involved almost two years of information gathering which was done from May 2009 – October 2011. The study took place in 15 cities throughout Canada, except (due to accessibility and funding issues) the far north. Over that period of time I lived in 12 shelters with capacities ranging from 8 – 300 occupants. Attended programs offered to the homeless through 15 drop-in centres and accessed 24 meal programs. The study involved total immersion with the subject population. Stays varied from 3 weeks to 4 months depending on the size of the homeless population with whom I was assimilating.

Methodology: Constant for this project was the use of a single researcher, me Variables were basically everything else; size of facility/ population/ protocols/ staffing/ orientation (secular or religious)/ provincial government priorities/ funding sources/ etc. Veracity: Anyone wishing to verify my results can do so by simply repeating this process. I presented myself as a middle-aged woman, between jobs, without ties to the city, checking into the potential job market and looking for a new place to settle down (all of which was quite true). This is in no way an unusual situation for shelters to encounter, so it did not raise any suspicions among staff or clients, It is human nature to modify our behaviour when we are being observed; so to prevent contamination of the study, the subject staffers and clients were not informed of the my full purpose until the end stages of each stay. I lived with and among the client population for up to 4 months at a time with 4 visits home to Calgary of 3-5 weeks between each leg of the journey, dubbed Angels of the Road. This immersion process allowed me to get unvarnished feedback from clients. Further I was able to observe client to client, staff to client and management to staff interactions on an ongoing basis, revealing patterns of interconnectedness between them.

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Demographic Information First I observed that the homeless populations in other cities were very similar to that of Calgary. Working poor (including people on social assistance) comprise 50% of the homeless. Marginally employed it is difficult for them to maintain housing at current market values. They stay in shelters intermittently for only a few weeks or a few months at any one time. Another 20% are in the shelter due to medical issues which prevent them from creating a stable income from employment. Some have physical challenges which do not qualify them for a disability income but many are coping with mental health issues. Only 30% of homeless are the stereotypical street person struggling with addiction, concurrent disorders and/or undiagnosed mental illness. These numbers break down a bit differently in the DTES (Down Town East Side) Vancouver with easily 50% being street people, this is in part due to B.C. housing and several not-for-agencies collaborating on affordable housing options for the working poor and medicals. Some sources would like to have us believe that mental health issues account for 80% of homelessness, this very misleading (albeit comforting) statistic is created by including people dealing with situational depression, which I contend is a normal response to finding oneself homeless. The same could be said regarding drinking… not every homeless person who drinks is homeless because of alcohol addiction. Many are drinking as a coping mechanism for a difficult situation; for self-medicating the depression or as a sleep aide. The lack of privacy, ongoing noise from other residents, 24hr lighting, antiseptic smells and the body odors which are inherent to close quarters living; make normal sleep difficult to achieve. Most homeless from all three population groups (poor, street people, medicals) are white males age 20 – 60; with visible minorities from the same age group comprising about 10% of the overall population. This shifts slightly as we move from east to west where we see an increase in homelessness among the urban Native populations from Thunder Bay continuing to the west coast. There may be several factors at work, but from my conversations with Natives it would seem that conditions on eastern reserves are somewhat better than those of their western & northern counterparts resulting in lower migration levels into the cities. Some cities estimate as much as 30% of urban Natives are homeless. Women of all populations (poor, street people, medicals) and age groups account for about 10% 15% of homeless. Oddly enough 50% or more of the available resources are targeted exclusively to women. Most other programs are co-ed; this could be one of the reasons for the population disparity. 5

Newfoundland had no year-round shelters which I was given to understand would be changing as of winter 2011. This is due in part to a vigorous re-housing program for medicals and the low level of migrant populations. Anyone who lives on the rock has family or friends who will put them up at least part of the time. Those who are completely on their own, camp out or squat over the summer months. During the winter months there is an Inn from the Cold type sleep program in various church basements. Since I was there in summer, I only have reports from local social workers to confirm the above. Saskatchewan had a lower percentage of female homeless; I am not sure why that is different. The shelter where I stayed was dry (admission limited to clean & sober clients) and seemed to function as a stepping stone for woman entering a rehab program. If you were not in the rehab program the bed was billed out at $10 per day for a stay up to one month. When I asked the women who lived among the street population where they would sleep, all seemed to have a place of their own. Very often they would invite me to come spend the night with them. These women seem to look out for each other because there is no shelter space and no shelter space is provided because the women look out for each other. Edmonton has a commendable re-housing program for medicals, which is operated by a group called E4C; this likely explains the distinguishable difference in the demographic between Edmonton and Calgary. Though the same provincial government supports were available in both cities, the Calgary Drop-In served as a permanent home for many disabled and mental health clients. Calgary had no specific strategy for moving these people into supported living or group home facilities. At Edmonton’s WEAC (Women’s Emergency Accommodation Centre) women who were on disability were channeled into E4C housing within 4-6 weeks of arrival. Since E4C housing is co-ed, I will assume a similar situation for the male medicals. Also I observed fewer seniors using the shelters in Vancouver due to B.C. government making subsidized housing for 50+ (drunk or not) a priority. I was told by a worker they could get me into B.C. housing within 6 weeks; be aware you do not get to choose the facility in that situation and social housing does have some less desirable buildings.

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Shelters (Sleep Programs) Observations: The main distinction between shelters is whether or not clients are allowed access while under the influence of alcohol or drugs. Shelters that allow the intoxicated (under the influence of drugs or alcohol) have sleep areas designated as harm reduction. I have never seen a shelter exclusively dedicated to harm reduction. All common areas of the building are shared by all populations. Dry shelters which do not allow intoxicated people, do however allow clients in a state of withdrawal, or unmedicated; so the designation of “DRY” in no way reduces the level of chaos felt within the shelter environment. The rules around shelter use, are meant to manage large numbers of people and equally important to provide the necessary “head count” for funding applications to various levels of government. Sign in procedures vary widely from shelter to shelter. In the worst case scenarios (due to limited staffing because of budget concerns) the clients must first stand in line before the doors open (sometimes for more than an hour) to ensure they get a bed. Often these lines are outside the building where anyone driving by might see and recognize a person. Once signed in your movements are restricted to specific areas and specific times. You are required to turn in personal property regardless of any consideration for your ability to manage your behaviour. Your work tools or personally purchased aspirins must all be accessed through the office and often on a limited schedule. Many places do not allow food in the dorm areas, so anything you bring in for yourself is unsecured in a publicly accessed kitchen area, where it is often pilfered by other clients. Other shelters allowed no outside food at all, you eat only what is provided exactly when it is provided. You get up when you are told, leave when you are told (regardless of your mental or physical condition) and are allowed to return when you are told you can return. In most shelters personal property can be searched and seized by staff (something as innocuous as a nail-clipper can be seized as a weapon). This ignores the fact that every chair or pencil can be used as a weapon if someone were so inclined. Initially a client will respond to this situation with resentment, followed by acceptance and over longer periods of time a kind of learned helplessness. Harm Reduction areas, for clients under the influence of drugs or alcohol, are designed more for safety than comfort. Matts placed on the floor or low lying cots prevent serious injury from falling out of bed. As much space as possible is allowed between matts, so the staff or paramedics can respond to client emergencies. Clients’ belongs are kept next to their matt and carried in and out with them each day, only a handful of places provide storage for this group. Bag searches are done regularly; with smaller populations everyone is searched both entering and leaving the facility. 7

Alcohol, drugs and parafinalia are seized and disposed of by staff. Anyone caught in possession of or using these on the premises is automatically barred from services. Often clients will take the risk of over consumption or just sleeping rough (outside) rather than lose their stash. Transient beds are issued on a nightly basis for clients who are clean & sober for today or are just needing a few nights shelter before moving into more stable housing. The smell of body odor and urine which is so prevalent in Harm Reduction is decidedly less conspicuous in transient areas. A little more attention is paid to comfort here, with beds or bunks replacing matts. Clients do NOT have assigned beds; one must line-up and sign in each night and there is some storage available to regular users over the short term. Transitional sleep programs are open to persons who return to the facility clean & sober on a regular basis. The bed is yours until you miss curfew; this varies from 9 p.m. to 12 a.m. depending on the facility. The advantage for the facility of these quasi permanent beds; is the reduction in laundry, sheets need only be changed weekly. You are allowed to leave your property behind during the day and some shelters even have lockers to secure your belongings. This is a great benefit to clients who need to keep appointments with professionals to assist in moving forward out of the shelter and back into the community. Lockers can always be accessed by staff and searched for contraband (a reasonable expectation).

Conclusions: By attempting to service all client populations under one roof we fail to properly serve anyone. The protocols we use to manage large and /or blended populations strips away what little dignity and sense of self may be remaining from people who are already fragile. As a group the current system provides adequately for the barest necessities, supervised and relatively safe places to sleep (spend the night). For the individual client having to stand on public display (possibly in their hometown) is demeaning. There is a loss of autonomy within this tightly controlled environment, to the point where one starts to wonder if they even remember “how” to make a decision for themselves. Uncertainty about the disposition (drunk/ sober/ crazy/ sane/ healthy/ sick) of other the clients, causes people in sleep programs to isolate. This adds to the growing feeling of invisibility; which quickly erodes a person’s ability to reintegrate into society. Unlike in the military where the stripping of the individual’s identity is replaced with the brotherhood of the corps; we have no system for replacing the client’s lost identity with something better.

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Recommendations: The easiest recommendation to implement would be separating the populations. Many sleep programs already separate the intoxicated clients for the safety reasons as given above. Separation within the other population groups is of far greater concern when it comes to the delivery of reintegration services. Transitional clients should be housed in an entirely different facility; which would provide extended stays 6+ months and a focus on reintegration services. Elimination of the line-up check-in process would be of benefit to clients from a mental health standpoint. Each agency would have to determine what would work best for it depending on several variables, like size of population, number of staff, space etc. I would suggest designating a time (say the 2 hours prior to dorm opening) when clients could walk-in and sign-up for a bed. Anyone not claiming their bed within 1-hour of dorm opening will be bumped. Anyone showing up intoxicated to claim their bed can be refused for the night, at the discretion of the staff. Exception would have to be made for people whose employment prevented them from attending early sign-in. Day labourers could phone-in their signup and confirm with a copy of their work ticket (employed should have a pay-stub on file with the shelter) when they present to claim their bed. Think of eliminating these humiliating line-ups as “harm reduction” for our sober clients. Government funding for shelter sleep programs needs to change, these programs should be funded by the bed… NOT by the head. This change would result in more stable funding for the agencies from one year to the next. It would also encourage greater collaboration between agencies which would allow for the employment of a diversified shelter model where the various populations are sheltered in different locations. Again, this change would reduce psychological damage and speed up reintegration of the homeless (poor). Also every single effort must be made to keep people housed. Provincial social service agencies should NEVER tell someone to stay at a shelter because it is going to take 2 months to process their request for social assistance. This is an emergency situation and emergency protocols must be created to reduce the incidents of poverty induced homelessness in this country.

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Meal Programs (Free Food) Observations: Meal programs vary widely depending on the source, but generally a person living homeless in Canada can expect meals to be very high in carbohydrate fillers, usually pasta, rice and potatoes in that order. Meat protein is included in very small quantities and is often of questionable origin (just meaning unrecognizable by sight or taste). There is equally limited access to the fiber provided by fresh vegetables or fruit. Grains are accessed through the use of day old (or 3 day old) bread products served dry (unbuttered). The least nutritious meals were provided at centres which serve multiple meals per day to a large client base. Such programs rely heavily on donated food which varies widely both in quantity and quality. There are also storage issues, as well as the problem of anticipating the number of meals that will be needed from one day to the next. In these situations it is easier to grind up 100 lbs of pork into a pasta dish then it is to fry 400 pork cutlets. In an effort to prevent any waste all leftover meat is chopped or dumped together into a soup, which provides endless lunchtime entertainment (speculation) for our clients. Next up the culinary food chain are facilities providing one meal per day or in some cases per week. This is often done by churches or benevolent societies. They do it once and generally provide more nutritionally balance meals. Breakfast programs will include cereal with milk and/or egg in some form, toast, juice and or a piece of fruit and coffee. Lunch programs are where we see the term soup kitchen applied seriously. Low sodium soup served with a half sandwich or buttered roll/bread and juice (this term is applied loosely and includes powdered drink mixes) but the best places offer milk as an option. Dinner has an identifiable meat source and a couple of times a week you might even need to employ a plastic knife. Potatoes show up more often here, there will be a side of vegetables, the occasional wilty salad and from time to time even condiments. In other words, something a little closer to what you would call a “home cooked” meal. Some very good meals for the homeless were delivered at the smaller shelters, these were available only to people who were staying in their sleep programs. The Lookout shelter in Vancouver served three meals a day, to two seatings of 60 people each. The meals were always well balanced and nutritious with fresh fruit, cereal, milk and juice in the mornings; salad with lunch and meat with dinner. This residents only policy is an acceptable restriction in Vancouver or Edmonton where there are several other options for the homeless (and community poor) to access meals. Calgary has few options outside of the Calgary Drop-In, so their meal programs must be open to the entire community. 10

Meal Programs (Low Cost Food) Observations: I only found this service in the DTES (down town east side of Vancouver) but it is a model worth looking at for other agencies. The Carnegie Centre is a community centre on the corner of Hastings and Main. They have a cafeteria style restaurant where they sell $2 - $3 “blue plate specials” and low cost accompaniments (sides, desserts, beverages). The best run of the cheap meal programs is provided by the Evelyn Saller Centre on Alexander St in the DTES “The 44” as it is popularly know, serves three meals a day at a mere $2 per meal. That is all inclusive… and meals are usually well balanced. Menus are posted weekly on the door and except for the frequent swapping out of rice for potatoes, things are usually as they were predicted. Meals can be purchased individually for cash or in bulk at the beginning of the month. Under some circumstances people receiving income support can have a monthly meal card issued through the area Social Assistance office. The pre-purchased meals are listed in a ledger which is kept at the cash register and marked off as used.

Meal Programs (over-all) Conclusion: I met a worker in Regina who plans to do her thesis on Nutrition and Homelessness. I would be very interested in reading her report of findings. When I was doing my research I developed a problem with my ligaments, as well as severe weight gain, and dangerously low iron and vitamin D levels. My doctor in Ontario had me on several supplements for over a year in an effort to recover my health. On the plus side for street people the high carb diet provides quickly accessed energy stores for a lifestyle which often sees them going days without food; a fact which was pointed out to me by a former street person. Cities with multiple sources of free food, especially agencies/churches providing one meal per day or week provide clients with access to better nutrition over all. A single source for multiple meals, while convenient, struggles with the cost of providing meat protein and/or fresh produce. This also removes the need for clients to get out and do a little walking between meals, which is for some their only source of exercise. Edmonton had an excellent network of meal providers, all within a 6 block radius of Bissell Drop-In Centre on Boyle Street.

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Recommendations: Everyone is doing the best they can with what they have to work with. My only suggestion is that, agencies could communicate with each other to ensure all days are covered with a couple of options for each meal. In Regina, women had 0- Breakfasts… 3- Lunches & 5- dinners per week; with a co-ed Sunday meal at the Marion Centre which normally only caters to males (3 meals per day, 7 days per week). Wholistic shelters which provide meals and sleep programs need to create some late day meal options for residents who work late and cannot report for regular meal times. It would also be a good idea if sleep programs could make multi-vitamins available to clients who might be interested in dietary supplements.

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Skills Development & Education: Observations: As I explained in demographic about 50% of shelter residents are homeless due to poverty issues. When the working poor are between jobs or are employed in low income service industry positions it is impossible to have emergency funds put away (this group is often paying 60%-70% of their income for housing. This situation, in combination with a personal crisis (accident, injury or divorce) can easily cause one to be displaced from their home. These are, our transitional clients and the best candidates for skills training and upgrading. The DI (Calgary Drop-In) is the only shelter I have found offering all levels of these services in house. Most shelters work in conjunction with other agencies and programs. Given the wide variety of needs it is understandable that most client care providers do not offer job skills training. Drop-In centres are often good sources for basic needs in the area of job search. Many have literacy programs run by volunteers; given that 20% of Canadians are functionally illiterate this should be seen as an essential service. Also tutoring is offered in resume writing and job search, these are usually managed by an employment counselor working for the centre. Most cities have some kind of “Dress for Success” program which provides free wardrobe options for interview situations or re-entering the workplace. Some even offer self awareness programs, personality testing and such to help clients who (through illness, injury or just economic shift) are forced to rethink their life plan including employment options. Much can and is being done for clients wanting to re-enter the workforce. Some shelters which designate themselves as “transitional” have these programs mandatory for clients. This is a great thing for the working poor clients who seemed to respond well the encouragement and guidance. However, medicals and street people found the system burdensome and intimidating to the point of driving them out of the shelter for brief periods of time into less safe environments (squats or outside). Many able-bodied homeless and street people choose to work day labour, earning between $40 - $80 for 6 hr to12 hr shifts. Some of these agencies are reputable and honest, matching workers with companies for a reasonable percentage of the hourly wage. They screen employers and employees so that all parties are satisfied with the result. Unfortunately this industry is rife with exploitation, with some agencies taking as much as 50% of the hourly wage while providing little or no assurance to the workers.

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The good agencies have a regular base of workers so it is difficult for a new face to catch-out (get chosen for a job assignment). The Calgary Drop-In and the Bissell Centre in Alberta both run a day labour office on site in the mornings, this a real benefit to clients and can result in ongoing employment if the fit is right. This is a good option for street people because it provides ready cash, when you are feeling up to it, without any ongoing commitment to an employer. Many working poor have to resort to day labour, because no resources are in place to provide for their basic needs (meals, transportation, cigarettes) in those first 2-3 weeks before the first paycheck arrives from regular fulltime employment.

Conclusions: Unfortunately shelters which designate as transitional also house people who are nowhere near ready to move forward with their lives. Their failure to comply will result in conflict with staff and having them barred or boycotting the one safe shelter a city may have. Again this is where the diversified shelter model would be of benefit. Acquiring a forklift ticket (or any other accreditation) does not insure a person will use it. As the shelter environment erodes a person’s self-esteem, it also erodes their sense of purpose and direction. Having the tools (academic or real) to build a better life, does not make a man believe he deserves a better life. The psychological factor cannot be ignored if we are to have successful reintegration of clients into the community.

Recommendations: It would be great if every shelter/drop-in ran its own day labour program. If, I haven’t said it before… separate the client populations. For this particular matter the benefits would be better concentration of services and staff. Clients could be assessed and served based on their individual needs. I would also recommend that every client care worker be knowledgeable about the services, training and education options offered through other agencies and the various levels of government. Also funding should be set aside to provide for people who are beginning permanent fulltime employment. A daily stipend and flexibility in shelter protocols to allow access to food and accommodations appropriate to the person’s work schedule.

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Recreation Programs Observations: This is an area which varies widely from place to place and definitely reflects the commitment of an agency to the advancement of the client population. Many drop-in programs have staff assigned specifically to develop recreational programs and activities for clients; recognizing that these kinds of programs positively impact esteem building and/or social investedness (feeling of belonging to the community as a whole) for individual clients. Edmonton and DTES Vancouver have the support of the community for developing events and programs. So there is a (comparatively) rich assortment of cultural experience for clients who have an interest. More often the success or failure of a program depends on the enthusiasm of the individual worker hired as recreation director. The Calgary Drop-In has many arts programs (visual, theatre, music etc), all conducted from in house. A few years ago, Calgary fielded a team to attend the World Cup of Homeless Soccer and to the best of my knowledge all of the men involved in the soccer program, were off the streets within a year. The Bissell Centre in Edmonton has programs running everyday and also they acquire tickets to special events (rock concerts etc). Also the City of Edmonton issues passes to shelter residents for free access to all city owned venues. My very favourite thing is the Bissell’s summer camp; (which I think is a bit underutilized) but an excellent venue for everyone who gets the opportunity to experience it. In Hamilton I saw little interest on the part of the drop-ins regarding the value of recreational activities. A pick-up game of baseball on Saturday in the summer, the accompanying B-B-Q is likely the bigger draw. A well intentioned volunteer brings newsprint and a tackle box full of worn out oil pastels (grown-up crayons) to the Saturday afternoon art program at the Wesley. No instruction is offered, he barely engages the clients in conversation about their work. This tells me he is providing the supplies himself without being underwritten by the agency. The city of Hamilton offers more free activities to its citizens than any other city I have ever been in; which could be the reason local agencies don’t feel the need to step up. Again, there is the self-esteem issue which make clients reluctant to mix with civilians (general population), so in a real sense these programs are inaccessible to the homeless.

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Conclusions: The area of recreation is under-valued. If we want to fully integrate our homeless population into the community this area must be explored fully and considered an intrical part of their experiential development. The individual’s identity is eroded by every aspect of the shelter/homeless experience. Artistic and recreational pursuits allow for the client to have self-expression, the choice of activity is entirely up to the individual. When an activity takes place may be dictated by the agency, but how the client expresses their vision and participates is very personal. This thread of individuality can be an anchor to the person they once were or the person they wish to become.

Recommendations: I believe the value of recreational programs to be even greater then job training and must be given priority in budgeting decisions. Arts, crafts and athletics allow clients to get (or stay) in touch with their individuality. Also there is something timeless and communal about art, rich or poor you can appreciate beauty and the joy of creating that beauty. In an environment which strips people of their autonomy, these small opportunities for self expression are essential to personal development.

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Counseling Services Observations: Counseling in the shelter environment should not be confused with therapy; this is more the role of “guidance” counselors. Therapy as such is delivered through peer support groups facilitated by staff counselors and/or esteem building programs (arts, sports, culture, etc). Counselors work with the clients to advise them on actions which will facilitate in acquiring stable housing and employment. They assist clients with obtaining (or retaining) applicable income support from government sources. In some provinces this is how the shelters are funded. Welfare checks are sent directly to the shelter and the client is given a stipend ($1-$4 per day) for personal expenses. In Nova Scotia, every client is required to sign up for social assistance which then pays the shelter $93 per day for that person’s care; in Saskatchewan that payment is $63 per day. In shelters which designate themselves as “harm reduction” the counselor just makes his/her presence known and patiently waits for someone to darken the office doorway. Recovery from addiction cannot be mandated, only supported. In this environment counselors primarily mediate disputes between the client and management or advocate for clients with outside agencies. They make sure clients attend medical appointments and monitor prescription refills. These counselors act as ombudsman while building trust relationships with their clients. In shelters focusing on transition, the role of the counselor is more proactive. The counselor has weekly meetings with each client to update what (if any) progress is being made toward re-establishing independence and a return to the community. The counselor will recommend a course of action for each week… but it is left up to the client to take the initiative to make and keep any appointments discussed. The counselor in all cases must keep detailed records of interactions and recommendation for future action with his/her clients. This is necessary because of movement and/or staff changes.

Conclusions: This is another area which would benefit from use of a diversified approach to sheltering. Transitional clients (homeless) staying in shelters with a harm reduction mandate, have low expectations regarding the interest and expertise which they can expect from the counselors there. Conversely, street people feel intimidated and bullied (not motivated) by the ongoing involvement of counselors under the mandate of transitional shelters.

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Recommendations: Since we are not working under a diversified shelter system, this is what I suggest we can do immediately to improve the effectiveness of counseling/counselors in the shelters. First, counselors need to get to know the client population as individuals; this can be best accomplished by spending an hour or so each day out of the office observing and even chatting informally with them. What you will learn through these interactions will help you tailor your approach to each client’s capacity and needs. The working poor are best served by being quickly re-housed, street people may not be ready or able to sustain housing. With the addict/alcoholic population counselors need to look for forward movement. Notice little things like longer periods of sobriety (1 day becoming 2 days) or an interest (however fleeting) in an activity which can be encouraged. Interagency co-operation is essential for moving clients forward (this is something I noticed in Vancouver’s DTES). Many clients do not advocate well on their own behalf. The newly homeless do not “know the ropes” or understand how the system works or what to expect, it is for, the counselor to help them navigate and get optimal results. Over time the street people accept their invisibility and give-up on themselves and the system, or they often become unreasonably demanding, again it is for the counselor to explain how things work; why it is, as it is and how they can get the best possible result for their particular needs. Having contacts within other agencies facilitates both a counselor’s understanding of that agency’s function and capacity, as well as improving the counselor’s ability to smooth interaction between outside agencies and clients.

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Outreach Services Observations: Any time services are taken to the client, it is out reaching. So the counselor, who shuts the office door and spends an hour just chatting up clients in the common room, is outreaching. Any client support worker, who takes the time to get to know the client as an individual, is outreaching. By the current industry definition, outreach covers any activity which takes place outside the agencies’ offices or program centres. The larger centres have “safe works” vans which distribute condoms, clean needles &/or rigs; pretty much anything the drug addict or sex-trade worker needs to minimize their health risks. These run predominately after 7 pm when agencies and drop-ins are closed. Some agencies send out teams to search for people sleeping “rough” in alleys, parks and doorways. First priority is to try to talk them into moving into a shelter…failing that they will drop off water, sandwiches and/or blankets. This is also done by church groups and benevolent societies and various clubs. Up close interaction with street people is always a good gratitude building exercise for the "everyman". One shelter has refurbished (name painted on the door) an ambulance for outreaching. This is used to transport clients to the shelter once they have been clear by paramedics after an ambulance call. Often a client will refuse to go to the hospital against the recommendations of the paramedics; so the client is transferred to the custody of shelter staff. These staff are often perceived by clients as less authoritarian than uniformed city employees, resulting in a more compliance and willingness to be moved to inside.

Conclusions: Given the large number of clients with varying degrees of mental health challenges these outreach services are essential to their survival. These services are in no way redundant to in house services, these services provide for clients who cannot or will not access in house programs. You cannot help someone if they are dead. By outreaching, we not only feed people but we create an opportunity to build trust relationships with individual clients and the street population in general.

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Recommendations: Keep up the good work and if your shelter doesn’t have an outreach affiliation find or create one. The interactions an outreach staff has with clients, provides a rare opportunity to build the kind of trust relationships that are the foundation for moving people forward in their lives. The first step is acceptance, no judgment, no directions, no intrusive questions (yet). Introduce yourself, learn that client’s name, use it and remember it for next time you see them (if you can do this for one client a week you are doing great). Do not question or challenge what they tell you. If he says he is Napoleon, just smile say nice to meet you Napoleon; then until he tells you otherwise, just call him Napoleon. The next step is to make a little small talk; share something about your day, then let him/her share something with you. Every interaction has value, for this one moment she/he is not invisible.

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Management / Staff Relations Observations: This is a very important consideration because it directly impacts on client care. Under paid, under-appreciated employees will put in the hours but will never put their hearts into their work. The shelter industry suffers from a shortage of funds (there is always more need, than dollars) and the people who go into human services truly want to “make a difference”, unfortunately this leaves them vulnerable to exploitation. The worst offenders when it comes to pay/benefits/hours are often the religious based shelters. Paying minimum wage, part-time hours (no benefits) and erratically placed on-call, short shifts; leave staff frustrated and resentful. Clients cannot build any kind of real trust relationship with the staff because in a few short months each has moved on; not because they don’t love the work or their clients, simply because they also need to eat and pay rent. Another issue is the use of too many unenforceable rules. Perhaps it is fear of litigation or the need to exert control over a generally chaotic environment (probably a combination of both). A couple of places had a flat out “NO TOUCHING POLICY”. This policy meant that a young woman passed out on the floor was dragged to the dorm by her equally drunk cousin, who fell down twice in the attempt. It meant that staff could not intercede in altercations, and police were being called in for minor skirmishes; which created a lot of resentment between the Ottawa Police and the Shepherds of Good Hope. The no touch policy left staff feeling vulnerable; when a client became confrontational staff would all retreat to the front office and someone would try to talk her down through the Plexiglas. Failing that, once again the police would be called. This was by no means the only shelter with a no touch policy but it is by far the worst case scenario because we are talking about hundreds of clients. Even in less volatile situations a no touch policy only prevents good touching (a pat on the back, a supportive hug or a reassuring hand squeeze) it does not stop clients from assaulting each other or staff. Another widely used and misguided rule is the, “NO fraternization” rule. Any contact between clients and staff outside of the work environment is forbidden (not merely discouraged) and can result in dismissal. I have known many good, compassionate people who lost their jobs for acts of kindness and support given outside the parameters of their job. A worker in Hamilton was fired for giving a ride to a client who was walking to the shelter on a rainy night. The shelter management sites liability issues. What if the staff was attacked by the client? What if there was an accident?

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What if the client imagined (or was) sexually harassed? There is, under the law, a level of culpability (personal responsibility for risk) assumed by both driver and passenger. Clearly that particular employee felt safe with that particular client and was willing to assume responsibility for that decision. These types of situations should not be subject to anything beyond the “Be prepared to justify your actions” rule, unique situations like this need to be addressed individually as they come up.

These kinds of imagined, “what if?” scenarios are the excuse for much of the wrong-headed unenforceable rules which plague the system. Essentially the more rules an organization has, the less your staff feels trusted and supported by management. Agencies adopting the more flexible Policies & Procedures approach had better relationships with their staff. The staff, in turn were more effective with clients, because they could tailor their interactions to the clients’ individual needs.

Conclusions: Agencies that have Policies & Procedures instead of Rules & Regulations have better management / staff relations and promote better client outcomes. Any money saved by underpaying your staff must be offset against the ongoing cost of training their replacements.

Recommendations: First let me make the following suggestions regarding compensation, hours, shifts and benefits. Pay your people a decent starting wage for your region. If there are no other shelters (or similar human service support agencies) then; what do bank tellers make to start, or what do new hires with the construction industry make? Adjust compensation for education and experience (which would include small annual increases). If a staffer is not productive get rid of them quickly; you cannot train lazy, selfish or arrogant out of a person. Let them go before their seniority (for unionized shops) saddles you with this dead wood forever. These types of people are a burden to fellow workers and damage the moral of the whole team.

Anyone, who is productive enough to keep on the job; is productive enough to deserve an annual raise in their wages. For part-time staff, give them stable hours on a specified schedule, this will allow them to get a second part-time job so they can continue to work for you until you have an opening for them full-time. Know your employees; hire good people, then get out of the way and them to do their job. If you are a large organization then know your management and trust them to do their jobs; including taking responsibility for the staff on their team. A happy staff is a productive staff and nothing makes a person happier than a workplace where they are treated with respect. Now regarding this issue of un-enforceable rules; you cannot hope to cover every possible contingency, so stop trying. The best RULE I was ever given was, “never do anything you are not prepared to justify”. This was a great rule because I could not act impulsively when following that rule. Another great RULE is to always “Always err on the side of compassion.” 22

Here are a few suggestions around fraternization; zero tolerance for counselor/ client romantic or sexual interactions. Notice I said counselor not staff, the reason for this is that some agencies are so large that many clients and staff have little or no professional interaction. Those situations need to be addressed individually. I strongly recommend never getting involved with anyone from your workplace (staff or client) just complicates things. Another RULE would be zero tolerance for racism, sexism, any of the isms, homophobia, and bullying in any form. That applies to every dynamic; shelters (as the name implies) need to be safe nurturing environments, where everyone is treated with kindness and/or respect.

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Staff / Client Relations Observations: The staff / client relationship begins from a place of mistrust. It does not matter how welcoming, friendly and pleasant a staffer may be, their motives are immediately assumed questionable because they are staff. Clients had more respect for the staff who presented with integrity. They seemed to need to know what to expect from individual staff, the meanest S.O.B. in the building or Mary Poppins either would be respected if he/she always responded with consistency and fairness. Whether staff was being lenient or tough was not as important as treating everyone the equally. I found staff often had unrealistic expectations for client behaviour, beyond what they would expect from anyone in a regular world environment. Don’t use curse words, don’t be cranky when staff wakes you up, don’t bicker with other residents and don’t intentionally or unintentionally break a rule. Clients are just people and what is reasonable behaviour in any household is the kind of behaviour I witnessed in the shelters. Street people, form family dynamics which substitute for having an actual home and family. As a result clients play into those roles which evolve from several factors including age, gender and emotional maturity. A sixty year old may be being parented by a 20 year old, siblings will squabble, what appears as bulling may be parenting; being aware of these dynamics can explain many interactions, allowing for more realistic expectations by staff. The most striking observation for me was how the architecture of a building impacts staff /client relations. The most significant interactions between clients and staff come from casual encounters. Shelters with open common areas (drop-in style environments) where staff could join the clients for cards, crafts or just a cup of coffee; foster better interactions then the T.V. sitting room environment. In many shelters the staffers are relegated to bull-pen style reception area buffering a small bank of offices. This style proved to be quite workable, but required a few considerations be given to accessibility and traffic flow. The Lookout Shelter in Vancouver B.C. had an L-shaped counter separating staff from clients but, the isle in front of the counter was wide enough that people could easily pass by when a client stopped at the desk to engage in a conversation with staff. It was a very effective system for a facility with no common (conversational) areas. A similar bull-pen situation existed at Shepherds of Good Hope in Ottawa with the addition of counter to ceiling Plexiglas, the barrier could have been made of brick and been no more effective in alienating and dividing staff and clients.

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I never witnessed any inappropriate interaction between staff and clients, but of course if it was inappropriate, the people involved would have taken measures to keep it secret. As a client I was privy to confessions of undue attachment by clients toward an individual staff person. On these occasions I would caution the client that they were misreading the staff person’s intention.

Conclusions: It would be my conclusion that more attention should paid to facilitating interactions between frontline staff and clients. Frontline staff has the most contact with clients and properly trained can be a great asset in monitoring changes in client behaviour as well as encouraging forward action for individual clients.

Recommendations: First when purchasing, renting or renovating a space… paramount consideration should be as to how it will facilitate or block staff / client interaction. If your staff feels the need to protect themselves behind Plexiglas, they need to find a new line of work. The best protection you will ever have is a good relationship with the clients. That is not to say that there should not be a safety zone of some sort where staff could retreat to, in the unlikely event of a riot (probably triggered by a comet hitting the building). Truthfully a well trained staff will be able to de-escalate and resolve any incident long before it reaches a crisis level. Proper training is a difficult issue to address. Degrees (book learnin’ as my granny called it) are very important, but street smarts (experiential learning) are also important, knowing the culture you are working with and respecting those norms will gain you the respect you need to encourage a client to move forward. The best staff you can hope for are both street smart and book smart. Requiring a former “street-person” to acquire certification in counseling or social work before taking a position in client care, provides the best staffing option; equally a book smart kid needs the benefit of situational training by experienced staff. Who should be a mentor; is a matter of their relationship with the clients, NOT YEARS of SERVICE; many long time employees would be best suited to the role of security guards. I am not certain that, “How to choose staff mentors” falls under the scope of this paper, so until advised otherwise I will end here. Every staff person working with vulnerable clients needs to ensure that they and the client are clear as to the nature and scope of their relationship. Misunderstandings will cause confusion, humiliation and setbacks for these already vulnerable people. This is the only boundary issue any worker has; we do not need to worry about gossip or someone else’s idea of boundaries. If your client is clear on where your professional interest begins and ends…he/she will only grow from your support and commitment. 25

Summary Anyone who tells you that they can eradicate homelessness is deluding themselves. There will always be street people; those among us whose addictions outweigh any other consideration in their lives; a perfect society will build communities with room for everyone, even street people. It is however possible to reduce homelessness by 70% through affordable home ownership initiatives for the 50% working poor and supportive housing programs for the 20% with medical issues. Priority needs to be given to keeping medicals and working poor in the homes they have. As for the shelter industry, the single most important step is the diversification of shelters and services. Within 24 hours of checking into a shelter the person should be assessed as medical needs or poverty (working poor) or addicted (street person). Then the subject should be immediately channeled into a separate facility with protocols and staffing specific to their needs. For large organization like the Calgary Drop-In, or Shepherds of Good Hope, it would involve a repurposing of the facilities which are already owned by them, much like Victoria Cool Aid has done with their housing model. Smaller organizations need a co-operative series of programs with each agency providing service to different groups. To achieve this kind of collaboration funding models would have to change to remove competition between agencies. I recommend funding by the BED not by the head which is our current practice. This new found financial stability would allow agencies to focus on outcomes appropriate to their mandate. Diversification must exist in all parts of the shelter’s mandate and staffing. A transitional shelter should focus on skills training and reintegration services, psychological supports, guidance and encouragement in a structured environment. Autonomy and self-care (personal responsibility) must be reenforced in all areas of the clients functioning. Staffing transitional shelters with specialists during daytime (program hours) would be optimal and night staff would be simply custodial to deal with any situations that may arise. Facilities functioning as Refuge Shelters would require a high level of vigilance and control over client behaviours. All medications must be dispensed by staff. Searches would need to be done entering or leaving the building. We would need to enforce zero tolerance for drugs & alcohol or weapons; whatever is necessary to prevent harm coming to any client. These are people trying to take a break from addiction or prostitution or just hiding from a threat real or imagined. There should be no requirement that they intend to move forward from this place. 26

Refuge Shelters provide clients with a safe place to recoup and rethink. Staffing here should be done by generalists; staff who can be teachers, counselors, nurses, referees and bouncers, whatever the situation requires. With recovering addicts in either Refuge or Transitional shelters depending on their progress, Harm Reduction shelters can be less structured. No alcohol/drugs on site, is a necessary rule only because clients will fight over such things. It might be a good policy (in winter at least) to bag and tag anything seized and return to the client in the morning. I say this because we don’t want anyone to freeze to death protecting their bottle/stash or possibly get alcohol poisoning trying to finish it off before entering the premises. Again these facilities need to be staffed by generalists with priority given to skilled referees, nurses, bouncers and counselors in that order. When a street person wants to share or seek guidance they cannot wait to see the counselor (when an appointment is available) they live in this moment. If in this moment they want to make a connection; we have to provide staff that can make that connection. Trust is hard won in this population and limiting the ability of staff to build on trust relationships, means opportunity lost. True we will always have street people but it doesn’t have to be a lifelong condition due to neglect. I know many recovered addicts and most of them recovered because they connected with someone (usually an adult care worker or volunteer) who could see past the addictions to the person. The diversified housing model also would allow for better nutritional options specific to each groups needs. Transitional clients should be taking responsibility for all functions; shopping, preparing meals, cleaning and maintenance in accordance with their ability and under staff supervision. Refuge shelters would need to provide well balanced highly nutritious meals and snacks. Fresh fruit, fresh vegetables and meat protein are in limited supply at soup kitchens. So for the short time we have someone in a refuge shelter we need to do what we can to restore their health. The current soup kitchen fare is actual nutritionally acceptable for street people. The high carb diet provide the energy store necessary to go days without eating while binge drinking or on a crack run. Needless to say Drop-in programs are not affected by the need for diversification. Job search, literacy and life skills training are important but it won’t change anything until that person believes they deserve a better life. It is important to provide esteem building and self awareness programming.

I hear what you are thinking…BUT HOW DO WE FUND ALL THIS? Short answer, is by making better use of the money you have. Working backwards through this summery… 27

Drop-Ins need make better use of their volunteers. Staff supervision is not required for volunteers beyond once to train and one more time to view them in action. Allow volunteers to do more then fold sheets and hand out shampoo. Our Place (transitional housing and drop-in facility) in Victoria is run with 50 staff and over 300 volunteers. I can’t begin to list the number of different programs I could provide for clients with my life experience, skills and training. Allow a volunteer, who has raised her children into happy healthy adulthood to teach parenting or infant care, billions of babies survived mothers who were not trained by a registered nurse. Let people who have lived come into your agencies to teach life skills. You have a wealth of knowledge floating around in the form of middle-aged retirees. All of whom have the time and a willingness to share their gifts. Under the diversified model transitional and refuge client would receive at least 2 meals in-house. Because the need is finite it will be easier to solicit donations of food from local grocers, farmers and businesses. Start a recognition campaign; issue bumper stickers and window tags to the businesses that support you (the effect of this is they will want to live up to their new reputation for generosity); ongoing support gets you an annual certificate as a gold or platinum supporter. Brainstorm your own campaign. Under the diversified model staffing levels would be reduced. Transitional shelters would require less client supervision and administration. Clients are responsible for cooking, cleaning and maintenance. Staff only needs to supervise and handle minor emergencies. In refuge shelters slightly higher staff client ratio is required because the potential for a medical emergency is slightly higher with this group and they are not invested enough to participate in cooking, cleaning etc. The harm reduction facilities need the highest level of staffing because of the unpredictable nature of client reactions and behaviour. Optimum numbers would be 1/6 but no less than 1/10 with 2 staff to any position (building location) at any time. I have found most shelters juggling staff and unable to provide adequate coverage for the areas with the greatest need. Reintegration from the current shelter system is not easy. It took me 1 year of medical care and 2 1/2 years to reorient myself, before I had recovered to the point where I could write the final installment this report. The changes I have proposed here would minimize physical and emotional damage for the 70% of non-addicted clients. This in turn would free up resources to help our street people with their recovery and reintegration, when and if they are ready. Affordable housing initiatives are essential to a just society, as is supportive housing for our medicals. Urban planning must afford space for even street people, the cities who are best managing their homeless populations are Edmonton and Vancouver. Look to them as your model for social justice. 28