HOUSING FIRST in Hope, BC Readiness Assessment Prepared for the Hope and Area Transition Society by Jennifer Hawkins [email protected] •Final Report• March 23, 2015 photo courtesy of Ray Daws Table of Contents Table of Contents 2 Executive Summary 4 Report Recommendations Background Hope and the Thunderbird Motel Project 5 5 Hope and Homelessness 5 The Thunderbird Motel Project 6 Methodology 7 Stakeholder Engagement 7 Client Research 8 Community Outreach 8 Findings Community Gaps, Assets & Housing First Fidelity 9 9 Fidelity to Core Housing First Principles 9 Core 1: Immediate Access to Housing with no Pre-readiness Conditions 9 Core 2: Consumer Choice and Self-Determination 11 Core 3: Recovery Orientation 12 Core 4: Individualized and Client-Driven Supports 15 Core 5: Social and Community Integration 17 Recommendations 4 19 Housing First Core Support Team 19 Volunteer Coordination and Training 20 Aboriginal Partnerships and Outreach 20 Additional Staffing 21 Community Outreach and Engagement 22 Capital Project and Future Direction 22 REFERENCES 24 APPENDICES 27 Stakeholder Engagement Report Summary 27 Client Interviews Report Summary 28 Service Provider Report Summary 29 Community Forum Report Summaries 30 Statement on Appendices 36 Executive Summary Something that seems so simple— having a place to sleep at night, receive mail, keep personal goods, cook meals and socialize— provides the foundation from which people live their lives. —Karyn French, BC Partners for Mental Health and Addictions Hope has unique issues with homelessness mainly because of its location and prevailing socioeconomic conditions. That said, Hope has the capacity and potential to sustain an exemplary, best case practice model for the rural adaptation of Housing First (HF). The Thunderbird Motel Project is ahead in practice, employs skilled program operators, and enjoys broad-based community backing.1 However, challenges remain—namely, the creation of a sustainable, crosssystems body of support that will ensure the health and longevity of the program. Report Recommendations • establishment of HF Core Support Team • implementation of formalized volunteer training • procurement of an Aboriginal outreach worker • procurement of additional staffing and system supports • engagement in additional community outreach 1 This support is not universal, and outstanding issues and concerns remain. It will be imperative to maintain communication and dialogue with the community moving forward. 4 Background HOPE AND THE THUNDERBIRD MOTEL PROJECT Hope and Homelessness Hope represents only 2% of the population in the Fraser Valley Regional District; however, it contains an outsized 7.8% of the FVRD’s homeless population (FVRD, 2014; van Wyk, 2015). As the “last stop” between Vancouver and the mountains, and as a town located at the hub of five major highways, Hope attracts a migratory homeless population. It also contains a significant homegrown homeless population., the vulnerability of which is reflected in large part by statistical indicators. Available indicators2 relating to homelessness include low income, housing, serious drug crime, level of education, and mental health. Hope stands higher than the BC average on all indicators: 4.6% of the population receives income assistance (compared to 1.7% province-wide);3 59.2% of Hope’s renters live at a shelter-to-income ratio of more than 30% (compared to 43.4% province-wide); indicators of serious drug-related crime in Hope is 338.3 (compared to 170.3 for BC);4 20.2% of Hope’s residents have not completed high school (compared to 11.1% province-wide); mental health risk indicators for Hope is 8.7 (compared with provincial rate of 4.0). Additionally, Hope has sustained a vacancy rate of less than 2% for several years (CMHC, 2012) Homelessness Vulnerability Indicators Hope BC A - Income assistance B - Percentage of renters with STIR > 30% C - Drug-related crime D - Non-completion of high school E - Mental Health risk indicators A B C D E Source: BC Stats Socioeconomic Profiles 2012 2 There are many triggers and risk factors relating to homelessness; these represent available census data 3 Multiplied by 10 on the chart for better visual comparison alongside other indicators 4 Divided by 10 on the chart for better visual comparison alongside other indicators 5 The Thunderbird Motel Project Despite the vulnerability of these indicators, for a small community, Hope is very much ahead of the game in addressing homelessness. Most rural communities have only implemented emergency services at best (Waegemakers-Schiff, 2014). However, the Hope and Area Transition Society (HATS) piloted a low barrier housing project—the Thunderbird Motel Project —in 2009 that leaned towards Housing First before Housing First was even officially embraced by the federal government. This project has therefore been the central focal point of the following HF readiness analysis. The Thunderbird aims to provide permanent, semiindependent housing for people trapped in chronic homelessness. Residents are not encumbered with any pre-housing readiness conditions (such as sobriety or mental health case management), but the project emphasizes recovery and community integration. It offers 24 units on 3 acres of land, with a communal drop-in centre on site, as well as access to horticultural and other activities. Outreach, intake and case-management are provided through the full-time Homeless Program Coordinator (HPC), Paul Keller. Keller’s position is funded by BC Housing and contracted through HATS. The remainder of this report will indicate both gaps and strengths in the Thunderbird’s embodiment of a Housing First approach; it will also outline steps in moving forward with further HF implementation. I’ve been in a few different shelters, and what you have at the Thunderbird is extraordinary! —Thunderbird resident 6 Methodology Research included both quantitative and qualitative aspects. Primary quantitative data from both past and current Point-in-Time counts, BC Housing stats, BC Stats, and Stats Canada were used to get a statistical picture of homelessness and homeless vulnerability factors in Hope. Additionally, throughout the assessment period, a considerable amount of secondary academic research provided both a baseline for framing the issues and continuing input. The qualitative, exploratory research engaging stakeholders, clients and community members does not offer a scientific assessment of nuanced perspectives and feelings—if it were truly possible to quantify feelings. It rather outlines themes and concerns that emerged from multiple narratives of experiences and opinions. Summaries of reports submitted to HATS and the Housing Task Force are provided as appendices at the end of this report. Stakeholder Engagement Community stakeholder engagement was more exploratory in nature and therefore more qualitative. The researcher began with individual stakeholder interviews based on recommendations and insights from Housing Task Force, HATS, other stakeholders, and academic research. This included stakeholders from the political and business sectors, the volunteer and faith communities, related social service industries (including addictions and mental health) and representatives of other models in the region (including abstinence-based and higher-barrier options). Participants were asked questions such as what their experience had been with low-barrier housing, how they felt that it had worked so far in the community, and what they felt the major issues were that needed addressing. 7 Client Research Client research was also qualitative in nature. The researcher spent time integrating into and participating in day-to-day operations of the Thunderbird in order to get a sense of operational logic, program structure, and general atmosphere. Individual interviews were conducted in order to hear personal narratives and lived experience of clients. Two additional focus groups were held to get client perspective on what they perceived did and did not work about the Thunderbird. These interviews and focus groups were conducted independently of the Homeless Program Coordinator. Community Outreach Community research formed another component in the assessment. This involved both quantitative and qualitative research. The first point of contact was an informal, day-long forum in the Blue Moose Coffee Shop. The purpose was to enter into an initial dialogue with the general community about issues surrounding low barrier housing and homelessness in a way that supported a local business. A survey was provided as an additional way to hear from attendees if they chose. As issues in the Silver Creek residential community began to emerge from community engagement, a second forum was held at the Silver Creek Elementary School to hear from residents regarding their experiences with low barrier housing in the community. However, participants seemed to want answers just as much—if not more—than they wanted to provide input; accordingly, a third forum was held as a Housing First Informational Forum at the Hope Recreation Centre. At this forum, a brief survey was provided at the end of the event to give attendees an opportunity to indicate their general support or opposition to Housing First implementation in the community. 8 Findings COMMUNITY GAPS, ASSETS & HOUSING FIRST FIDELITY Canada has adopted five core philosophical principles that underline its approach to Housing First (Gaetz, 2014; Goering, 2014). The following analysis in relation to these five principles forms the basis for the recommendations in this report. Gaps and assets are discussed throughout. Fidelity to Core Housing First Principles Core 1: Immediate Access to Housing with no Pre-readiness Conditions In not requiring any pre-readiness conditions before accessing housing, the Thunderbird aligns completely with HF philosophy. In spite of this strong fidelity, however, the type of housing offered is not the most common for HF programs and should be discussed here. Because of the priorities of client choice and community integration, scattered-site housing is most often preferred in HF programs (Gaetz, 2014). As a congregate model, the Thunderbird Motel Project is weaker in alignment with a typical HF program framework. This does not, however, preclude fidelity to the theoretical framework, and government policy makers and practitioners recognize that HF programs can look different and still maintain core HF fidelity (Gaetz, 2014). Two things are of note here: 1) a congregate model is most certainly the best option for HF implementation in Hope, despite its lack of consumer housing choice; 2) additional outreach and intake staffing could provide a greater level of choice for placement within existing housing options in the community when available and fitting. This report addresses the second point in its discussion of Core 4 below. 9 Regarding the first point, rural HF implementation often encounters difficulties with a scattered site approach (Waegemakers-Schiff, 2014). Limited rental stock is one concern; additionally, one of the main obstacles is the smaller-town phenomenon of being known, where clients have often “burned bridges” (Forchuk, 2010; Greenberg, Pathways, 2007). A study of homelessness in small BC communities highlighted the difficulties for people with histories of homelessness in finding housing because of their reputations (Greenberg, 2007). Rural communities also find difficulty in achieving efficiencies of scale with scattered-site approaches. The Homeless Outreach Program (HOP) in Hope encountered all these typical rural difficulties before the Thunderbird Project began. Research supports the efficacy of a congregate approach for rural communities. Participants in the At Home/Chez Soi Most of us don’t have family. study5 identified a lack of supportive relationships as key to We’ve left stuff behind. their path to homelessness (Piat, et al., 2012). Congregate This is our family. housing can go a long way in developing a supportive community. —Thunderbird resident In the rural arm of the At Home/Chez Soi study, participants experienced difficulties with the scattered-site approach, so the project implemented a congregate, peer-supported home for those participants that were particularly difficult to house (Aubry, et al, 2014). An additional study of low barrier, supported housing in rural Nova Scotia demonstrated that supports were strengthened through the peer networks that developed through congregate housing (Leviten-Reid, 2014). The congregate model also helps achieve efficiencies of scale. One of British Columbia’s first examples of HF, the Princess Rooms in Vancouver, operated under a congregate model. The operating agency, RainCity Housing, developed formal partnerships with health care and community service providers to bring services to clients (Remund, 2007). This can This is an interesting and exciting family lessen the load of formal support services to belong to. There’s always something delivered through a scattered site approach. going on. … We care for each other. Everything gets resolved, and everyone understands. —Thunderbird resident The congregate model embodied in the Thunderbird revolves around empowerment, responsibility, and social support. It centralizes outreach resources, and it provides immediate 5 Conducted by the Mental Health Commission of Canada, this was the world’s largest trial of Housing First; the final report was released in 2014. 10 housing for those with known histories within the community. In short, a congregate HF model remains the best option for Hope. Core 2: Consumer Choice and Self-Determination Nobody wants to be told what to do. —Thunderbird resident The second HF core involves consumer choice. It does not view formerly homeless people as passive recipients of services that affect change in their lives; rather, services help support and direct, but people themselves have primary agency in their own future trajectories (Parsell, 2014). As discussed above, the Thunderbird is limited in its offering clients choice in terms of housing; however, it has the potential to offer considerable amount of choice in living environment, personal contribution, supports, and personal progression. Paul Keller operates strongly under supportive case-management relationships; his door is open to meet with residents to discuss anything they want or need. Almost every resident interviewed expressed the sentiment that Keller “had their back” and seemed to experience a genuine belief in his concern for their welfare. Clearly, residents interviewed felt empowered to engage with Keller about issues in their lives. Additional opportunities for self-determination A lot of them [service involve communal meetings. On the first Thursday of every providers] just put the time month, residents attend a Resident Meeting where they can air in for the government, they concerns and deal collectively with issues that come up. On the just put the hours in. other Thursdays, residents can choose to attend a Support Not Paul. Meeting. These platforms give residents a chance to provide —Thunderbird resident input to each other and the HPC. That said, client self-determination could be stronger. One of the main obstacles is lack of staffing. Residents repeatedly told the researcher that they desire additional open hours for the the common spaces. Residents live in what most people would 11 consider to be cramped quarters. The common space (aka “Social Cafe”) provides a place to sit together, play pool or music, watch tv, and even cook together. The space is under-utilized because of staffing shortages, and this impacts residents’ quality of life. Currently, the common space is only open from 9:00 am - 3:00 pm MondayThursday, and 9:00 am - 12:00 pm on Fridays. It is completely closed on the evenings and weekends, which is difficult for residents and can even undermine the sense of community that supports the congregate model. A Peer Council or Resident Council with the more invested and longer-term residents could also be a positive step; however, again, a lack of staffing support would impede any implementation of resident input. Additional staffing support would allow the Thunderbird to align more completely with HF Core 2 priority. Core 3: Recovery Orientation A burning question for some in the community seems to be: Does Housing First actually work? By “work,” people seem to mean different things; it depends largely on how one frames the problem. If the problem is homelessness—people not having a home—giving them a home solves this problem. If the problem is addiction, giving people a home will not necessarily entirely “solve” this problem (nor, it must be noted, do abstinence-based programs). However, stable housing has been proven, over and over, to have a strong link with decreased substance use—even if complete rehabilitation remains a working goal (French, 2007; Larimer, 2009; Kertesz, 2009; Gaetz, 2014; Goering, 2014). One American study by the National Institute of Mental Health compared Treatment First (TF) and Housing First (HF) program models for homeless clients (Henwood, 2011). Researchers found that TF providers became consumed with finding housing, where HF providers were able to focus more on treatment. The At Home/Chez Soi Project echoes these findings when it reports that in the midst of daily survival struggles, “shelter becomes the 12 primary concern over and above maintaining health and wellness” (Piat, 2012, 16). So it is safe to assert that providing housing “works” even when people frame the problem differently.6 That said, the level of services has a correlative impact on the recovery orientation of a HF program. At the beginning of the readiness assessment, service provider research in the community of Hope revealed a distinct People here are hurtin’. lack of outreach support in any capacity: police, medical, mental —Thunderbird resident health, or addictions. Community-based supports (such as Read Right Society and Free Rein) are strong, although transportation is an issue (discussed in section 4). Most HF programs operate with Assertive Community Treatment (ACT) or Intensive Case Management (ICM) teams.7 These teams are typically available to clients 24/7, particularly in the first 6 months of the challenging transition from absolute homelessness to being housed. Teams can include physicians and nurses, mental health case managers, addictions outreach workers, harm reduction, peer support, police outreach, and even positions such as home economists, recreation supervisors, or employment development specialists (Gaetz, 2014). At the onset of the research, the Thunderbird had one 35 hour/week outreach position, very little police liaison, no mental health connection, nurse visits once a month or less, bi-weekly harm reduction visits, and no addictions outreach—although an addiction counsellor was available in town on a drop-in basis two times a week. Support levels at the Thunderbird have tended to vary with the changing winds of funding and related program opportunities and has enjoyed, at times, higher levels of surrounding supports. The level of supports at the onset of the readiness assessment were unsustainable for the program but particularly for Housing First implementation. In recent months, HATS has made progress in buttressing the system of collaborative supports surrounding the Thunderbird. Stronger police liaison through the new Staff Sergeant Bruce Anderson, additional volunteer presence8 and community events coordinated by Sue Martin, the 6 As discussed elsewhere, further dialogue on these and surrounding issues needs to go forward in Hope. 7 Policy-makers, academics, and practitioners alike do not expect rural adaptations of HF to have access to the same levels of support as urban models. Creative and/or regional approaches are encouraged. 8 Volunteer presence is a vital link to recovery and a strength in Hope’s community—discussed further in recommendations below. 13 addition of a Serious Addiction Mental Illness (SAMI) worker provided by Fraser Health, and the addition of a temporary, 35 hr/week peer support position for the Thunderbird are all making a difference. Efforts to procure additional staffing and strengthen connections with community supports are ongoing and still very much needed. An additional factor in recovery that has yet to be addressed is nutrition. According to homeless advocate Judy Graves, a preponderance of lived experience, anecdotal evidence, and common sense leads to the conclusion that proper nutrition is a vital component in recovery orientation (Graves, personal correspondence, Feb 10, 2015). It impacts overall physical health, substance use, and one’s frame of mind. The Thunderbird has an orchard, but year-round nutrition remains a working goal. Creative ways of boosting nutrition—either through volunteer presence or formal supports—would make a strong contribution to recovery orientation at the Thunderbird. A last point of note regarding recovery orientation is that the HPC in Hope operates very strongly from the Strengths Perspective developed out of the University of Kansas School of Social Work. This same perspective helped Princess Rooms in Vancouver deal with an incredibly challenging, street entrenched demographic in a congregate setting. Leslie Remund writes: “Instead of focusing on a person’s weaknesses, deficits or ‘issues’ and trying to ‘fix’ them, we focus on their strengths: resiliency, knowledge from past experiences, personal interests, hopes and skills. These strengths are often the same personal resources and talents that have helped the person survive” (Remund, 2007). At the Thunderbird, Keller integrates residents into community life by encouraging home and building maintenance through residents’ application of personal skills and communal sense of This place is the best thing that’s commitment and responsibility. This contributes happened to me in a long, long time. positively to recovery orientation no matter what level —Thunderbird resident of supports surround the Thunderbird. 14 Core 4: Individualized and Client-Driven Supports Aboriginal Engagement: This remains one of the largest gaps in services to the homeless in Hope. Hope is surrounded by several bands, and its population is 16.6% urban Aboriginal— double that of the rest of the province. Additionally, over the past six years, 30% of the HOP clients have been Aboriginal. However, there has been little or no engagement with surrounding bands or any Aboriginal agency or organization. There is no easy blame or solution to this situation, but it needs redressing. In speaking of rural homelessness in the BC addictions and mental illness journal Visions, Greenberg writes, “Situations of homelessness are still rooted in experiences of poverty, colonization and trauma, and there is still the same overrepresentation of First Nations people; landlords still discriminate against First Nations people” (Greenberg, 2007, 11). According to a study in Southern Alberta that looked at reserve-city migration and homelessness in the Aboriginal population, “the need to retain and renew kinship ties is a strong element in urban Aboriginal experiences” (Belanger, 2013). As Hope is surrounded by bands, kinship ties with urban Aboriginal populations are particularly pertinent. At the same time, according to a local First Nations RCMP representative, alienation from reserve communities is also a common experience (Starr, personal correspondence, November 2014). These culturally-specific circumstances are best met with culturally-sensitive practices delivered by Native practitioners. It is simply best practice to have Aboriginal workers supporting Aboriginal people (Greenberg, 2007). One of the main recommendations below is the addition of local, Aboriginal homeless outreach in the community. Clinical Support: HF is designed for chronically homelessness individuals, many or most of whom experience mental illness (Trainor, 2013; Goering, 2014). Mental Health is therefore a vital link for Thunderbird residents. However, the current Mental Health office in Hope does not operate in outreach capacity because of high caseloads (Rosemarie Fabian, personal communication, November 2014). There also seems to exist some (not insurmountable) 15 philosophical differences in approach, as well as some past relational difficulties. This needs renewed outreach and continued connection to build trust in moving forward. The addition of the SAMI outreach worker working 2 days per week in Hope is a hopeful step in the right direction on this issue. Additionally, HATS has been working with managers in Fraser Health to advocate for additional mental health outreach to the Thunderbird. Additional support staff could also potentially help Thunderbird residents access the Mental Health office for appointments. For the most effective HF implementation, Mental Health is a vital link that needs continuing maintenance and care despite difficulties. Regarding general medical care, it has been expressed repeatedly by both residents and service providers that nurse practitioner Sue Lawrence is a highly-valued presence at the Thunderbird. However, her availability is limited—even though she comes at the full capacity in which she is able. Given the distance of the Thunderbird from town, the drop-in clinic would be a greater asset when paired with additional staff presence. Cross-systems advocacy and collaboration would also be an important step in increasing clinical supports. Staff Support: Additional issues related to staffing are discussed throughout this report, but increased staff presence would also improve the client-driven, individualized supports core value. The Thunderbird may not be for everyone—particularly youth or geriatric, high-service needs clients who are at currently at risk of homelessness. Additional staff and case management support could ensure that all available options in the community are engaged, including any scattered site locations. Additionally, staff support would better equip Thunderbird residents to access the robust system of community supports located in-town. Transportation to these services is a problem cited by both Silver Creek residents and Thunderbird residents. It is also one of the most common issues faced by rural communities attempting to support HF (Waegemakers-Schiff, 2014; Leviton-Reid, 2014; Forchuck, 2010). BC Housing provides a van, but its use presents challenges if only one staff member is available on-site. Rent Support: Also in keeping with client-driven supports, the Thunderbird residents need more rent support. The goal of HF programs is that clients do not have a STIR of more than 30% 16 (Gaetz, 2014). Two thirds of Thunderbird residents are eligible for a rental supplement; however, all residents have a STIR of over 30%, many have a STIR of around 60%, and some even have a STIR as high as 80-90%. Donated food and clothes help, as do community services such as the Joshua project and Hope Community Services food bank. But an ease in circumstances of poverty through rent support would help some residents achieve individual goals and further facilitate independence for those who are able. Core 5: Social and Community Integration Overall, the Thunderbird sustains—or has the hopeful potential to sustain—high fidelity to this core philosophical principle. According to the cross-site participant narratives of the At Home/Chez Soi project, stigma and discrimination has been a huge part of participants’ experience (Piat, 2012, 6). The Thunderbird and its residents have most certainly come in for their share of experiences with stigmatization. In the past, Keller and HATS have done a commendable amount of community outreach— testified to by the strong base of support the Thunderbird enjoys. Keller consistently encourages tours and visits from community members, and he has formed strong, positive relationships with the Thunderbird’s immediate neighbours. That said, persistent negative stereotypes—as well as voiced community concerns—need ongoing community engagement to offset the tendency towards stigma and discrimination. It also keeps the door of communication open to address legitimate problems. And these problems do occur. Remund writes that at the Princess Rooms, they routinely encounter problem guests, damage to rooms and buildings, psychosis and aggression or violence (Remund, 2007). In light of this, RainCity Housing has expressed the importance, particularly in the beginning, of recognizing residents’ challenges and remaining tolerant of drug- and trauma-related behaviours (Scott, 2014). This tolerance needs clear policy direction supported by HATS. But it could also use some additional strategy on the backside. The Vivian—another congregate, HF site— implemented a “Good Neighbour Policy” that requires residents to sign a Neighbouring Agreement, negotiated with surrounding neighbours, to ensure a commitment from residents to maintaining positive relationships with the community (Scott, 2014). This approach recognizes that problems do occur, but it commits residents to thinking of their housing in relationship with the wider community. 17 Aside from community engagement, volunteer presence provides a wealth of resources for community integration. Events open to the community and hosted by the Thunderbird have also been a key aspect supporting this core value. Additionally, as previously discussed, the congregate model, along with Keller’s Strength’s Perspective approach, provides substantial support in social integration. An additional aspect of social integration is the ability to pursue a spiritual path in connection with community. The At Home/Chez Soi Moncton Site Final Report highlights this need. Moncton was the only rural area studied in the At Home/Chez Soi project, and the first main theme identified in qualitative interviews with participants was spirituality, which played a fundamental role (Aubry, 2014). During focus groups and interviews, Thunderbird residents repeatedly expressed the desire to Church is like family. either attend weekend religious services in town or have a religious —Thunderbird resident service available at the Thunderbird. This is currently a gap. 18 Recommendations A formidable body of research exists that testifies to the efficacy of Housing First in helping chronically or episodically homeless maintain housing. Furthermore, it appears to work over sustained periods of time (Byrne, 2014). It is also quite apparent that it does this at decreased costs to the community (Hwang, 2011; Kellen, 2010; Gaetz, 2012). However, there is a dearth of research and successful case models for rural implementation of HF philosophies and programs. With proper supports and systems collaboration, the Thunderbird Motel Project could be an exemplary case model for rural implementation of Housing First. Housing First Core Support Team Intensive Case Management or Assertive Community Treatment teams may not be doable in the shorter-term for Hope and area; however, a HF support team is definitely within range. The team would consist of the HOP worker, an RCMP liaison, the current Fraser Health Serious Addictions Mental Illness (SAMI) outreach worker, Aboriginal outreach, an addictions counsellor, a mental health liaison, and a Fraser Health physician or nurse practitioner. Time and experience could add or subtract to the team as needed. The team members would meet regularly and be able to commit to regular visits at the Thunderbird within their capacities. This cross-agency communication and collaboration is absolutely vital in maintaining a positive relationship with the community as well as a strong base of support for the HF program and Thunderbird residents. 19 Volunteer Coordination and Training One of the chief assets in Hope is its vibrant volunteer community. One beautiful example was the gourmet Christmas dinner arranged by Fraser Canyon Hospital Site Director Catherine Weibe and Hope and Area Transition Society Board Member Pat Daws. Families and Thunderbird residents enjoyed a banquet at the Thunderbird together on Christmas Day— something that deeply impressed the residents. The strength of Hope’s volunteer base has already been recognized by a community advisory committee that is currently looking for funds to support a town-wide volunteer coordinator. The HPC does not currently have room in his schedule to be the main point person coordinating all the people willing to volunteer at the Thunderbird; ideally, a town-wide volunteer coordinator would have a strong connection with the Thunderbird. Although volunteers have a lot to contribute, they do need training in order to mitigate any risks involved. It would also benefit HATS to have a policy regarding volunteer presence. The sooner this happens, the better. Skilled and seasoned volunteers, in combination with peer support workers, could potentially have the capacity to offset some of the gaps in available services; however, they would need to be trained and integrated through a clear policy. For example, some residents have talked about having a Friday night game night, and others in the community have been interested in hosting. Also, several residents have mentioned their interest in having a chaplain visit the Thunderbird on Sundays for a song service. Currently, however, the common space is closed during evenings and weekends due to lack of staff. Aboriginal Partnerships and Outreach In accordance with the discussion in Core 4 above, an Aboriginal Homeless Outreach worker would be vital to any HF program in Hope. The position would provide a greater connection to Aboriginal services in surrounding areas. It would also, hopefully, engage those living at risk of homelessness in Hope. Nikki Lamarre, Vice President of the Trails Crossing Friendship Centre 20 in Hope, attests to the fact that many of Hope’s 1300+ urban Aboriginals live at a high risk of homelessness (Lamarre, personal correspondence, Nov. 2014). Again, reserve-town mobility may be a factor here that would most certainly need Aboriginal involvement. Additional Staffing For the HF demographic, one staff member for 30 residents is high risk and unsustainable. The Thunderbird’s distance from town means that shuttling residents to and from services in town takes up a lot of time during the day, and while meaningful connection and relationship-building happen during those drives, it also means that there is even less staff presence at the Thunderbird. Residents repeatedly expressed frustration with “nobody being there” even when the common space was open. Low-barrier service providers, particularly those working with individuals living with a mental illness, express the unified opinion that a congregate setting needs 24/7 staffing—most often with a minimum of two staff. This is most likely not necessary—or doable—for the Thunderbird, although it does attest to the challenges and needs in engaging a HF clientele. The need for 24/7 staff usually comes from operators of a more institutional setting where residents all present the same kinds of challenges. However, because of the nature of BC Housing HOP funding, the HPC position can ensure diversity in resident demographic. According to Keller, this lessens some of the risks and contributes to a more positive community. Judy Graves also echoed this sentiment (Keller & Graves, personal communication, Feb It’s your home, not a hospital. 10, 2015). Sometimes low-barrier housing is so highly staffed, —Thunderbird resident with such high levels of security, that it ends up feeling more like an institution. The solution to homelessness is facilitating homes; residents often expressed their need for a place that felt like a home. The Thunderbird needs more support staff, but not so many and in such a manner that the building feels like another Riverview. Ideally, the Thunderbird would have another 35 hour a week position that could possibly take some weekend or evening hours. During the regular work day, if or when this HF support position was off duty, an intern or other staff could support the regular HPC position. The Aboriginal Outreach position previously mentioned would provide additional support as well. 21 Community Outreach and Engagement If the readiness assessment revealed any one thing about the community of Hope, it was that its residents display a commendable level of support for marginalized populations. In fact, commendable might be an understatement. Compared with other surrounding communities, phenomenal might be a better term. That said, the readiness research also revealed how quickly rumours can start in a small town, and how damaging misinformation can become. It also showed how quickly things can escalate. Furthermore, it showed that an energized and motivated group of people can place these issues at the forefront of community consciousness. People may be passionately misinformed or simply passionately disagree, but nevertheless, these issues can garner a high level of engagement. Given the above realities, it is imperative for service providers to remain engaged with the broader population. Communication, outreach, opportunities for involvement and volunteer service, and collaborative representation with related service providers is essential. In particular, beginning a dialogue—in collaboration with related services providers—regarding addiction, substance use approaches, and available services in the community would be a healthy next step. Another healthy next step would be the consideration of a Neighbouring Agreement as implemented by The Vivian in Vancouver. Capital Project and Future Direction Exploratory efforts towards identifying a potential location for and pathway towards a new, low barrier capital project were largely unfruitful. If such a project would be advantageous for the community of Hope, for HATS as a non-profit agency, and for the at-risk population, it most likely remains a relatively long ways off. Finding adequate and sustainable supports for the Thunderbird is the imperative next step to supporting Housing First in the community. Efforts to purchase the Thunderbird involve careful consideration and assessment. BC Housing has not proved to be as supportive a partner in ownership as initially hoped. 22 Given this situation, as a stop-gap measure until progress is made on finding the most beneficial direction, an appropriate next step should involve municipal support. After the Housing Fist Information Forum, Town Council members must know that these issues are important to Hope’s residents, and the Thunderbird enjoys a high level of community support. Given the fact that the Thunderbird is owned by a private owner yet is providing essential service to the community, it would be entirely appropriate and advisable to ask the municipal government to consider supporting the Thunderbird by re-investing associated tax revenue back into the project. This makes both political and practical sense. When the elements are positively aligned, ‘home’ is a foundation, a base, and a key component of our personal lives. A life in the community is built from home, and after facing the daily challenges of community life it is the place to return and recharge. —Mental Health Commission of Canada 23 REFERENCES Aubry, T., Bourque, J., Volk, J., Leblanc, S., Nolin, D., & Jette, J. (2014). At Home/Chez Soi Project: Moncton Site Final Report. Calgary, AB: Mental Health Commission of Canada. Retrieved from: http://www.mentalhealthcommission.ca Belanger, Y., Weasel Head, G., & Awosoga, O. (2012). Assessing urban Aboriginal housing and homelessness in Canada. Ottawa: National Association of Friendship Centres (NAFC) and the Office of the Federal Interlocutor for Métis and Non-Status Indians (OFI). Ottawa, Ontario. Belanger, Y. D., Weasel Head, G. 2013. Urban Aboriginal homelessness and migration in southern Alberta. Final report prepared for the Alberta Homelessness Research Consortium (AHRC). Edmonton, AB: April 30, 2013. Byrne, T., Fargo, J., Montgomery, A., Munley, E. & Culhane, D. (2014). 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Visions: BC’s mental Health and Addictions Journal. BC Partners for Mental Health and Addictions Information. 4 (1), 4. Gaetz, S. (2012). The real cost of homelessness: Can we save money by doing the right thing? Toronto: Canadian Homelessness Research Network Press. Gaetz, S., Donaldson, J., Richter, T. & Gulliver, T. (2013). The state of homelessness in Canada: 2013. Toronto: Canadian Homelessness Research Network Press. Gaetz, S., Scott, F., & Gulliver, T. (2014). A framework for housing first. In Housing first in Canada: Supporting communities to end homelessness. Toronto: Canadian Homelessness Research Press. 24 Gaetz, S., Gulliver, T. & Richter, T. (2014). The state of homelessness in Canada: 2014. Toronto: The Homeless Hub Press. Goering, P., Veldhuizen, S., Watson, A., Adair, C., Kopp, B., Latimer, E., … Aubry, T. (2014). National At Home/Chez Soi Final Report. Calgary, AB: Mental Health Commission of Canada. Retrieved from: http://www.mentalhealthcommission.ca Greenberg, T. (2007). Pathways into and out of homelessness in small BC communities: Interviews with clients and landlords involved in CMHA BC Division’s homeless/income outreach project. Canadian Mental Health Association, BC Division. Greenberg, T. (2007). Homelessness: Not just an urban phenomenon. Visions: BC’s Mental Health and Addictions Journal. BC Partners for Mental Health and Addictions Information. 4 (1), 10-13. Henwood, B., & Padgett, D. (2011). The role of housing: A comparison of front-line provider views in housing first and traditional programs. Administration and Policy in Mental Health. 38, 77–85. Hulchanski, J., Campsie, P., Chau, S., Hwang, S., Paradis, E. (2011). Introduction: Homelessess what’s in a word? Finding home: Policy options for addressing homelessness in Canada. Toronto: Cities Centre Press. Hwang, S., Weaver, J., Aubry, T. & Hotch, S. (2011). Hospital costs and length of stay among homeless patients admitted to medical, surgical, and psychiatric services. Med Care. 49(4), 350-354. Kellen, A., Freedman, J., Novac, S., Lapointe, L., Marranen, R., & Wong, A. (2010). Homeless and jailed: Jailed and homeless. Toronto, ON: The John Howard Society of Toronto. Kertesz, S., Crouch, K., Milby, J., Cusimano, R. & Schumacher, J. (2009). Housing first for homeless persons with active addiction: Are we overreaching? The Millbank Quarterly. 87, 495-534. Kertesz, S. & Weiner, S. (2009). Housing the chronically homeless: High hopes, complex realities. JAMA. 301(17). Larimer, M., Malone, D.K., Garner, M.D, et al. (2009). Health care and public service use and costs before and after provision of housing for chronically homeless persons with severe alcohol problems. JAMA. 301(3). Leviten-Reid, C.; Johnson, P. & Miller, M. (2014). Supported housing in a small community: Effects on consumers, suggestions for change. Canadian Journal of Community Mental Health. 33 (3), 57-69. Mercier, Jon (2007). “Life on the Streets.” Visions: BC’s Mental Health and Addictions Journal. BC Partners for Mental Health and Addictions Information. 4 (1), 15. Parsell, C.; Tomaszewski, W. & Phillips, R. (2014). Exiting unsheltered homelessness and sustaining housing: A human agency perspective. Social Service Review. 88 (2), 295-321. 25 Patrick, C. (2014). Aboriginal homelessness in Canada: A literature review. Toronto: Canadian Homelessness Research Network Press. Piat, M;, Polvere, L.; Townley, G.; Nelson, G.; Macnaughton, E.; Egalite, N.; Goering, P. (2012). Baseline consumer narratives of lived experience of the Mental Health Commission of Canada’s At Home/Chez Soi Project: Cross-site report. Calgary, AB: Mental Health Commission of Canada. Remund, L. (2007). Housing first—The Triage experience. Visions: BC’s Mental Health and Addictions Journal. BC Partners for Mental Health and Addictions Information. 4 (1), 30-31. Robertson, M.; Harris, N.; Fritz, N.; Noftsinger, R. & Fischer, P. (2007). Rural homelessness. Toward understanding homelessness: The 2007 national symposium on homelessness research. Retrieved from: http://aspe.hhs.gov/homelessness/symposium07/robertson/ Scott, F. (2014). Vancouver, British Columbia: The Vivian. In Housing first in Canada: Supporting communities to end homelessness. Toronto: Canadian Homelessness Research Press. Stefancic, A.; Henwood, B., Melton, H., Shin, S., Lawrence-Gomez, R., & Tsemberis, S. (2013). Implementing housing first in rural areas: Pathways Vermont. American Journal of Public Health. 206-S209. Trainor, J., Taillon, P. & Pandalangat, N. (2013). Turning the key: Assessing housing and related Supports for persons living with mental health problems and illness. Mental Health Commission of Canada. van Wyk, R. (2015). Fraser Valley Regional District 2014 Homelessness survey: Findings, conclusions, and recommendations. Retrieved from: http://www.fvrd.bc.ca Waegemakers Schiff, J. & Turner, A. (2014). Housing first in rural Canada: Homelessness & housing feasibility across 22 Canadian communities. Human Resources and Skills Development Canada. Homeless Partnering Strategy. Calgary, AB: University of Calgary. 26 APPENDICES Stakeholder Engagement Report Summary Stakeholder Interviews Participant Sectors • RCMP • Trails Crossing Friendship Centre • Mental Health • Fraser Health • Volunteer • Municipal government • Business (informal) Questions • • • • What is your role in the community? What has your experience been with low barrier housing? Housing First? What are your thoughts about a proposed Housing First capital project in Hope? Can you tell me anything about Hope that would pertain to these issues? Main Themes 1. 2. 3. 4. 5. 6. 7. concern over sustainability desire to make sure project benefits community belief in the importance of keeping people informed volunteers are keen; churches want to help concern over accountability and recovery incentive perception of need for rules and standards some community negativity building Quotes “Housing First needs 24/7 care.” “We have to walk beside these people.” “Make sure it’s for our people, our community.” “If you do for them, they don’t do for themselves.” “Volunteers are really important—they have the heart of gold.” “For our people, it’s all about being connected to the land—you need to include that in any program for healing.” 27 Client Interviews Report Summary Client Interviews Participant Sectors • Thunderbird residents • Shelter occupants • Soup kitchen clients (informal) Questions • • • • • • What led to your situation of homelessness? How did you end up at the Thunderbird? What do you think works at the Thunderbird? What community services do you like? What do you think isn’t working? What makes things difficult for you? Main Themes 1. 2. 3. 4. 5. 6. 7. 8. desire to be heard and included need for more resources and support perception of overall effectiveness appreciation of the property problems with transportation perception that Paul needs help importance of a sense of home belief that community and relationships are key to overcoming addictions and other challenges 9. STIR problematic 10. need for better connection with Mental Health 11. appreciation for Sue Lawrence, nurse practitioner who comes to the Thunderbird Quotes “Needs more help around here.” “Things were better with an extra support worker around here.” “This place is the best thing that has ever happened to me.” “There has to be someone here all the time to enforce the rules and see what’s going on.” “The one solid thing that keeps it going is rules—we have rules here.” “Poor Paul is trying to do everything on his own!” 28 Service Provider Report Summary Service Provider Interviews Participant Sectors • Homeless Outreach • Low barrier practitioners • Medium barrier practitioners • Clinical Questions • What is your role in your community? • What has your experience been with low barrier housing? Housing First? • What are your thoughts about a proposed Housing First capital project in Hope? (for Hope residents) • Can you tell me anything about Hope/your context that would pertain to these issues? Main Themes 1. 2. 3. 4. 5. 6. 7. 8. need for additional outreach (cross-sector) problematic caseload levels concern that project could draw people from outside Hope concern for other at-risk populations tension between various treatment outlooks concern over relationship between the possibility of service providers sharing building space with HF clients concern over what could happen with most challenging demographic perception that volunteers are gold Quotes “WE NEED MORE OUTREACH RESOURCES!” “Free barrier housing is not going to fly in this community.” “Without 24/7 staffing, there’s no way you can do it.” “If we’re going to have this, it needs to be in town.” “We need outreach on every level: police, medical, mental.” “The things that help involve real, human touch.” 29 Community Forum Report Summaries Blue Moose Forum Survey • provided below Main Themes 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. tension between concern over crime and concern to help tension between harm reduction and abstinence approaches tension between perception of the problem (ie homelessness or addiction) concern to be informed about any changes support for Thunderbird, looking for ways to help negative perception of Thunderbird, breakdown in trust feeling that agencies are not doing enough concern for other at risk populations concern about bringing in homeless from other areas problems in Silver Creek Quotes “I think Paul Keller has done a great job over at the Thunderbird.” “They need a NO TOLERANCE policy for drugs/alcohol!” “‘Zero Tolerance’ is what got us into this mess in the first place!” “It’s the drug addiction that’s the problem.” “I love what is happening at the Thunderbird; anyone who hasn’t visited, should.” “Free meals and clothing do a lot for the homeless, but having a safe place to live would help to stabilize their lives.” “No need to expand on this experiment gone wrong.” “We need more connection with the Aboriginal community.” “More policing would be helpful.” “We do not need any more services for the homeless!” “I think the Thunderbird is an excellent project. The distance from the main business centre makes sense.” “Overall we need to be sure that ‘helping’ people is not enabling them.” “I strongly support the Thunderbird project.” “Children/families have been disrupted enjoying our community park.” “I do not like or approve of the Thunderbird project—housing drug addicts with no rules.” “It’s a significant issue if one person is homeless. We’re a community. We need to help our people.” 30 Housing Task Force Commi2ee: Community Survey 1) Do you see homelessness as a significant issue in the community? If so, why? If not, what other issues do you see as significantly affec<ng the community of Hope? 2) Do you think that exis<ng services are adequate to meet the needs of the homeless community (or other issues of concern)? If so, what are the strengths and assets of exis<ng services? What are gaps or weaknesses in service? 3) How do you think that the community of Hope can leverage or create services to meet the needs of homelessness or other areas of concern? 4) What is your opinion on low barrier housing? Also, please feel free to write down any comments or quotes that you would like to have on record. Contact: Jen Hawkins [email protected] Name (op<onal): _____________________________ 31 Silver Creek Forum Participant Sectors • Silver Creek residents • wider community Main Themes 1. 2. 3. 4. mistrust over past history, sick and tired of crime feeling that community was not properly consulted over Thunderbird fear that the same thing will happen with a new project suspicion there is a hidden agenda that will be forced on the community under false pretense (a bit less than half of participants) 5. weariness and bitterness over crime, including theft, vandalism, private property trespassing, and assault (rarer but verified) 6. grief and anger over perceived loss of safety in community 7. disgust and anger over general vagrancy, particularly when accompanied by behaviors under substance influence 8. fear of harm to those under influence and also what happens to people who may accidentally harm them 9. against any type of low barrier housing in community (about half of participants: 21/41) 10.supportive of helping homeless, but do not support location (some participants) 11.assertion that residents would be still committing crimes regardless of Thunderbird (a handful of participants) 12.conditionally supportive of low barrier housing; assertion that it needs to include more supports and rules (a few participants) 13.majority of participants felt that crime had gotten worse in the past few years; some participants felt that it had not 14.transportation (particularly on Richmond and Airport) is a huge issue Reported Experiences • included below Quotes • included below 32 Silver Creek Forum 2 Reported Experiences1 • 2 women assaulted at work by reputed Thunderbird residents (one not reported to police) • truck vandalized, $3,500 worth of damage • clients in Silver Creek from 10:30 at night to 6 in the morning • woman had resident jump in front of her car at a stop sign and slam hands on hood, trying to get a ride into town • woman living on Airport road experienced trespassing, residents on her porch, says residents are constantly on her road at 3 in the morning • man driving almost hit about half a dozen people at various times staggering down the street • one man has lived in Hope for 30 years and in Silver Creek for 20 and has been robbed 6 times; 5 were not Thunderbird residents, 1 remains unsolved • man’s experience of panhandling at Flying J has increased • woman experienced people at the end of her driveway in the early morning hours, also sees people wandering around in the middle of the night • man had windows broken, stuff stolen - addicts doing damage • three times a woman drove by the Thunderbird, and a person presenting with drug usage tried to jump in front of her car • same woman had problem person try to light a fire behind her business • two accidents from residents on road, plus one elderly lady had a client leap on her windshield and smash it; woman is still traumatized Quotes • included below 1 These experiences have not been independently verified; the main purpose of the forum was to listen and report. 33 Silver Creek Forum 3 Quotes “We have people that could be considered crackheads or drug users living in other parts of Silver Creek and in town as well. There’s no orange bracelets on the people that are from the Thunderbird. … In my experiences, I’ve seen the before the Thunderbird project too.” “It’s changed. The dynamics of the community have changed. You notice it quite a lot.” “Low barrier is not helping them, it is not rehabbing them. It is warehousing them.” “I’m not absolutely opposed to low barrier housing, but there has to be support on the backside.” “I would feel safer if there were some kind of rule—within a year or two you had to get off drugs, or something like that.” “My concern is that they have to go past the school here. You have to deal with them occasionally cutting through the yard.” “We all realize that these people need a place to live. … The thing is, why did you put them out of town? They don’t have transportation. … There’s nothing out there for them.” “I think everyone here agrees and is sympathetic and everything. I think the issue is, is the Thunderbird, is it the right location for the services? The school here is a central part of our community. I feel bad for them, the Thunderbird residents.” “There is a hate because there is so much damage.” “There’s lots of kids. They should be able to walk safely up and down that road to the creek in the summer. They can’t.” “They like this place because they can do anything they want to. And they do.” “We have to find a solution not just for the Thunderbird—it’s all around.” “All they do is conspire to do drugs. That’s all they do. I know first hand ‘cause we live right across the street from them.” “If the Thunderbird shuts down, they’re still going to be here.” “Why wasn’t it put in town? … At least put in a bus service or something.” “We’ve lived here 22 years and we’ve never seen anything like it until recently.” “For me, I understand harm reduction. But it just seems like such a poor location.” “I think that it is frightening because you see people that perhaps you wouldn’t invite in for tea, walking up and down the streets at various times of the day and screaming, and whatever challenges they face—and everyone has them—it’s unnerving. I think a lot of us are quite disgruntled because there was no public discussion and community input. It just sort of happened. You know, great—you want to help—but at the same time, you have to respect that people have property, they have children, they have their own concerns.” 34 Housing First Informational Forum More than 230+ people attended this event. According to many attendees, it was the largest attendance of any public event in recent memory. The event was slated as a HOMELESSNESS IN HOPE “Housing First Community Information Forum.” Advertisements described it as following: “Hope and Area Transition Society will be hosting a HOUSING FIRST COMMUNITY INFORMATION FORUM community forum to present information regarding the Housing First approach in addressing February 19, 7-9 pm REC. CENTRE CONFERENCE ROOM homelessness. The forum will also provide opportunities to address any outstanding questions and concerns from the community.” Hope and Area Transition Society will be hosting a community forum to present information regarding the Housing First approach to addressing homelessness. The forum will also provide opportunity to address any outstanding questions and concerns from the community. HATS hosted a panel with various representatives who had connections with HOPE & AREA TRANSITION SOCIETY Thunderbird clients: harm reduction, clinical, cultural, the executive director, and faith-based poverty outreach. The event confirmed the researcher’s experience “on the ground.” There are most definitely questions and concerns from the community. And there is a vehement and vocal opposition. However, the majority of Hope’s community stands in strong support of the Thunderbird and a Housing First philosophical approach to addressing homelessness. At the beginning of the event, the moderator asked for a show of hands for those in opposition, for those who hadn’t made up their minds, and for those who came in support. The very strong majority indicated support. Towards the end of the event, surveys were provided for people to give a record of their views. They could check off one of the following statements: I am fully supportive of Housing First in the community of Hope I am absolutely opposed to Housing First in the community of Hope I am leaning towards support of Housing First, but I need more information I am leaning against Housing First, but I need more information 35 Of the 91 responses, 64 were in full support, and 14 were leaning towards support. Ten were absolutely opposed, and 3 respondents were leaning against. Again, this matched experiences “on the ground.” That said, although a majority of Hope’s community will support Housing First, there are definitely outstanding issues, concerns, and misinformation. In fact, the whole social service industry—particularly as touches on harm reduction—needs to engage in wider dialogue within the community. Statement on Appendices The above appendices are summaries of reports—both verbal and formal—given to HATS and the Housing Task Force on interviews and forums conducted in the community, with the exclusion of the Housing First Informational Forum. This forum was attended by both the Executive Director and the Board of HATS, so no report was given other than the results of the survey. HATS also had the event filmed for the record. It will be apparent in these report summaries that opinions from Silver Creek receive more representation than other stakeholders, clients, and even other community members encountered by the researcher. Two important points are of note in this respect: This representation does not reflect their relative importance alongside other constituents outlined in the Homeless Partnering Strategy contract. Nor is it indicative of proportional representation of particular viewpoints alongside other constituents. Rather, this representation reflects the conviction of the researcher that when frustration exists, people need to be heard and given a voice and space to air their experiences and concerns. This is particularly true when oppositional philosophies are at play. A concurrent factor in the community outreach and research that led to the Housing First Information forum was the considerable amount of misinformation9 afloat in the community— particularly through social media. As outlined in the recommendations, this is a continuing issue that needs addressing. 9 Again, it must be noted that there are also legitimate concerns that need engagement. See Findings: Core 5 and Recommendations. 36
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