In today’s National Post, I have an op ed on homelessness and Housing First in light of our national effort to take in and house 25,000 refugees.
Here’s the link:
The article follows.
Our next great national project: let’s end homelessness
David Gratzer | December 2, 2015 3:02 PM ET
Last week, the Prime Minister admitted that he couldn’t keep his promise of admitting 25,000 Syrian refugees by Dec. 31, shifting his deadline to February. Even with this change, it’s ambitious to screen, transport and house so many transatlantic refugees so quickly. Ottawa will spend $1.2 billion over six years for the effort, with most of it spent on one-time costs like air charters.
This begs a hopeful question: if we can set deadlines, find funding and race against time to help thousands of refugees, can we do the same to house Canada’s homeless population?
Some critics insist we should help every impoverished Canadians before we help any refugees. Candidly, some say this because it’s more polite than saying they’d rather not help any refugees at all. That’s not my view. Ottawa has some tough decisions to make about who to help in Syria, how to screen them, and how quickly. But this doesn’t have to be an either-or choice (and I haven’t forgotten that while my parents were immigrants, so many of their friends and relatives were refugees).
However, there has been a recent revolution in thinking about homelessness, and it raises fascinating parallels to our refugee challenge. Homelessness was once widely stigmatized — and it still is. But most Canadians now understand that homelessness is largely driven by mental illness, uncontrollable addiction, domestic abuse, or a combination of these factors.
Governments spend untold millions to treat homeless patients who walk into emergency rooms. Then, we discharge them onto the street, and spend untold millions on paramedic services, aid organizations and police pickups to deal with the consequences. Cruelly, we’ve normalized homelessness in the process. In recent head counts, Winnipeg has over 1,700 homeless people; Toronto over 5,000; Edmonton over 2,000; and so on.
The “Housing First” revolution attacks this with a simple and obvious step: give homeless people homes. No matter how tiny the unit, a permanent home helps patients restart their lives in relative safety and security (unlike our current shelter system). Over 80 per cent of homeless people housed in Housing First tests stay housed after their first year. Small centres like Medicine Hat have all but wiped out onstreet homelessness with this approach. Through the leadership of the Mental Health Commission of Canada and other organizations, the strategy is spreading to larger Canadian cities. Several American mayors have even declared states of emergency to get faster action on housing the homeless.
To understand why this works, consider my own psychiatric practice with schizophrenia. House a patient with schizophrenia and you instantly transform her environment, stabilizing medication schedules and follow-ups. Caring family members and volunteers can make regular connections to a patient with a fixed address. The alternatives — frequent emergency room visits, police pickups and on-street care — can cost taxpayers as much in one day as the rent for a modest micro-apartment would for months.
With this revolution in mind, I can’t help but see refugee resettlement as a teachable moment in the struggle against homelessness and mental illness. Canada is racing to prove that we can house the unhoused and help the helpless quickly if we choose to. Sure, Trudeau’s deadline got moved. But the very act of setting an ambitious national goal meant that resources suddenly appeared out of thin air.
A Vancouver developer generously donated a building to house refugees. In Hamilton, a school board suddenly realized that empty schools could serve as residences. Ontario’s minister of health is talking about refitting disused hospitals as housing. Toronto’s mayor asked dentists to volunteer to give Syrian refugees their first check-up in years. The Manitoba government is even setting up a command centre to co-ordinate refugee resources.
If we can do all this once on a deadline — why not twice?
The challenges aren’t perfectly comparable. For example, Ottawa will house some refugees in military barracks in smaller cities. This wouldn’t be effective for the homeless, since patients need housing that’s accessible to a range of health support services.
Still, we’re learning to tackle an urgent housing problem at high speed. So, let’s give the refugee effort its due. By February, Ottawa’s new resettlement deadline will have been met, while more homeless Canadians will be suffering on winter streets due to entirely treatable illnesses. That could be the moment when we start applying the lessons of the refugee campaign to help men and women living on our streets — and hopefully, with the same sense of urgency.
David Gratzer is a psychiatrist and author. He practices in Toronto.