Homelessness doesn’t have to be a fact of life

Housing First policies have been successful and should be more widely implemented, Julie Anne Pattee says.

Every winter, the sight of people shivering in the cold and begging for change moves the issue of homelessness to the forefront of our minds.

Homelessness seems like a sad fact of life in big cities like Montreal.

It feels like there is just no solution. I mean, if there were a solution to the problem of homelessness, our governments would surely be all over it, right?

In fact, the Canadian government and our provincial and municipal governments have been well aware that there is a solution to most chronic or episodic homelessness since 2014, when the At Home/Chez Soi research and demonstration project published its final report.

The $110-million study, funded by the Mental Health Commission of Canada and replicated in five cities across the country, including Montreal, concluded that the Housing First approach was an effective solution for the majority of people who suffer from mental illness and who experience homelessness.

Indeed, Housing First specialists say 80 per cent of all homeless people can relearn to live successfully, once they are given ordinary, subsidized apartments and support. This can mean overcoming health issues, and going back to work.

For years, the majority of services operated on the reverse premise. It was believed that people with mental health and addictions issues needed to become stabilized, before they could be housed successfully. We now know this is simply not true.

On average, Housing First costs somewhat more than usual services. So we’d need to spend somewhat more money than we currently do, to provide people with permanent housing and supports. But just because a service has an initially higher cost, does not mean it is not cost effective in the long run. Research has now also shown that the more costly homeless people are at the outset (in terms of shelter use, ER visits and especially hospitalizations), the more likely it is that Housing First will pay for itself — and in many cases, even more than pay for itself.

But in any case, as a society, we provide people with things like hip replacements, cataract surgeries and nursing homes — not because they pay for themselves, but because they provide a benefit to society that we consider worth the cost.

There are approximately 3,500 people living in Montreal who are chronically or episodically homeless.

Currently, however, there are only about 600 people receiving Housing First services, in programs mostly funded by the federal government.

There is a lot of room for improvement.

Changing things would involve convincing the public that blaming homeless people for their situation doesn’t help. Very often child abuse and other circumstances outside their control underlie homelessness.

In some cases bad choices such as getting into drugs played a role in people becoming homeless. But we all make bad choices. Should doctors refuse to treat our heart disease because we exercised less and ate a less healthy diet than we could have?

Our health and social services system has been built on the principle that when people are sick or in need of help, we help them.

There has been some progress. Our homeless shelters are rethinking their approach. And some Housing First programs are now funded. It’s just that more can be done — here in Quebec we could almost completely eliminate homelessness if we wanted to.

We have the tools and the know-how. All we need is the political will.

It would also help if we could understand that our successes are not the inevitable results of our hard work, talents and abilities, but also owe a lot to our good fortune.