Simon Fraser University researchers found about 39,000 inadequately housed adults with severe addictions and mental illness in BC. 26,500 of the 39,000 have inadequate support. This is an at-risk subpopulation for homelessness. Also, an estimated 11,500 are homeless.
This is a conservative number. There has never been an official provincial count of the total homeless citizens. These figures are aggregated estimates approximated via tallies of homeless citizens from regions across BC. The study finds up to 51,500 inadequately housed citizens, where 35,500 are at-risk of homelessness and 15,500 are homeless.
The Province provides an inadequate total of 7,741 beds/units for our fellow citizens. applying the more conservative figure of 26,500 citizens who are at-risk of becoming homeless, that means there are 18,759 individuals who are seriously at-risk of becoming homeless.
Considering the conservative estimates for the number of citizens who are absolutely homeless, the annual public cost for providing non-housing service costs in British Columbia is a staggering $644.3 million. This is an average cost of about $55,000 per homeless citizen per year.
Providing housing and support for these citizens will reduce non-housing service costs to about 37,000 per person per annum, it would have an annual cost savings of about $211 million. There is substantial support in BC for basic housing provisions for homeless citizens.
ProBC considers a housing first approach rather than the traditional housing continuum approach preferable. A housing first approach reduces ongoing costs of maintaining various levels of transitional housing. In the traditional continuum housing approach, homeless citizens progress from street outreach programs to shelters, to transitional housing, to low-barrier housing, and to permanent housing. A housing first approach emphasises providing permanent housing to citizens in the immediate.
In order to evaluate the progress of homeless initiatives, the BC government should conduct regular homeless counts and offer incentives for homeless citizens to come forward without judgment of them. BC needs to establish a temporary database with the names and details of homeless citizens to determine the efficiency of provincial initiatives for solutions to homelessness.
Any information provided voluntarily by homeless citizens would be deleted from the system as soon as they are no longer considered homeless. Core principals of the Housing First model as determined by The Homeless Hub, Toronto, Ontario:
1. Immediate access to permanent housing with no housing readiness requirements. Housing First involves providing clients with assistance in finding and obtaining safe, secure and permanent housing as quickly as possible. A key to the Housing First philosophy is that individuals and families are not required to first demonstrate that they are ‘ready’ for housing.
Housing is not conditional on sobriety or abstinence. Program participation is also voluntary. This approach runs in contrast to what has been the orthodoxy of ‘treatment first’ approaches whereby people experiencing homeless are placed in emergency services and must address certain personal issues (addictions, mental health) prior to being deemed ‘ready’ for housing (having received access to health care or treatment).
2. Consumer choice and self-determination.
Housing First is a rights-based, client-centred approach that emphasises client choice in terms of housing and supports.
Housing - Clients are able to exercise some choice regarding the location and type of housing they receive (e.g. neighbourhood, congregate setting, scattered site, etc.). The choice may be constrained by local availability and affordability.
Supports – Clients have choices in terms of what services they receive, and when to start using services.
3. Recovery orientation. Housing First practice is not simply focused on meeting basic client needs, but on supporting recovery. A recovery orientation focuses on individual well-being and ensures that clients have access to a range of supports that enable them to nurture and maintain social, recreational, educational, occupational and vocational activities.
For those with addictions challenges, a recovery orientation also means access to a harm reduction environment. Harm reduction aims to reduce the risks and harmful effects associated with substance use and addictive behaviours for the individual, the community and society as a whole, without requiring abstinence. However, as part of the spectrum of choices that underlies both Housing First and harm reduction, people may desire and choose ‘abstinence only’ housing.
4. Individualised and client-driven supports. A client-driven approach recognises that individuals are unique, and so are their needs. Once housed, some people will need minimum supports while other people will need supports for the rest of their lives (this could range from case management to assertive community treatment).
Individuals should be provided with “a range of treatment and support services that are voluntary, individualised, culturally appropriate, and portable (e.g. in mental health, substance use, physical health, employment, education)” (Goering et al., 2012:12). Supports may address housing stability, health and mental health needs, and life skills.
Income supports and rent supplements are often an important part of providing client-driven supports. If clients do not have the necessary income to support their housing, their tenancy, health and well-being may be at risk. Rent supplements should ensure that individuals do not pay more than 30% of their income on rent.
It is important to remember that a central philosophy of Housing First is that people have access to the supports they need if they choose. Access to housing is not conditional upon accepting a particular kind of service.
5. Social and community integration. Part of the Housing First strategy is to help people integrate into their community and this requires socially supportive engagement and the opportunity to participate in meaningful activities. If people are housed and become or remain socially isolated, the stability of their housing may be compromised. Key features of social and community integration include:
Separation of housing and supports (except in the case of supportive housing)
Housing models that do not stigmatise or isolate clients. This is one reason why scattered site approaches are preferred.
Opportunities for social and cultural engagement are supported through employment, vocational and recreational activities.
While all Housing First programs ideally share these critical elements, there is considerable variation in how the model is applied, based on population served, resource availability, and other factors related to the local context. There is no ‘one size fits all’ approach to Housing First.