From the street to a home
- Angela Hill | September 25, 2014
They are called the hard to house.
They are people who have been homeless for a long time, often with addictions to alcohol or drugs and sometimes with mental health issues.
The people who don’t make it to housing through the traditional social services model of entering a shelter, going to a detox program before maybe getting to move on to supervised housing.
But, Housing First, a program that is coming up on its six month anniversary, is changing all of that.
“This jumps right in,” said Jordan Mills, Housing First team leader.
“I think this concept, which is sort of radical – take somebody who is your most at risk and acute in the community and homeless and plops them in a house and see what happens, is quite contrary to the way we usually do work.”
Housing First started in April, another piece of the City of Saskatoon homelessness strategy.
There are already 11 people housed, with more undergoing the assessment process, and the people working in the program are seeing positive results.
One client had a fairly normal childhood before he was pulled away from his family to go to residential school. Even when he completed school, the loss of family life lead to a decline for him – he turned to alcohol. Then another tragedy; his wife died and shortly after that his child was apprehended.
“So this man went through a pretty traumatic series of events earlier on in his life that led to a lifetime of alcoholism,” Mills said.
The man moved from drinking beverage alcohol, like wine, beer or spirits, to consuming Listerine, rubbing alcohol or Isagel.
Before coming into contact with the Housing First team he had been living on the street for 17 to 18 years, camping out in the bushes, sometimes turning to a detox center, and intoxicated daily.
“He’s actually now been successfully housed going on five months. For a good portion of that time, he’s actually been sober,” Mills said, “seeing that has been tremendous.”
Measuring success is not only through the quality of life changes, but tangible changes in the community.
The Housing First case managers monitor statistics, such as how many nights clients spent in the hospital emergency department prior to Housing First, or how many ambulance rides required, or how many times they were incarcerated, or how many visits they had to brief detox.
A study found that 23 people in Saskatoon were using $2.8 million in services every year. The same people were circulating through the system over and over again, but nothing was changing, said Myra Potter, director of resource development at United Way of Saskatoon and Area.
She added that the cost to house someone is only $23,000 or $24,000 over the same time period.
In one case of someone currently in the program, there were 150 hospital and ambulance visits in the six months prior to entering Housing First – since then there has only been four visits for the client, Potter said.
“Not only does that say his quality of life is probably quite a bit better, but the cost savings to the systems is remarkable,” she said.
The United Way funds Housing First in Saskatoon through donations from private individuals and funding from the Federal Government.
There is buy in as community groups are already seeing a difference.
“We are already hearing from organizations like brief detox – some of their clients who (used to go) back again and again.”
Landlords and rental companies are also getting behind the Housing First strategy.
According to Mills, it took some work to explain the program and its goals, but rental groups like the fact clients in Housing First have supports, so they won’t get burned.
“We guarantee the rent will be paid on time and in full, we guarantee that the damage deposit will be covered and that the startup will be good, we also guarantee to the landlord that we will be in there, providing in-house support with the intent for helping the person reaching their optimal tenancy independence,” he said.
Not every renter can make those same guarantees.
Pilot projects for Housing First in other major cities like Halifax, Montreal and Moncton, have shown around an 80 per cent success rate, but some clients need several tries to be ready to live on their own.
So if, there is an eviction the program will help things go smoothly and cover damages if that is the issue, said Mills.
“So I think we can be seen as kind of a safety net around the people they are taking,” he said.
“Some of our clients are exceptional tenants and you wouldn’t even know if they are in the building.”
There are three case managers for Housing First, with their offices in Saskatoon Crisis Intervention Service. They assess clients in order of need, not unlike how nurses do triage at a hospital, using a tool called a SPDAT – Service Prioritization Decision Assessment Tool.
The clients that are found to be the most at risk are at the top of the list and the only thing they need to do to enter the program is agree to allow a case manager into their home once a week.
As soon as they do, clients are engaged in apartment shopping. Case managers try to provide as much choice as possible, from the area of the city someone wants, to the type of furniture they want.
“The goal is to make it feel like home for them, so they don’t want to leave,” Mills said.
Once the client is into the apartment it becomes about service co-ordination, he said, helping the clients to access health care, psychiatric services, medication etc.
Based on the current program, there is space for about 50 of the most acute and vulnerable people, Mills said.
But they are looking to expand. Mills wants to see the addition of an Elder to the team to make sure they are culturally competent and he’d like the addition of a part-time position for a person who has been homeless and can help others adjust to having a roof over their heads.
By having people in a house and not relying on MD Ambulance, emergency rooms and shelters, money is saved, Mills said.
“It’s an astronomical cost savings, so that’s success right there. Then if you look at the quality of life stuff and the people and the complex issues that have come into our realm. It’s pretty phenomenal what we’ve been able to accomplish, who we’ve been able to house and what we’ve been able to access for these folks this early on. It’s pretty significant.”