Out of the Cold Emergency Winter Shelter 2010 Final Report

1. Out of the Cold Emergency Winter Shelter 2010 Final Report Executive Summary

2. History The Out of the Cold Emergency Winter Shelter first opened in March, 2009 (closing at the end of April, 2009). Created by a group of individuals and organizations that were concerned about the lack of options for Halifax’s homeless population the Out of the Cold Shelter ran on donations of supplies, space, money and time. Out of the Cold’s second season began in November, 2009 and ran until April 2010.

3. Operational structure The Out of the Cold shelter was to provide a welcoming alternative shelter environment with a higher staff/shelter user ratio with 15 beds open to men, women, trangendered people, and youth. Recognizing that there are other shelter services in the city, the OTCS aimed to serve people who could not readily access the existing shelter system due to mental health issues, barring from other shelters, couples who did not want to be separated and/or the increasing capacity issues experienced at other shelters. The shelter operated within a low-barrier and harm reduction framework in the hopes of being able to accommodate those who were unable to access elsewhere.

4. Operational structure The shelter was open from 9pm to 8am every night of the week during the winter. The shelter was staffed by a committed and trained group of over 100 volunteers and 5 paid staff. Beyond these individuals, a committee of professional staff from partnering organizations managed the shelter and supervised volunteers. Members of this committee provided on-location and on-call support to the volunteers and staff who provided front-line services at the shelter Out of the Cold was a collaborative effort of numerous community and service-based organizations across Halifax operating under the umbrella of Metro Non-Profit Housing Association.

5. The shelter space in the basement of Saint Matthew’s United Church.

6. Volunteers The first season of the Out of the Cold shelter saw 50 volunteers donating their energy and time. This number increased to over 100 in the second season. Volunteer were provided with training in shelter operation and orientation, Non-Violent Crisis Intervention, suicide intervention awareness, street health, first aid / CPR, conflict management and overdose education. In the 09-10 season volunteers worked over 5,300 hours. Volunteer tasks included staffing shelter shifts, cleaning the shelter space, meal preparation and delivery, laundry delivery and fundraising. In addition to the volunteer staff there was a team of 14 on-call members who oversaw each night of the shelter, coordinated communication, held weekly case conferences, oversaw policy changes and took on an administrative role.

7. Budget The OTCS operated with expenses of $40,000 Financial donations and grants totalled $50,000 The remainder of the funds raised in the 2009/2010 season will go towards start-up costs for next season.

8. Numbers at a glance • 226 different individuals accessed OTCS for a total of 2,221 overnight stays. • The Out of the Cold shelter had an occupancy rate of 92.5%. The month of March was a particularly busy month (107.5% occupancy rate) with the shelter recording an additional 50 intakes reflecting a high number of referrals out to other shelters. • OTCS was at capacity 43% of the time – when looking at nights where we had only 14 of the 15 beds occupied, this number increases to 50%. • Average number of clients who stayed each night – 13.9. • Youth between the ages of 16 and 24 accounted for 38.9% (88 individuals) of the total stays at OTCS. Of that number, 31% (28 individuals) of the total stays by youth were by women. • Approximately 75 people had to be turned away over the course of the winter.

9. Numbers at a glance

10. Case studies Individual who required 1:1 personal care A man in his late 20s arrived with police escort to the OTCS one evening with nowhere else to go. He had both mental and physical disabilities relating to an accident that he had had earlier in life which had left him with brain damage. He had been kicked out of a Small Options home for drinking and behavioural issues. He had tried to access other shelters in Halifax but was denied each time. He needed 1:1 personal care in order to move around and perform basic tasks like going to the washroom and changing himself. He was also prone to severe seizures. Additionally, his cognitive functions were impaired, causing him to make inappropriate and hostile comments to other guests which put his own safety at risk. He needed a staff member by his side at all times to help him with his physical needs as well as mediate between him and the other guests. After one night at the OTCS, the organizing team strategized about how to best support him and refer him to the most appropriate service or shelter.

11. Age inappropriate spaces 16-year-old Kalem stayed at the Out of the Cold shelter off and on for over a month. He found himself in foster care for much of his childhood. After experiencing unimaginable trauma and abuse, he ended up in a group home and secure care facility at the age of 13. Kalem takes no medication and has no medical diagnoses but self identifies as having attention deficit disorder. Staff at the Out of the Cold Shelter noticed him as both an instigator of conflict and a rational and genuine supporter of fellow shelter guests. Kalem’s stays with OTCS were sporadic as he preferred to be at the youth shelter in the city. After getting in trouble there due to his difficulty with focusing and controlling his understandable anger surrounding his situation, he was timed out several times. Several of these times were even in a row. At age 16, Kalem was exposed to scenes and experiences in the shelter system that most adults find disturbing. His hope was to have more than one option for shelter as a youth, but other than the one emergency shelter for youth that he had been timed out of for over two weeks, there were only adult facilities available.

12. Mental illness barriers to shelters Mr. Roy came to the Out of the Cold shelter with a police escort. He had been timed-out of all other shelters for men in the city due to his unmanaged schizophrenia. Mr. Roy’s illness prohibited him from sustaining stable housing and kept him in a place where delusions and hallucinations were often present. This became a complex situation for both staff and guests at the shelter. Therefore, Mr. Roy was unable to coordinate his own support system in the web of services as his mental illness was debilitating on many levels. He was also unable to access support through the in-patient ward at the hospital. Throughout the several weeks that Mr. Roy resided at the shelter staff became advocates on his behalf and acted as a liaison between the hospital, community mental health workers, medical clinic staff and the hospital. Through this coordination, he was admitted to the hospital in order to attempt to stabilize his condition. After his hospital stay, he was released back into the shelter system where he continued to have conflict in a group setting. Mr. Roy was arrested by the police and has still not found adequate or appropriate support.

13. Couple not wanting to separate Sandra and Martin, both in their early twenties, had been living in an apartment together and supporting themselves with Martin’s paycheque as Sandra searched for a job. Martin was laid off and, suddenly unable to pay the month’s rent, their landlord evicted them. In the midst of all this the couple found out Sandra was pregnant. They tried accessing separate shelters but hated being apart, especially since this was when they needed each other’s support most. Sandra and Martin found out about the Out of the Cold shelter and came because couples could access together. Now that they had found a shelter that they felt comfortable with they could work on other goals. Sandra and Martin went to the Department of Community Services to apply for income assistance and discovered that they needed a stable address in order to even apply for assistance. An income assistance worker explained that there were single-sex shelters in Halifax that could be used as addresses to apply for income assistance but the Out of the Cold shelter’s address would not work. Staying together meant more than receiving income assistance so Sandra and Martin continued to search for work and stay at the Out of the Cold until travel arrangements could be made for them both to go out West where family support was available.

14. Individual who was working but still unable to find housing Stephen is in his mid-thirties and was living with a roommate when a dispute forced him to leave. Though he was working in a retail position, his job did not pay enough for Stephen to pay for rent, bills, food and other necessities by himself and he found himself on the street. Stephen tried accessing Metro Turning Point but felt unsafe and tempted into drinking and drug habits that he had dealt with in the past. He went to the Salvation Army but could not afford to save for a new apartment and also pay the nightly rate they required. He came to the Out of the Cold shelter where he enjoyed a quieter atmosphere with fewer guests than larger shelters. He was also able to save money as the Out of the Cold shelter does not require payment for room and board.

15. Individual with high mental and social needs Rachael, a 32-year-old woman, often came to the shelter in a state of crisis. Each night she would talk with staff and guests about the government conspiracies she was convinced of. Though staff were supportive and listened to her as best they could she was often unable to calm down and relax in the space. This tension carried over to other guests who grew more and more agitated with her volume and constant attempts to draw them into a conversation. Staff tried to discuss various mental health and support agencies with Rachael but her time at the shelter was always too short and unfocused to work on a real plan, even for the short-term. When staff discussed other shelter options that may provide more stability for Rachael it was discovered that her behaviour and untreated mental health issues had created conflict at other shelters as well. She was a threat to herself as she created conflict with other guests and often exasperated staff with her behaviour. The Out of the Cold shelter was able to act as a mental health respite for her but, as we close, Rachael is left with little to no resources that haven’t already been explored.

16. Individual with complicated medication needs On the first night that Thomas, 49, accessed the Out of the Cold shelter he turned in numerous bottles of medication he was taking for mental health issues. When asked if he was able to access other shelters in the city Thomas stated that he had had numerous conflicts with both staff and guests at other shelters, mostly stemming from behaviour related to his mental health situation. Thomas stayed on and off for a week before staff at the Out of the Cold shelter were contacted by nurses with Mobile Outreach Street Health (MOSH) who were concerned about him. Thomas was in a complicated situation where if he did not take his medication his mental health would become unstable and he could not navigate his way safely through the city. If Thomas took too much medication at once his physical health would be in jeopardy and he would often collapse in public. MOSH tried to work with Thomas by meeting with him frequently and distributing his medication in small doses but this still did not ensure that he took the proper pills in the proper doses at the proper times. Thomas required a stable shelter situation with both mental health supports and staff trained to dispense medication . When he is supported Thomas is a chatty and vibrant individual but his stability can easily deteriorate when his medication gets out of control, which happens easily on the streets.

17. The cost of not funding Housing is one of the most basic requirements required to ensure an individual is healthy in both mind and body. The impact of a lack of secure, safe, and affordable housing on the health of individuals has been studied at length and has been recognized as one of 15 major social determinants of an individual’s overall health. Street youth interviewed in Halifax in a 2004 study stated that they usually had multiple health problems exacerbated by cold, hunger, poor housing, poor diets, and the high-risk behaviours they engage in to survive. Numerous studies also demonstrate that mental illness –depression, anxiety, post-traumatic stress, and feelings of uncontrollable anger – are further exacerbated by homelessness. As well, substance misuse and addiction are major problems for some individuals experiencing homelessness. While in some instances this may be a possible cause of this homelessness, it is also a subsequent barrier to getting off the street.

18. The cost of not funding A study undertaken by the BC provincial government found that in 1998–1999, providing major government services, including healthcare, criminal justice and social services (excluding housing) to the homeless included in the study, cost on average, 33 per cent more than the housed ($24,000 compared to $18,000). When combined, the service and shelter costs of the homeless people ranged from $30,000 to $40,000 on average per person for one year (including the costs of staying in an emergency shelter). The combined costs of services and housing for housed individuals ranged from $22,000 to $28,000 per person per year. It is worth noting that these housed individuals were housed in government funded supportive housing. Thus, even when housing costs are included, the total government costs for the housing formerly homeless individuals amounted to less than the government costs for the homeless individuals, with a savings of up to $18,000 per person.

19. The cost of not funding Providing adequate supportive housing to the homeless people in this study saved the provincial government money.

20. Department of Community Services (DCS) Sometimes our efforts to support our guests meant that we had to advocate on their behalf to the Department of Community Services (DCS). Two of the biggest challenges that we faced when doing so are outlined below: The Department of Community Services did not see the address of the Out of the Cold shelter as an address that could be used for an income assistance application. DCS no longer has a 24 hour helpline. This phone line used to be available for calls in emergency situations, which occurred often during the 09/10 season. There were nights that we saw people sleep on the steps outside of the Out of the Cold Shelter because we were at capacity and they could not access other shelters due to capacity or being timed-out. At these times staff were greatly concerned about the safety of these individuals, especially when the weather was harsher or when they were in a more vulnerable state. At these times staff needed a 24 hour line to call to obtain assistance from DCS to help the population they state they serve.

21. What we are calling for • Short-term • To have the address of the Out of the Cold shelter be recognized for application for social assistance. • To have the Out of the Cold shelter recognized as an integral part of the HRM shelter community. • To receive funding from the Department of Community Services for shelter operations. • Long-term • To have the Department of Community Services commit to supporting the creation of more affordable and supportive housing.