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Supportive housing — who benefits?

April 10, 2011

We all do!  The benefits of helping someone move from intractable poverty to feeling some hope about being able to support her/himself spread through the society.  It’s not just that that person might actually cost the public purse less and even contribute taxes.  It’s that hospital costs, jail costs, social services costs can dip.  AND for those subject to that darned compassion, they can sleep a little better knowing that some others are less miserable.

We agree that a roof over one’s head is a necessity to a manageable life.  However the problems many have in managing their lives don’t disappear once a home is in place. Carrots and sticks (incentives) are sometimes held out ($100 monthly for TTC costs to volunteer sites) or more often deprivation, threats, or penalties (cuts to benefits, removing ODSP status).

I posit that ultimately, hope and trust have to replace the core shame and depression that grow out of having lost too much or from never having had enough.  Attempts to force or impose change falter and fizzle out because they are coming from outside. Building hope and trust happens within the hurt person and develops over time.  Helping this to happen is the Housing Support Worker’s job and I’ll try to set my conviction in context.

Good Supportive Housing and the Tenants with Whom I’ve Been Engaged

In the Tea Party parlance of the new Toronto, I’d like my elected officials to direct a chunk of my tax dollars toward good supportive housing because I believe it leads to positive change in poverty.   Slow, but real.

I haven’t seen all the forms and variations of supportive housing – wish I had, because most are inspiring.  I will outline the qualities of the ones I’ve seen or been involved with, that help turn lives around.  Fundamental is that Housing Support Workers are located on site and available to tenants for most days of the week.

The tenants have come from living on the street, or have been severely under-housed.   Recovery from serious addictions and/or the sex trade is a task for many.  Some are recently reunited with children because of now being ‘clean’ and having housing.  Mental illness and/or personality disorders, many undiagnosed, abound.  Histories of trauma are common – the untimely death of loved ones, abusive relationships, loss of children to social services or previous partners, permanent injury, refugee status, escape from war and persecution.  When they arrive, none have income beyond what social services or various compensation packages provide.

Starting at the End – the Common Factors of Good Supportive Housing

Fundamental to successful supportive housing is safety.  Whatever form of dwelling into which he or she is moving – a house with a handful of tenants, a larger group home, or an apartment building – the tenant needs to feel safe.  Specifically, 1) the building has to be secure from unwanted intrusion of anyone with a history of violence, 2) the individual units or rooms have to allow the refusal of guests whom the tenant thinks pose a personal danger, 3) there has to be some form of security presence, hired or a trusted tenant, and 4) management has to take an interest in any incident that threatens a tenant’s sense of security.

The management and staff have to be trustworthy, and prepared to invest time in building trusting relationships with tenants. For this to happen depends on a big IF:  IF there is stable funding for stable staffing.  Having the same Management and Workers around for years makes a good difference.  The treasure that is any tenant’s time and emotional energy invested in deciding to open up to staff is wasted if the staff keeps changing. And there are only so many chances before the tenant firmly clams shut.

The previous building blocks lead to the third – opportunities for tenants to connect with other people who are also recovering from the street and to staff who want to engage with them.  All by him or herself, no one moves past isolation and being “stuck”.

What do the Supports Look Like?

If these are the building blocks, what form does good supportive housing look like?  That can depend on the personality, working philosophy, and gifts of people in charge, or the physical layout of the place, or the particular demographic.  More children?  More elderly?  A common challenge like addiction or diagnosed mental illness?  Are shared meals a designated part of the program?  The point is that there isn’t any one model that would fit all.  Tenants and staff build the community.

The supports I’m speaking of come with the housing, not with the tenant. Support from sponsors or social workers can be critical but don’t replace what is offered by the day by day consistency on location.  When the person moves in, a staff member welcomes, helps with settling in and obtaining furniture if the tenant so wishes, checks in regularly in the early weeks with low-key information on how to work the laundry facilities (especially with front loaders!), how to handle garbage (big factor in not upsetting neighbours), identifying signs of vermin and who to tell about it, fire alarms and fire drills, security details.  This can be all pretty new for a tenant.

As time passes, as many as a third of the tenants in the building don’t indicate a desire to move on, to become more independent.  Some stay attached to the ethos and values of the street. Housing Support Workers gets to know who wants something further: medical care, schooling, connecting with agencies for help with specific problems (immigration, children, other legal problems, vision and hearing – whatever).  Sometimes just going with someone to a tough appointment is the extent of the help wanted or accepted.  Workers come to learn just how ‘stuck’ some tenants are.  For every step forward there might be two back.  Self-sabotage recurs.  Infinite variations in not breaking out of the poverty mold.  But as Workers and tenants hang in, changes do occur.

Toronto Finds Support Too Expensive

The assumption I’m making with all the above may apply less and less to the social housing scene in Toronto.  In the past decade, more pressure has been put on all areas of Toronto’s social housing to become more business-like in its goals and operations.  Hence, the more endangered is TCHC’s supportive component.  A consumer model is in vogue, whereby someone in need goes out and obtains it.  Small housing providers are encouraged to “partner” with social agencies, allowing tenants a way to seek out help from an agency.  Or to bring with them support workers from others agencies.

There isn’t much doubt that supports are needed.  Once properly housed, people who couldn’t manage their lives (being mentally or emotionally weakened) hit the reality of all the other life problems they carried into housing with them.  It can take years to sort it through, and all kinds of help toward which they can be guided by a caring Housing Support Worker.

Can We, Should  We Sell Supportive Housing to the Public?

The public, particularly ‘taxpayers”, is discouraged by the apparent intractability of poverty and seem tempted to blame it all on addictions, laziness, bad attitudes, personality disorders, poor character.  These can all be part of the mix but don’t get at how hard it is to change.

The best bet is real deep-down help that comes about through proximity, contact, human caring, knowledgeable resource people who hang in and who can pluck out of the mystifying huge city those ‘helps’ that will fit the person in need.

Can we sell that?  Is it worth it?  What do you think?

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2 Comments leave one →
  1. tonobungay permalink
    May 28, 2011 1:06 am

    There are people for whom supportive housing is the best solution, but all of the research seems to say that the “Housing First” programs like Toronto’s Streets to Home have a success rate several times higher than the group housing modes that fit within the Continuum of Care model.

    Housing First doesn’t put chronically homeless people into housing run a social agency, it puts them into scattered site usually private landlord housing in the neighbourhood of their choice, then provides intensive support by professionals in their own home. Rather than supportive housing, it provides housing with supports. It’s more expensive to deliver per case because it’s one-on-one and uses no volunteers, but the higher success rates, in the high 80s and 90s rather than then mid-20s, in getting people permanently housed, along with the elimination of capital costs and of the capping of services when units are full, make it cheaper overall. For substance abuse, Housing First without rehab is more successful than Continuum of Care with rehab. The key is the complete separation between facility management and case management. Social agencies aren’t landlords. If someone gets evicted they don’t lose the services, the program gets them a different apartment elsewhere.

    The research shows that for the vast majority of the chronically homeless, group housing is not very effective. That doesn’t apply to everyone and youth in particular benefit from it, but most mental illnesses do not.

  2. May 28, 2011 6:25 pm

    So good to hear from you. Just the sort of good thinking I was hoping this blog would generate!

    I was puzzled though, by your remarks that “all of the research” seems to show Housing First programs have higher success rates than group housing.

    First of all, supportive housing IS a “Housing First” approach, according to the US Department of Housing and Urban Development – offering choice, self-determination and permanence. Remember, supportive housing is permanent housing, not a residential care program. Services are available, but people stay whether they use these services or not. The real difference is that, as you say, units are grouped, rather than scattered, and that the landlords are non-profit rather than private landlords.

    A major study in the US (Skryha et al, 2002) did a direct comparison between “supported” (i.e. scattered) and “supportive” (i.e. grouped) housing among substance users. People in supportive housing moved less frequently, and had significantly lower incidence of arrests, jail time and use of crisis services. They also had slightly higher resident satisfaction with choice, location, affordability and housing quality. Otherwise, results were about the same.

    Also puzzled by your “high 80s vs mid-20s” success rates. I know that, based on the last Streets to Homes evaluation I read, eviction rates were triple those of, say, Houselink Community Homes, and voluntary moves were much higher. But perhaps we’re defining success differently? What’s yours?

    It would be great to hear from people who work locally, either in supportive housing or in Streets to Homes. What information can you add?

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