Why can’t TCHC be more supportive?

In her last entry, Rosemary Gray-Snelgrove showed us the power of supportive housing, where compassionate staff help create a safe and caring community. 

Why can’t Toronto Community Housing be more like that? Why can’t staff forge the trusting relationships that can make all the difference in tenants’ lives? These are the questions that lurk behind much of TCHC’s media coverage. The answer?

It all comes down to numbers.

Most people don’t think of TCHC as a mental health organization, but it is home to more people with mental illness than anywhere else in Canada – including Canada’s largest mental health hospital.

Based on prevalence rates, 7% of TCHC tenants – that’s 8,900 adults with signed leases – have a mental illness serious enough to make them eligible for the sort of supportive housing Rosemary describes. (1)

To give a sense of scale, that is:

• Twice as many as live in all of Toronto’s 4,374 supportive housing units combined
• More than double the 3,703 people admitted as inpatients at the Centre for Addiction and Mental Health in 2008-2009
• More than 20 times the 411 people who received case management support in 2008 from CMHA-Toronto, a leading mental health agency.

You see the problem.

Knee-jerk solutions — “these people belong in an institution” — are non-starters.

Building more supportive housing would absolutely help. But given the 25 years needed to build up the 4,374 units we have – and given that most supportive housing buildings have fewer than 40 units – it’s certainly not a quick solution.

And as for telling TCHC staff to just smarten up, or become more compassionate? Let’s look at the numbers again.

The supportive housing Rosemary describes typically has a staff to tenant ratio of 1:30. At YSM Genesis Place where Rosemary used to work, sixty tenants were served by 5.5 staff, including two housing support workers who work directly with tenants.

Now let’s look at the staff-to-tenant ratios in the properties TCHC manages with its own staff.

• One Health Promotion Officer – the only staff expected to have a social work or community development background — for every 2,166 units
• One Tenant Service Co-ordinator – the people who manage leases, correspondence and evictions and calculate subsidies —  for every 539 units
• One Superintendent or Senior Superintendent – the people who oversee cleaning staff and contractors, handle keys and respond to emergencies — for every 184 units.
• One Customer Service Facilitator – a triage person who sorts out complaints and manages records – for every 4,875 units
• One Community Housing Supervisor for every 2,438 units, and one Operating Unit Manager for every 4,875 units.

The staff ratios in properties managed by private management companies are no better. Greenwin has received a lot of bad press for the 200 Wellesley fire. I’m not close enough to the action to know whether they were remiss or not. But I do know that no property manager – public or private – has the resources to address the situation TCHC finds itself in.

What would it take for TCHC to reach the staff levels in supportive housing? It would need an additional 300 staff, just for the 8900 people with serious mental illness. At current rates for social workers, that’s between $12 – $18 million per year.

TCHC can’t do it alone.

TCHC can do its part by being a good landlord, and by making the best use of the resources within its control.

But let’s remember: most TCHC tenants don’t turn to their landlord to sort out their health issues. They turn to the same public services we all rely on. There’s no shortage of ideas for improving the mental health system.  The Federal Government’s Out of the Shadows at Last pointed the way in 2006.  So did the Ministry of Health’s Respect, Recovery, Resilience in 2010. Now we need the public will to turn the words into action.

We also need personal will. Government can set up the formal supports. But there is not enough money in public coffers to meet every need. That’s where we all have a role to play.

Let me use one example. I have a friend who does not live at TCHC. She is too afraid of enclosed spaces to live anywhere but the street. The people that have made her life bearable are the staff at the public library, where she spends every day on her strange and mysterious journal.  They are the staff at KFC who give her a free coffee every morning, and the owners of the Chinese restaurant who give her discount prices and treat her with courtesy. And they include her sister who takes her for dinner or visits on park benches — who has not been able to coax her into an apartment but has kept the invitation open.

I’m not suggesting everyone should set out, boy scout style, seeking people to help. I am suggesting (at the risk of sounding preachy) that we say “yes” when opportunities arise, and not wait for the government, or landlords for that matter, to do what we can do ourselves.

(1) All figures drawn from TCHC’s Mental Health Framework, co-authored by Joy Connelly and Adair Robert (used with TCHC’s permission).