Hamilton project breaks down silos to end homelessness

When John Corby moved into an apartment after six years of homelessness, he had trouble sleeping in a bed.

I had to put my tent up in my room just to get used to the fact of being indoors," Corby recalls.

He also slept sitting up with his back to the wall, a safety measure that lingered from the rough-and-tumble street.

But just under a year later, with the stability of his one-bedroom apartment, he has undergone dramatic changes.

I'm feeling absolutely astonished," says Corby, 47. What a total turnaround in life events."

He has reconnected with his estranged daughter and spent time with his grandson. He's planning to start treatment for addiction.

The key to Corby's rebound has been a local pilot project that combines the expertise of four organizations to help bridge gaps between the health and housing sectors.

Launched in January, the Intensive Supports Pilot is led by the City of Hamilton, St. Joseph's Healthcare, the local Canadian Mental Health Association (CMHA) and the Coalition of Hamilton Indigenous Leadership.

The trail-blazing collaboration helps secure affordable units for those who face complex barriers, such as severe mental-health and addiction issues, and keeps them housed through wraparound" support services.

It involves a team of registered nurses, peer-support workers, an addictions counsellor and occupational therapist, drawn from St. Joseph's and CMHA, that coalesces around the participants, who receive housing allowances and units through the city.

That support team also opens the door to an array of services through agencies that specialize in housing and health.

For the January launch, the partners cobbled together funding and in-kind services for 16 people (one person has since moved out of province and another recently died).

It's seen as a seminal silo-breaking test run that could have a major impact on chronic homelessness in Hamilton if scaled up through permanent funding.

There are so many people that could use it and whose lives could be changed in significant ways if they had this kind of support," said Mary Puntillo, clinical director with St. Joe's mental health and addiction program.

But by spring, the pilot's $200,000 in provincial funding will run out.

We're working on the fumes of that," Puntillo said.

A deepening crisis

Hamilton's homelessness crisis has only deepened during the COVID-19 pandemic.

That's starkly apparent in the clusters of tents dotting the urban landscape.

As the city clears encampments from parks, some dislocated residents have found their way to shelters and housing.

But not all. That's due to a longtime shortage of beds, especially in the women's system, and for those with acute mental-health and addiction issues.

Last week, the city also stopped taking couples into overflow hotel rooms due to concerns of domestic violence.

• At the end of September, 1,375 people were on Hamilton's active byname list, a database that includes shelter and drop-in centre users.

• Of those, 47 per cent were considered chronically homeless, which means for at least six months in the past year, and on a recurring basis over at least 18 months in the past three years.

• Of roughly 100 encampment residents, the average time spent homeless was 2.6 years, while 64 per cent displayed a high acuity of social needs," a recent city report notes.

This suggests a majority are experiencing chronic homelessness and a complex range of barriers to securing and retaining housing."

Principal gap'

The city aims to minimize the duration of shelter stays by helping people get into housing.

But during the pandemic, stays have lengthened, creating a bottleneck amid staffing shortages and burnout.

There are programs through agencies that follow a housing first" approach paired with intensive case management" to help people transition from shelters to homes.

But when it comes to addressing the most complex needs, there is a principal gap," says Edward John, the city's housing director.

It's not just a case of us not being able to provide it. It's a case of us not being able to fund it. It transfers over into a health issue," he told councillors last week.

In an interview, John said the city and agency partners have struggled to ensure long-term tenancies for 100 to 160 people with very acute challenges.

The Intensive Support Pilot currently only reaches 14, but it offers a ray of hope of what could be achieved.

The transition from chronic homelessness to stable housing for people with highly acute needs is not uncomplicated," Puntillo said.

People need far more than a roof over their head when they're moving from living rough to permanent housing."

The pilot operates through a health-and gender-equity lens: 25 per cent of its resources are dedicated to people who self-identify as women, nonbinary and transgender; 10 per cent to youth ages 16 to 24; 25 per cent to those who are Indigenous.

Due to Canada's colonial legacy, which includes residential schools, a disproportionate number of Indigenous residents are represented in Hamilton's homeless population.

That's why it's important to have the Coalition of Hamilton Indigenous Leadership at the table, says acting executive director Cindy Sue Montana McCormack.

Collaboration is the word because that's what's needed for appropriate supports to secure and maintain housing. Period."

Happy to be housed'

John Corby, who is Indigenous, can attest to the value of his support team.

They're a lifeline to him at Vanier Towers, the CityHousing highrise at Jackson and Hess he calls home.

They come and talk to me and give me the support that I need to make sure that I'm doing OK because I do have some mental-health issues."

Life is better, but the years of desperation and chaos remain vivid in his mind.

I was living in tents. I was living in apartment stairwells."

He stayed with people for spells, tried getting places, but nothing ever stuck.

Corby went to jail for theft.

But I didn't care. It gave me three hots and a cot and a roof over my head."

That was then.

I'm a 120-per-cent different person. I'm happy to be housed. I want to help people."

Corby delivers food and supplies to homeless people on weekends. He hopes to go back to school to become an outreach worker.

In his one-bedroom apartment, he has a couch, a television, photos on the walls. He's now able to collect comic books - a passion since childhood - and keep them.

His subsidized rent is deposited directly from his disability pension. The support team also ensures he's paying other bills and buying groceries, Corby notes.

If it wasn't for them," he says, I wouldn't be able to keep this up ... and I love them dearly. I'm blessed to have them in my life."

Challenges and accomplishments

Throughout the pilot, there have been challenges - including loneliness.

For some who leave their communities on the street for more independent living, the isolation can be overwhelming.

It can spur the reliving of traumatic life experiences, notes Sue Phipps, chief executive officer of the local Canadian Mental Health Association branch.

There's also an understanding of reciprocity" among people who live in communal settings but don't have much, Phipps explains.

If I help with this, then tomorrow you can help me with that."

And when it comes to housing - an amazing opportunity" and privilege" - there can be an impulse to share with friends who don't have it.

So I think there is this tendency to invite people into their homes, which can lead to eviction when they don't leave, or they cause disturbances within the unit."

Hoarding has also been an issue, says Holly Raymond, director of general psychiatry at St. Joseph's.

When you think about it, people come from having very few possessions to having the opportunity to have more possessions."

An addictions counsellor who's on shift until evening has offered tremendous support, but 24-hour services would be ideal, Raymond says. This is the piece that's missing for us."

But with the challenges, there have been tremendous gains, including the setting of life goals, Phipps says.

Because they know, see themselves as securely, safely and permanently housed, which is, to me, an incredible accomplishment."

A way forward

The provincial health dollars for the pilot dry up March 31.

It really needs to be permanent funding, because if not, you're wondering what's coming next for people," Holly Raymond said.

Puntillo notes scaling up the initiative to include as many as 60 participants would require at least $1.5 million a year.

If not for the obvious humanitarian case, the investment also makes economic sense, she says.

A 2013 research paper, The State of Homelessness in Canada," noted homelessness costs the Canadian economy $7 billion a year.

That cost included emergency shelters, social services, health care and corrections, noted the study by Stephen Gaetz, Jesse Donaldson, Tim Richter and Tanya Gulliver.

The study authors cited figures in a 2007 Wellesley Institute study that found $1,932 was the average monthly cost of a shelter bed, $10,900 for a hospital bed and $4,333 for jail.

Housing stability translates into better health and fewer trips to emergency rooms. It also means fewer crimes of desperation and time spent incarcerated.

If there's a way to prevent that from happening, then wouldn't that be good for everyone, for the person, for the hospital system, for the community?" Puntillo asks.

It has been good for John Corby.

Just consider Alyssa, his 28-year-old daughter.

Me and her just had a very estranged relationship because of my drug addiction and being in and out of jail throughout her young life."

Like so much else, that has changed.

She wants me to be a part of her life. She wants me to be a part of my grandson's life."

Just the other day, they had a visit. Corby got to hold baby Xavier John.

Oh, he's dynamite. He's beautiful. Like, it's amazing."

Teviah Moro is a reporter at The Spectator. tmoro@thespec.com