At the same time councillors heard the latest report on homelessness numbers in our city this week, Dr. Michael Krausz spoke to them about his study on homelessness and health in British Columbia.
Krausz is a professor of psychiatry at the University of B.C. and the UBC Providence Leadership Chair at UBC. His work breaks new ground, not just here but across the country. Thats because it provides clues on how to stop what he calls the flow into homelessness.
In past homeless counts, the numbers have been relatively threadbare in terms of giving us a picture of those who live in our community without a permanent home. We know their ages and whether they are aboriginal. And given Mayor Gregor Robertsons commitment to ending street homelessness by 2015, we note how many of those who are homeless are living on the street as opposed to in shelters.
For the first few years of Robertsons mandate, and thanks to a partnership arrangement with the province, the numbers of street homeless drop significantly. Low-barrier professionally run HEAT shelters opened, welcomed folks with pets and piles of possessions in shopping carts and offered social and medical services. New construction of supportive housing was also under way.
Yet now, with cuts to the HEAT shelter budgets, street homeless numbers have jumped by almost 50 per cent in the last year.
So the city points fingers at the province for its failure to fund those shelters. And the province grumbles that it is making a significant contribution by funding the construction of 14 buildings, designed in part to house the homeless, which the city says should be taking in a higher percentage of homeless people.
But back to Dr. Krausz and his picture of who is homeless.
What his study has found is that more than 50 per cent of people who are in that population first found themselves there before they turned 25. Furthermore, 85 per cent of all those who are now homeless reported moderate to severe emotional, physical or sexual abuse in their childhood. An inordinate number came through the foster home system. Ninety-three per cent have a current mental disorder and 83 per cent exhibit a substance abuse disorder.
Given all that, the notion that a significant number of homeless people are in that state because they chose to be is patently absurd.
Rather, Krausz says, the homeless represent the most complex challenges in the health care system.
To interrupt the path that takes people to homelessness Krausz says, We should try to prevent homelessness through better, earlier low-barrier access to quality mental health and addiction care.
That approach presents two problems. For one, he says, we are woefully inadequate in training people to deal with dual diagnosed patients. You just cant have a health care worker with no clue about dealing with the complexities most homeless people face.
Secondly, we are more inclined to support a system that deals with the problem once they arise rather than focus on prevention.
Homeless people, especially those on the street, tend to have no connection to the health care system. Vancouver Coastal Health essentially doesnt recognize these folks; they have no medical records on file. It takes a dramatic emergency for the system to pay attention. That is both expensive and life-threatening.
It does nothing to provide people either on the street or in shelters the stability they need to get out of their situation.
What is also required to deal with a lot of significantly ill people if we are unable to prevent them from joining this population is stable housing and the medical support to go with it, says Krausz.
That is far more urgent and would be more productive than a debate about whether the numbers of street homeless are up or down and who deserves the credit or the blame.
agarr@vancourier.com
