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hamsmart’s delegation to the emergency and community services committee

RE: Homeless Encampments

Thank you for accepting my delegation today. And thank you for all of your work throughout these unprecedented times.

Since the start of the pandemic, Hamilton has seen an increasing number of people experiencing homelessness who are choosing to sleep outside or “sleep rough”. This is certainly not a new phenomenon and there are many reasons that people avoid the shelter system. Some people find the rules too restrictive at shelters (there are curfews and bed checks in place). Others lament all the theft that occurs and simply don’t feel secure sleeping in a dorm style setting. Still others have pets that are not welcome in shelters and when people have so few supports in their lives, sometimes their pets take precedence above all else. As you know, people who are homeless suffer from a disproportionately high level of mental health issues and we often see people who are simply too anxious or too paranoid to be in close contact with so many people. Other people want to avoid the drug use that is often rampant in shelters. And on the flip side of that there are people who use drugs who are repeatedly evicted from shelters due to their drug use. Many times people are asked to leave shelters just because they have drug use paraphernalia on them. Peoples belongings are routinely searched and a clean needle or an unopened can of beer is enough to be restricted from a shelter. Lastly, there are very few shelter beds open for couples so different-sex couples are either forced to go to different shelters or opt to sleep outside so that they can stay together.

These are all reasons that people choose to sleep rough. Then you add a pandemic on top of that and hearing the repeated message that people living in congregate sleeping settings are at highest risk can be an added worry for people.

I have been working with many people who are sleeping rough during this pandemic. From a health perspective, I see how unwell these individuals often are. I have seen people with severe life-threatening infections, people who have untreated spinal cord issues that put them at risk of becoming paraplegic, women who are in their last few weeks of pregnancy, and so many folks who have addictions that they are desperate to get help with but lack the stability in their lives to make that possible. Imagine trying to get to a pharmacy every day for a dose of methadone when you don’t know where your next meal is coming from, you have to somehow protect your belongings from theft, find a place to charge a cell phone so that you won’t miss a call from your housing worker and acquire water for your dogs. Never mind finding a place to simply relieve yourself in the morning.

I know that in the past the City has felt they had to dismantle homeless encampments in response to complaints from residents. We saw that at Sir John A McDonald, Jackie Washington Park and Ferrie Street not long ago. When this happens the connections that were made with people are lost. The outreach workers who have been working on housing applications, the health care workers who have been working on the physical and mental health piece – these connections are all lost when people are told to move along. I was working with an elderly gentleman with a fever and pneumonia who could not do much more than lay on the floor of his tent but refused to go to hospital. With minimal notice he was told to move along and I have not seen him since.

The city has slowed down on dismantling homeless encampments in recent weeks and I am grateful for that, as are my patients. I am asking that this continue to be the overarching principle in dealing with homeless encampments: let them be. This pandemic is unprecedented. We can’t expect that responses that might have seemed reasonable in the past are appropriate during a pandemic. People do not cease to exist when they are told to move along. They still need a place to be and by virtue of sleeping rough they have shown that they do not fit into the current shelter system as it is. The Centre for Disease Control (CDC) has issued guidelines stating that “Unless individual housing units are available, do not clear encampments during community spread of COVID-19. Clearing encampments can cause people to disperse throughout the community and break connections with service providers. This increases the potential for infectious disease spread.”

We are imploring you to recognize the severe health consequences facing people who do not have housing, to recognize that we are in a new era where the old rules are not necessarily the best ones and to refrain from moving encampments along whenever possible. From our perspective, it would only be acceptable to move people along when they are either being moved to housing units with appropriate supports or to an ultra low-barrier, highly supportive shelter model that will give them a chance of success. Moving people into one of the current shelters or hotels to have them evicted two days later only further decreases the trust that people have in the system, making them less likely to engage in the future.

We need to recognize that the current shelter system does not meet the needs of many of these individuals. I ask that, in the re-imagining of our city’s response to homelessness that the pandemic has instigated, we make this group of high-needs individuals who sleep rough a priority. Currently, we see many of these folks being service restricted from all of the shelters in the city and turned down from city-run hotels due to the fact that their needs are too high. In the healthcare world, that is like saying that you are too sick so we are not going to offer you any care. Instead of turning our backs on them and continually telling them to move somewhere else so that they won’t be seen, we need to find something that WILL work for them. What about a motel space that is as low-barrier as possible with intensive social and health supports? Other jurisdictions in Canada have done this with great success. The city has recently made a precedent of helping two people get directly from a homeless encampment into permanent housing. This was successful and there is no reason that it would not work for other folks as well. What this group needs are options and at this point viable options for them do not exist.

I understand that the focus for you right now is likely the encampment outside of First Ontario Centre. But our concerns about this issue predate that encampment. Part of the reason the FOC encampment developed was due to smaller encampments in the city being dismantled – groups of two or three tents at the back of a park that were told to move along, or a single tent along the rail trail somewhere. Another group of people outside FOC are people who have been service restricted from all of the shelters in the city. And other people sleeping outside of FOC have been illegally evicted from their residential care facilities (RCF’s). The encampment developed in that particular spot likely because of the neighbouring shelters that offered community to people as well as the fact that amenities existed in that area. Toilets and meals have not been as easy to come by during the pandemic and people will go to areas where services exist.

So please, stop dismantling homeless encampments for the duration of the pandemic unless people are being moved to an indoor space where they will have a modicum of success. This is not only a matter of public health and best practise as per the Centre for Disease Control, it is also a matter of human dignity and human rights. We need to recognize that the current system does not work for many people who are sleeping rough and work to either get them directly into permanent housing with appropriate supports or accommodate them in a shelter/motel that is low-barrier and high-support enough to meet their needs. Barring that, our city needs to be following an evidence-based approach to this issue, follow the international health guidelines that are available to us and stop dismantling homeless encampments.

Dr Jill Wiwcharuk and Dr Tim O’Shea
Hamilton Social Medicine Response Team (HAMSMaRT)

EST. 2018

Keeping Six – Hamilton Harm Reduction Action League is a community-based organization that defends the rights, dignity, and humanity of people who use drugs.