Housing Continuance / Continuum BCS Lifeline Plan

This is a working document that is subject to change as partnerships and ideas are developed.

Research tells us that over seventy to eighty (70 - 80) percent of people who are offered, and accept, a stable living situation after being homeless for a length of time, remain housed after one year. This was found to be the case with federal At Home/ Chez Soi research and reflects the ongoing results of the Homeless Outreach team funded by the City of Vancouver and BC Housing. It is the other twenty (20) percent who are unable to accept the conditions of the housing offered to them, or who are found to be undesirable to the landlords who oversee their housing, who are continually abandoned to the streets and parks to fend for themselves. It is within this group of people that we find those who are most vulnerable to overdose, who have the most involvement with police and emergency services and whose physical health deteriorates rapidly.

The housing that is needed, by people who suffer from a combination of brain injury, mental illness and substance dependency, changes depending on the severity of the condition and the treatment and supports they are accessing for these conditions. One choice is not sufficient to provide for individual needs. New options for housing may be needed but we know that, as a start, most people need a lockable space with a private washroom. This not only serves the individual need for autonomy and safety but also greatly diminishes management issues that exist in communal situations. How do we provide the simplest of housing models for people who are not well enough to take care of their physical or mental/emotional needs and whose dependency on drugs or mental dysfunction has become severe to the point of overriding their decision making.

The first step towards housing and health stability for this group of people is a housing situation where their needs and goals can be assessed; a navigation centre. There are those who are very afraid of living in close proximity to others who need the security of a room with a door that locks and a relationship with a trusted caregiver. There are others who need the comfort of a larger community and shared meals. There are some who need and want detox and treatment to bring their addictions under control in order to live an integrated life and finally there are those who want to free themselves from addictions completely. What all of these people have in common is a desire to live in safety, with dignity and autonomy.

Autonomy can be the sticking point when it comes to providing housing for the most severely affected by mental illness and addictions. These conditions can create a situation wherein the individual makes decisions that are dangerous to themselves and the people who live in proximity. For instance hoarding is an issue that often results in eviction due to fire concerns when there are no controls on the amount of goods brought into a home. Unspecified anger and outbursts often cause a person to be evicted as well. An inability to control addictions and the need to sell drugs to access drugs can cause a dangerous situation both at home and on the street and cause housing providers to feel that visitors must be limited. This is unacceptable to some residents while others feel safe in a more contained environment. A coordinated and diverse response to these problems requires an organized and compassionate response from government, from the public and from health and housing providers.

It is central to any plan to provide supported housing that once an individual is shown to need those supports that they are never evicted without first securing a home, even if it is at a different place on the continuum. This loyalty to an individual and continuity of commitment lessens anxiety and chaos both in the person and in the treatment and housing system.

The first step in housing continuity must be an agreement between the individual and the system of care as to the level of supports needed. This can only be achieved with a trusted support giver. In the BCS Plan a team of workers will follow all people who have been considered for the program and attempt to make entry feasible. Some of the steps on the continuance are currently missing and it is the purpose of this plan to fill those gaps.

Housing continuity should provide:

• Assessment of need. (This could be accomplished at a navigation/shelter facility)
• Agreement between an individual and the facilitating program to accept a plan that is both short and long term in nature. Such a plan would include a plan re mental health and addictions treatment and assessment.
• Referral to and acceptance of an appropriate level of treatment or supportive housing for a specified amount of time.
• After this time, a move to more autonomous housing would be facilitated.
• Depending on where the individual started on the continuum, he or she or they would move from detox and treatment to second stage housing and then to supportive housing.
• The end goal for some individuals would be social or market housing without supports.

Gaps in Service

There are significant gaps, or ability to access services, at the level of detox and treatment. Because the former are not coupled with housing, too often the individuals needing support finish their programs without housing in place.

There is currently little ability for individuals to move from supportive housing to social or market housing due to a lack of housing availability.