3. Why does homelessness prevention matter?

Canada has gone through three stages to try to reduce homelessness, including an emergency response in the 1990s, an implementation of community plans combined with Housing First initiatives, and more recently is in the beginning stages of moving towards a stronger focus on prevention (Gaetz, 2020). In this section we take a closer look at what homelessness prevention is and why it matters. Before you begin this section, please take a moment to write down your own thoughts about homelessness prevention below. 

How to complete this activity and save your work: Type your response to the question in the box below. When you are done answering the question navigate to the ‘Export’ page to download and save your response. If you prefer to work in a Word document offline you can skip right to the Export section and download a Word document with this question there.

Homelessness is a trauma that has long-term detrimental effects on the people who experience it. We know from research that the duration of a person’s homelessness can negatively influence their housing outcomes, which is a strong argument for prevention and early intervention that decreases the amount of time a person spends experiencing homelessness (Chen, Cooper, & Rivier, 2021). In these three videos youth homelessness researchers Dr. Naomi NicholsDr. Alex Abramovich, and Dr. Kaitlin Schwan speak about the negative impacts of homelessness and how difficult it is to move people out after they become entrenched. 

 

Dr. Naomi Nichols: Why does prevention matter?

In this video, Dr. Naomi Nichols argues that prevention matters because homelessness erodes people’s well-being and their connections to people and places. She notes that homelessness subjects people to discrimination and stigma, which for youth in particular can have detrimental effects on their physical and mental wellness, as well as their connections to school, work, and other protective institutions. Dr. Nichols further argues that homelessness erodes a person’s sense of safety and while feeling unsafe is not good for anyone, it is particularly problematic for young people to have chronic stress in their bodies at a critical time in their adolescent development. This video is 3:06 in length and has closed captions available in English.

Key Takeaways – Dr. Naomi Nichols: Why does prevention matter?

  1. Homelessness erodes people’s mental and physical health, well-being, and connections to people and places. We want to prevent it because once these have been eroded, it is hard to do the work of mobilizing oneself.
  2. Homelessness subjects people to discrimination and stigma in their interactions with other people in society, such as service providers and the general public.
    • For young people in particular, experiences of discrimination erode physical and mental well-being. We do not want youth to grow up facing discrimination in school and other institutions within their communities.
    • School, work, and other institutions can be protective for youth, create long-term feelings of purposefulness, and provide the capacity to actualize their dreams, but homelessness creates material instability which can undermine these connections.
  3. Homelessness erodes a person’s sense of safety. It is difficult to move forward in life when you do not have the things that you need to feel stable, well, and safe.
    • Feeling unsafe is not good for anyone, but youth in particular should not have to grow up always on guard. This level of vigilance also creates stress in the body that has to be metabolized at a critical time in their development.

Dr. Alex Abramovich: Why does homelessness prevention matter?

In this video, Dr. Alex Abramovich explains that we have been talking more about prevention in recent years, but it is still not fully understood. He notes that it can be difficult to support people in successfully exiting homelessness and provides the example of LGBTQ2S+ youth who often have to have something tragic happen before they are provided significant support to exit homelessness. Dr. Abramovich cautions that this is a reactionary response and that if we put more energy and emphasis into prevention, we could help people avoid trauma and instead focus on supporting their long-term health and well-being. This video is 1:51 in length and has closed captions available in English.

Key Takeaways – Dr. Alex Abramovich: Why does homelessness prevention matter?

  1. Although we have been talking more about prevention in recent years, not everyone fully understands why it matters and is important.
  2. It can be difficult to support people in successfully exiting homelessness, which is why preventing it from happening is important.
    • With LGBTQ2S+ young people experiencing homelessness, it often takes something tragic to happen before they are offered any significant supports to exit. This is a reactionary response.
  3. If we put more energy and emphasis into prevention, we could avoid a lot of the trauma that people experience and focus instead on supporting their long-term health and well-being.

Dr. Kaitlin Schwan: Why does homelessness prevention matter?

In this video, Dr. Kaitlin Schwan explains that in Canada, our response to homelessness is emergency-based and that supports are provided on the basis of demonstrating high levels of need. The design of this system is such that people must go through a lot of harm and trauma before the system kicks in to help them. Dr. Schwan provides the example of working with young people who have been unable to access programs until they reached 6 months on the street. She argues that in this time, they can accumulate multiple harms and traumas. Dr. Schwan discusses how homelessness shapes the trajectory of a person’s life and can have lasting inter-generational effects. This is evidenced through the looping effect of involvement in the child welfare system across generations, which particularly impacts racialized and Indigenous communities, making prevention a particularly important equity-based approach. Dr. Schwan concludes that our current emergency response is expensive, and that prevention is the way forward to align with our commitments to human rights in Canada. This video is 4:35 in length and has closed captions available in English.

Key Takeaways – Dr. Kaitlin Schwan: Why does homelessness prevention matter?

  1. In Canada, our response to homelessness is emergency-based, and who gets priority is determined by who is in the greatest need.
    • We do need to urgently respond to people who have been on the streets for a long time and have chronic health conditions or other issues.
  2. The way this system is designed – to prioritize those most in crisis – means that we have built a system that requires people go through a lot of harm and trauma before the system begins to help them.
    • Youth experiencing homelessness often will express frustration over not being able to access programs until they have met a certain amount of time on the street.
    • While waiting to qualify for help, people accumulate tremendous amounts of trauma and harm. For example, young women and gender diverse people face high risks of sexual assault every day.
  3. Homelessness shapes the trajectory of a person’s life and can have longer inter-generational effects.
    • We see this impact in the looping effect of child welfare involvement. People who experience homelessness have often been in the child welfare system. They are also then more likely to have their own children apprehended and put in the child welfare system, creating a cycle that impacts a person but also carries through generations.
    • These impacts are particularly felt amongst racialized and Indigenous communities, making prevention tremendously important as an equity strategy.
  4. Our current emergency-based approach to homelessness is expensive. Providing people with income supports and affordable housing that meets their needs is fiscally prudent.
  5. Switching to a preventive approach is in line with the human rights treaties and obligations we have agreed to as a country. Preventing the accumulation of harm and trauma, keeping people connected to their communities, and offering supports is the right thing to do.

Quote Source

Our current response to homelessness is a crisis-based one that uses emergency services, like shelters, to help people only once they are on the far end of the homelessness continuum. This model is flawed in many ways, not least of all because of the poor quality of life it creates for service users.

On a systems-level, we can also see that the structure itself is unsustainable. You may have seen news coverage in your own city about shelters reaching capacity and people not having anywhere to go. Research by Jadidzadeh and Kneebone (2018) shows that there is a noticeable increase in shelter users who are experiencing chronic homelessness, which is concerning because it will strain the ability of the shelter system to provide crisis relief and is an indication of a social order in trouble. In this next video, which is brief but succinct, Dr. Jacqueline Kennelly explains that our system has it backwards. 

 

Dr. Jacqueline Kennelly: Why does homelessness prevention matter?

In this video, Dr. Jacqueline Kennelly argues that our system is designed as an emergency crisis response, and that a young person has to be in crisis before they can begin accessing services that allow them to get back into housing. She notes that this is backwards, as the more entrenched a young person becomes in homelessness, the harder it is to get back out. This video is 0:25 in length and has closed captions available in English.

Key Takeaways – Dr. Jacqueline Kennelly: Why does homelessness prevention matter?

  1. Our system is designed as an emergency crisis response. This means a young person has to be in crisis before they can start to access services that allow them to get back into housing.
  2. The more entrenched a young person becomes in homelessness, the harder it is to get them back out.

If our current system is backwards and only helps people once they are already entrenched in homelessness, what could we do differently? Three researchers who speak in this section, Dr. Erin Dej, Dr. Stephen Gaetz, and Dr. Kaitlin Schwan, have argued that we can learn from countries that have shifted to address the prevention of homelessness, like Australia, Finland, and Wales (Dej, Gaetz, & Schwan, 2020). They have proposed a typology of homelessness prevention that is made up of the five interrelated elements of (i) structural prevention, (ii) systems prevention, (iii) early intervention, (iv) evictions prevention, and (v) housing stabilization.

 

Building on that typology, through systematically reviewing the literature, Oudshoorn, Dej, Parsons, and Gaetz (2020) add the additional sixth element of empowerment. The ultimate goal of their comprehensive framework is to support communities and governments in more effectively preventing homelessness through upstream approaches that address the root causes (Oudshoorn et al., 2020).

 

As you begin to learn and think about prevention, it may be useful to consider what our system looks like now, and what it could look like if it focused more on prevention and early intervention. This infographic and video from the Homeless Hub help to illustrate the central concepts.

prevention image infographic

Shifting towards the prevention of homelessness will require the commitment of public sectors across society. Consider, for instance, the experience of a person who is leaving a jail, hospital, or foster care placement without having somewhere to go. If done well, discharge planning can account for the needs of people as they exit these systems and ensure they receive adequate and appropriate follow-up care. However, as you will see throughout this book, there is often a disconnection between how public systems operate. Many of our public systems do not think about homelessness as being their concern. Dr. Nick Falvo discusses this issue and why prevention matters within this context, in the following video.

 

Dr. Nick Falvo: Why does prevention matter?

In this video, Dr. Nick Falvo identifies prevention as something that has garnered more attention within the past 5 years, in large part due to the work of Professor Stephen Gaetz and the Canadian Observatory on Homelessness. Dr. Falvo explains that it is important to talk about homelessness prevention because when we do, we identify institutions that contribute to the problem and hold them accountable. As an example, Dr. Falvo discusses the corrections system and how inmates are frequently released into homelessness without prior consideration or discussion about their housing status. Additional examples of institutions that discharge into homelessness include hospitals and the child welfare system. Dr. Falvo concludes that talking about prevention forces us to shine a light on institutions that contribute to the problem. This video is 2:35 in length and has closed captions available in English.

Key Takeaways -Dr. Nick Falvo: Why does prevention matter?

  1. The idea of prevention has been getting more attention within the past 5 years. Much of the work in this area has been led by Dr. Stephen Gaetz and his team at the Canadian Observatory on Homelessness.
  2. It is important to talk about prevention, because when we do, we have to also talk about the institutions that are creating homelessness. That helps hold those institutions accountable.
    • We need to look at institutions, have a difficult conversation, and ask, “What are you doing to help and what are you doing to hurt?”
  3. An example of institutional responsibility can be seen in the release of people from corrections facilities, such as prisons and jails, into homelessness rather than into housing.
    • Most corrections facilities and their staff do not consider an inmate’s post-discharge housing to be their problem.
    • Some organizations, such as the John Howard Society of Canada and Canadian Mental Health Association offer assistance in some parts of Canada but there is not enough discharge planning or support on a broad scale.
    • Without discharge planning, an inmate can be released onto the street, and the corrections system is not held accountable.  Talking about prevention forces us to shine a light on institutions that contribute to the problem.
  4. Other institutions that discharge people into homelessness include the child welfare system and hospitals.

Quote Source

The shift towards prevention is markedly different than the current emergency-based system that we are used to. As you learn about this approach, it is useful to keep in mind the question raised by many researchers in this section, about why we make people wait until they are entrenched in homelessness before our system steps in to help them. Dr. Stephen Gaetz has written extensively about our current systems approach and the need to shift towards prevention. In the next video, he shares his thoughts. 

 

Dr. Stephen Gaetz: Why does homelessness prevention matter?

In this video, Dr. Stephen Gaetz explains that exposure to homelessness for any length of time has profound and long-lasting effects on physical and mental health and increases the risk of victimization. He notes that by letting people fall into homelessness and not helping them exit immediately, we are contributing to the number and severity of issues they will experience. Dr. Gaetz argues that a “new orthodoxy” has existed for the past 20 years – combining Housing First, community strategies to coordinate efforts, and prioritization of chronically homeless people who have complex mental health and addictions issues. While he notes this bundle of activities is important, he argues that we need to do more to ensure people do not have to wait for housing and supports, because it contradicts Canada’s commitment to the right to housing. Dr. Gaetz notes that people are often reluctant to consider new ways of doing things, but that focusing on prevention would have benefits for individuals, families, and communities. He argues that the problems that create homelessness can be solved if we are willing to think about the issues in a different way, to intervene early, and turn off the inflows. In concluding his response, Dr. Gaetz offers a hypothetical comparison to the COVID-19 outbreak to demonstrate the harm that can be caused if we do not focus on prevention. This video is 6:46 in length and has closed captions available in English.

Key Takeaways – Dr. Stephen Gaetz: Why does homelessness prevention matter?

  1. Exposure to homelessness for any length of time has profound and long-lasting negative impacts.
    • People’s physical and mental health are compromised. Common reasons for this decline include experiences of trauma, brain injury, and malnutrition.
    • People are exponentially more likely to be victims of crime, including being trafficked and exploited.
  2. By letting people fall into homelessness and not helping them immediately exit, we are contributing to the number and severity of problems that they will experience. The deeper the problems become, the harder they are to handle and recover from.
  3. Our current approach, “the new orthodoxy,” that has been around for 20 years involves a combination of Housing First, community strategies to coordinate efforts, and prioritization of chronically homeless people who have complex mental health and addictions issues.
    • This bundle of activities is important, but we still have to do better because what this approach means is that if you become homeless you have to wait until you are in the highest need, to qualify for housing and supports.
    • This approach contradicts Canadian legislation that declares housing a human right.
  4. In the United States, reports to Congress showed a period of time where there was a large reduction of chronic homelessness that then went back up. This reduction occurred because of a large investment made at the time into Housing First and integrated supports for health care, housing, and employment within the Department of Veterans Affairs.
    • This demonstrates the new orthodoxy works well if the systems are aligned. Outside of these contained systems, we need to consider whether new solutions are needed.
  5. People are often reluctant to talk about new ways of doing things. What if we flipped it around and rather than waiting for people to experience homelessness for a long time, we tried to stop it from occurring in the first place?
    • People would avoid the consequences of exposure to homelessness.
    • It would be less expensive.
    • It would be better for individuals, families, and communities.
  6. The reasons people become homeless are often problems that can be solved, such as being low on rent, or being discharged out of corrections or child welfare.
  7. Prevention requires a reorientation of the way we think. We should ask ourselves, “What is the problem that we are trying to solve?” If the problem is homelessness, then we need to turn off the inflow and intervene early.
  8. Consider if we treated COVID-19 the same way we approach homelessness. Rather than focusing on prevention, we would wait for people to get really sick and then see if they were eligible for help.

At this moment we encourage you to pause and read the framework for homelessness prevention developed by Dr. Gaetz and Dr. Dej. It is also noteworthy here that youth homelessness prevention is also critical and has its own framework document (Gaetz, Schwan, Redman, French, & Dej, 2018), which is discussed in depth in the chapter on Child & Youth Studies.


Featured Reading:

open book graphicGaetz, S. & Dej, E. (2017). A new direction: A framework for homelessness prevention [summary]. Toronto: Canadian Observatory on Homelessness Press.


Gaetz and Dej (2017) write that prevention not only makes sense but is standard practice in many areas of society, such as vaccinating to prevent disease or wearing a seatbelt to prevent collision fatalities. Yet, despite its benefits, the impact of prevention can be difficult to measure. How can we prove that someone would have become homeless but did not because of our efforts? This is an issue that Dr. Erin Dej and Dr. John Ecker discuss in the next two videos. 

 

Dr. Erin Dej: Why does prevention matter?

In this video, Dr. Erin Dej explains that prevention matters because it is easier to stop something from happening than to try and fix it afterwards. She argues that prevention makes logical sense and draws parallels in the fields of health care, such as smoking cessation programs to prevent cancer and seatbelts to prevent car accident deaths. Dr. Dej notes that homelessness can be trauma-inducing and we need to think about how to apply the same logic of prevention to intervene before it starts. She concludes that the challenge with prevention is that it is difficult to show something did not happen, and therefore justify it in a budget, but that it is a hurdle we must overcome. This video is 3:18 in length and has closed captions available in English.

Key Takeaways – Dr. Erin Dej: Why does prevention matter?

  1. Prevention matters because it is easier to stop something from happening than to try to fix it afterwards. Stopping something rather than addressing it after it has happened is usually more effective and efficient.
  2. Prevention makes logical sense and has a long-standing tradition in our health care and public health systems.
    • For example, preventing cancer such as through smoking cessation programs is better than treating it.
    • For example, installing seatbelts helps prevent injury and death in car accidents. This is preferable to waiting until people are hurt and then treating them in an emergency room.
  3. Homelessness can be trauma-inducing and a horrible experience. We need to think about how we can take the same logic and apply it to homelessness so that we stop it before it starts.
  4. The challenge with prevention is that it is difficult to show something would have happened but then did not. There is no easy way to measure prevention, which is a hurdle when trying to justify it in budgets. We need to get over this hurdle.

Dr. John Ecker: Why does homelessness prevention matter?

In this video, Dr. John Ecker argues that if we had stronger homelessness prevention strategies, we would not have the level of homelessness currently seen in Canada. He draws comparisons with Finland and Norway to demonstrate how their stronger social safety nets result in lower levels of homelessness. Dr. Ecker notes that prevention is important because it focuses on the structural and systemic causes of homelessness, such as the need for more affordable housing and increases to income support rates. He identifies institutions, such as hospitals and jails, as having a key role and responsibility to prevent discharge into homelessness, which could be accomplished through legislation. Dr. Ecker notes that prevention allows us to identify risk and address it earlier, through a focus on structures and policies. He concludes that, while prevention efforts are sometimes critiqued for not having measurable outcomes, it is important to remember that what we do now will have an impact on future levels of homelessness. This video is 4:18 in length and has closed captions available in English.

Key Takeaways – Dr. John Ecker: Why does homelessness prevention matter?

  1. If we had stronger homelessness prevention strategies, we would not have the level of homelessness we are currently seeing in Canada.
    • Comparatively countries like Finland and Norway have stronger social safety nets and report lower levels of homelessness as a result.
  2. Prevention is important because it focuses on the structural and systemic causes of homelessness.
    • The lack of affordable housing is a significant cause of homelessness. By increasing the stock of affordable or social housing and offering rent geared to income supports we could prevent homelessness.
    • Low incomes contribute to homelessness. By increasing wages, social assistance, and disability supports to the point where they match cost of living and meet the level of inflation, we could prevent homelessness.
  3. The role and responsibility of institutions, such as hospitals and jails, in preventing homelessness has started to get more attention recently.
    • Consider the impact we could have if there were legislation that mandated these institutions could not discharge into homelessness.
  4. Prevention allows us to identify the risk of homelessness and address it earlier. Our focus moves away from what is happening at the individual level and towards a consideration of how structures and policies we have in place impact people’s entries into homelessness.
    • It is important to remember that what we do now to prevent it, will have an impact on homelessness in the future. For example, point in time counts show many adults experiencing homelessness also experienced homelessness as youths.
  5. A critique of focusing on prevention is that it is difficult to measure something that did not happen, but that is the outcome we want.

What do you think?

human head with light bulb as brain graphicOne hurdle that researchers have identified with prevention is that it is difficult to measure something that does not happen, which makes it challenging to advocate for funding. If your job was to get funding for homelessness prevention efforts, what would you say to make this argument? 


One argument that can be made, is that ending people’s homelessness costs far less than our current emergency-based response. Consider this video discussion with Dr. Tim Aubry and the infographic that follows from the Canadian Observatory on Homelessness. 

 

Dr. Tim Aubry: Why does homelessness prevention matter?

In this video, Dr. Tim Aubry argues that we are coming to a greater realization that we need to not only address homelessness but also think more broadly about prevention. He explains that homelessness is an awful experience and if we can prevent it, we will save people from going through trauma and a life crisis. Dr. Aubry concludes that from a service and policy standpoint, it is cost-effective and logical to prevent people from having to navigate the complicated system of emergency and crisis supports needed to get back into housing after homelessness has occurred. This video is 2:08 in length and has closed captions available in English.

Key Takeaways – Dr. Tim Aubry: Why does homelessness prevention matter?

  1. Homelessness is an awful experience. If we can prevent it, that will make a big difference for people because they will not have to go through the same trauma and life crisis.
    • There is a greater realization now that we need to address homelessness, but we also need to think more broadly and try to prevent it.
  2. From a service and policy standpoint, preventing homelessness means people do not have to navigate the complicated system to get back into housing. Prevention will reduce service consumption and the associated costs of running crisis services.

 

At this point you may be thinking to yourself, “Okay, prevention sounds good and would save money, but let’s get real. We can never stop every person from becoming homeless!” If you are thinking this, you are absolutely right. Discussions around prevention always raise the concern that homelessness can never be completely avoided in every circumstance.

 

It may be useful to consider a parallel example of defining an end to homelessness. Turner, Albanese, and Pakeman (2017) explain that in a â€œfunctional zero” end to homelessness the goal is to achieve a point where there are enough services and supports to rapidly rehouse people and move them out of the homelessness system. In much the same way, while we may not be able to prevent every person from becoming homeless, we can prevent instances where possible and intervene early where prevention is not possible.

 

What we need in order to achieve a system where people are prevented from becoming homeless, or moved quickly back into housing, is a change in our thinking. We conclude this section with the optimistic words of Dr. Jeannette Waegemakers Schiff, as she shares her ideas for redesigning society for the collective good.

 

Dr. Jeannette Waegemakers Schiff: Redesigning society for the collective good

In this video, Dr. Jeannette Waegemakers Schiff argues that homelessness is first and foremost an issue of not having housing and that we can cut problems in half by keeping people housed. She notes that we are going to continue to perpetuate homelessness until we have government support at a federal and provincial level that provides an adequate supply of social housing. Dr. Waegemakers Schiff shares her wishful thinking ideal system, which includes systemic case management that provides instrumental support for people who are living precarious lives and may be experiencing one or more disabling condition. She concludes that we need to offer people more support, which is a larger political issue of governments recognizing that action needs to be taken for the common good. This video is 2:45 in length and has closed captions available in English.

Key Takeaways – Dr. Jeannette Waegemakers Schiff: Redesigning society for the collective good

  1. Homelessness is first and foremost an issue of not having housing. People may have problems that lead to them losing their housing, but a lot of problems are created because of the loss of housing.
    • We can cut the problems by keeping people housed.
    • Homelessness is a problem because we do not give people a place to live. We are going to perpetuate homelessness until we have government support at the federal and provincial level that provides an adequate supply of social housing.
  2. In the ideal scenario, we would have a systemic case management approach that would provide instrumental support for people who are living precarious lives and may be experiencing one or more of a number of intellectual, social, physical, and/or cognitive conditions.
    • We need to offer people supports to keep them on their feet. This is a larger political issue that needs federal and provincial government recognition and action for the common good.

In this section we asked you to consider the question, “Why does homelessness prevention matter?” Along the way, the answer to this question became another question in itself – why would we keep a system that makes people experience the trauma of homelessness before it steps in to help them? Homelessness is a horrible experience, yet our system is designed to help people only once they have lost all other supports. As we heard argued, this system is backwards. We have seen throughout this section that a framework for prevention makes sense, as the right thing to do for people and as a way to address homelessness more cost-effectively. Two challenges of prevention are that it requires commitment from various public sectors and that its outcomes are difficult to measure. What we need is a collective repositioning of the way we think, to understand the value of homelessness prevention in the same way we think about seatbelts and vaccines.

Podcast: Why does homelessness prevention matter? (32:05)

Click the link below to listen to all of the researchers answer the question “Why does homelessness prevention matter?” in audio format on our podcast!

 


 

License

Icon for the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

Understanding Homelessness in Canada Copyright © 2022 by Kristy Buccieri, James Davy, Cyndi Gilmer, and Nicole Whitmore is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, except where otherwise noted.

Share This Book