So let us return to Stephan and Zane. Without an understanding of the systematic issues in our society, we might consider that shelters must be a safe place to “house” individuals, however, it is evident that this couple is facing a number of safety risks. As we learned from Dr. Hwang folks living in shelters have a higher risk of contracting COVID-19. Stephan and Zane have been exposed and now must “shelter at home” in a congregate setting where space is limited, residents are transient, and supplies and resources to prevent transmission are inadequate. In addition, both Stephan and Zane have substance use challenges. They are currently living in a shelter that has a “no tolerance” policy for drug use which increases their risk of seeking substances from a significantly questionable and unsafe supply of both equipment and drugs. This increases the risk of an overdose or poisoning by tainted supply – increasing the risk of harm to both. They are living with daily fear, frustration, guilt, and feelings of hopelessness.

We need to ask ourselves:

• How does Stephan and Zane’s story make you feel?
• What event(s) do you think may have led them to this place and time? If you enlist a trauma-informed lens, what might you consider as you interact with this couple?
• What social determinants of health may have impacted their lives?
• How do you think Stephan and Zane’s social inclusion may be affected by their drug use?
• How do you think their drug use is affected by housing policies and tenancy supports?
• How might Stephan and Zane’s risk levels be different if the shelter had harm reduction, rather than “zero tolerance” policies?