“I’d do whatever I had to do to stay warm” recalls David, who was homeless on Toronto’s streets from 2000 to 2003. David said he spent the winter nights in emergency shelters, and bitter cold days in bank ATM lobbies or riding around on public transit. “Survival was tough” he says, describing everyday life on the streets marked by the struggle – to meet basic needs and against addictions.

Spending the Canadian winter on the streets

Every day and night, there are about 30,000 people across Canada who are homeless. They are among the most vulnerable – homeless people have higher rates of infectious diseases like HIV, mental illness and addictions, and much higher death rates than the average Canadian.

For more statistics on Canada’s homeless population, click here or on the infographic from the State of Homeless in Canada 2013 report.

The struggle for survival is often most pressing during the winter months when temperatures in Canadian cities can plunge to -30 degree celsius and below. Environment Canada warns that at temperatures with a wild chill of  -29 to -39 degree celsius, exposed skin can freeze in 10-30 minutes with subsequent hypothermia and frostbite.

There have been a number of reported deaths of homeless people from exposure across Canadian cities this year. Statistics Canada tracks deaths from exposure to excessive natural cold. Across Canada in 2011, there were 95 deaths from exposure, with these deaths occuring twice as often in men than women. Some researchers have suggested that this reflects the population of homeless men on Canadian streets who are more likely to die from exposure. While the number of deaths from exposure are small,  many advocates ask why these deaths, as well as exposure-related injuries or illnesses, are still happening at all.

“How is it that in a country as wealthy as ours, we leave vulnerable people outside during harsh winters?” asks Tim Richter, CEO of the Canadian Alliance to End Homelessness.

Expanding emergency shelter capacity in extreme weather

All Canadian cities have emergency shelters in place– which house about 14, 400 people on any given night. Emergency shelters are defined as facilities to meet immediate, short term needs of homeless people, and are not intended for long stay, with clients expected to leave each morning. The rest of Canada’s homeless population is split between other forms of shelter – such as a women’s shelters, hospitals or hostels.

However, there are nearly 3,000 Canadians who sleep outdoors each night. This population is described as ‘sleeping rough’ and is often resistant to staying in shelters, or use shelters as a last resort.

David says that during his time on the streets, he knew many people who “couldn’t handle being in shelters” because of personal safety concerns, as well as an inability to comply with the shelter rules which they viewed as restrictive. There is variability in shelter restrictions – but they can include no in and out privileges between certain hours, no drug or alcohol use and separation from personal belongings. Shelters can also be a place where diseases like tuberculosis are spread, and bed bugs can be rampant.

Stephen Gaetz, Director of the Canadian Homeless Research Network at York University says “being thrust into congregant living environments can be unsafe and challenging.”

Across Canadian cities when extreme cold weather, as well as oppressive hot weather, hits – cities expand emergency shelter capacity and deploy emergency response teams and resources.

In Calgary, the Downtown Outreach Addictions Program which does year-round mobile outreach, has a winter response program which includes additional checks on known homeless encampments or people sleeping outdoors, and offers them transport to shelter beds at any time of day or night.

Phil Abrahams, general manager of Shelter, Support & Housing Administration for the City of Toronto describes how the city puts in place an extreme cold weather alert when the temperature is forecast to hit -15 or below. This alert triggers the opening of additional shelter beds, as well as a request to  relax shelter restrictions, including that shelters stay open during the day to allow people to stay indoors.

Abrahams adds that during alerts  ‘warming centres’ are opened in select public buildings to provide people with a warm place for a hot drink off the streets. These are modeled on ‘cooling centres’ put in place during sweltering summer days and heat alerts. He says warming centres are “staffed to help coordinate getting people into emergency shelter beds.”

Cathy Crowe, a Toronto street nurse and cofounder of the Toronto Disaster Relief Committee has been highly critical of Toronto’s warming centres, suggests that more resources need to be in place at these centres.

“We know that each time warming centres open, people come” Crowe says. “It saves lives and reaches out to people who are alienated from social services and allows for potential referrals to shelters and other services.”

Crowe points to warming centres filling up as a sign that “we are way beyond capacity in the shelter system.” She says that expanded services during cold weather alerts should be sustained beyond these periods of extreme weather. The Ontario Coalition Against Poverty (OCAP) agrees with this assessment, pointing to a figure that the voluntary, charity-based Out of the Cold Program, which opens additional shelter beds in Toronto churches and synagogues is at 111% capacity. A recent OCAP news release argues that Out of the Cold overcapacity “speaks volumes about the overcrowding and conditions in the regular shelters.”

While some argue that more capacity is needed in shelters, many are saying governments and organizations shouldn’t devote the majority of resources to what amounts to a “band-aid” solution for homelessness. There is a growing consensus among advocates and researchers that what is needed to help keep homeless people out of the cold are longer-term solutions.

Stephen Hwang, physician and scientist at the Centre for Inner City Health at St Michael’s Hospital says that “while it’s important to take steps to prevent frostbite or hypothermia among the homeless, it is more or equally as important to address the problem of homelessness itself.”

Moving away from “band aid solutions” to homelessness

A 2012 study found that there were nearly 400 shelters across Canada’s provinces and territories. Shelters are operated by a patchwork of organizations, and are generally run by not-for-profit, religious or charitable groups that are partially funded through government dollars, as well as charitable donations. Along with emergency shelters, outreach organizations, affordable housing agencies, health care, social welfare and the justice system all provide programs and services to the homeless.

Tim Richter characterizes the patchwork of services and programs for the homeless as a “disconnected system of crisis response.”

He argues that the shelter system, designed as a short-term, emergency response to the homeless crisis, has become institutionalized, and that there needs to be a shift in thinking around service design and coordination.

Richter advocates for shelters as being the front door to a more permanent solution of housing and social supports. “Shelters are the emergency room for the homeless” he says, and should be thought of as “a part of a system designed for intake, triage and short stay where people can move on to a space that is more appropriate and permanent.”

Experts like Richter point to Alberta as leading the way in developing more effective, long-term solutions towards homelessness.

In 2009, the province established a Secretariat for Action on Homelessness with the goal to eradicate homelessness in 10 years. This included major investments in housing, as well as bringing together government ministries and services like health, corrections and child protection for program and service development.

As part of this work, seven Alberta cities developed multi-year plans to end homelessness. These plans focused on providing the provinces’ homeless with housing options and social supports to keep them housed.

Steve Gaetz applauds what he describes “a leap forward that has rapidly resulted in a difference” to the lives of people experiencing homelessness in Alberta. Results of the provincial commitment to end homelessness have included 6,600 Albertans who had been experiencing homelessness that have been provided with housing and social support.

Rather than expanding emergency shelter capacity, Alberta has seen a 10% reduction in emergency shelter use province-wide since 2008.

Whether other Canadian provinces and cities can follow Alberta’s lead remains to be seen. However, it appears that approaches are slowly changing. With successes seen in research programs like At Home/Chez Soi and Streets to Home, all of which provide homeless people with housing and social support, there is growing interest in dealing with the causes of homelessness, rather than managing it as a crisis.

“The best way that we can manage capacity in the shelter system is to do things to reduce demand” says Phil Abrahams. He says this can happen “by making progress on the alternatives to emergency shelters, like various forms of supportive housing.”