COVID-19 has affected the homeless disproportionately and as winter arrives and eviction moratoriums expire, it is urgent that steps to ensure their health and safety be taken.
Despite its high prevalence in Canada, homelessness is an issue that has not received the attention it deserves. According to estimates from 2016, about 235,000 Canadians experience homelessness in a year. However, a recent poll conducted by the Canadian Alliance to End Homelessness indicates a staggering 1.6 million people have experienced homelessness at some point in their lives.
Individuals experiencing homelessness often suffer from pre-existing illnesses and mental health conditions, making them more susceptible to infection in the event of a disease outbreak. Their living conditions often involve a lack of proper hygiene and crowded areas such as at shelters or encampments, thus increasing their likelihood of contracting infectious diseases. Moreover, closures of high-density communal environments such as soup kitchens during lockdowns may reduce their access to essential services and hygiene facilities.
Policies to help the homeless have been broad and generalized but it is important to recognize that there are many distinct subgroups within the homeless population. A major proportion suffers from mental illnesses and experiences barriers to forming strong social networks or maintaining employment, leading to poverty and an inability to afford housing. Another subgroup includes those who suffer from substance abuse. They may find difficulty obtaining and maintaining employment while also experiencing income instability. A third subgroup includes victims of domestic violence and childhood maltreatment.
To help people experiencing homelessness during the pandemic, in April Ottawa announced $157 million for relief including shelters, social housing and personal protective equipment. As the pandemic has progressed, cities have struck deals with hotels and building developers. In Toronto, more than 3,500 individuals have been moved into community centre programs along with temporary and permanent housing. In Victoria, the province has purchased a hotel for $18.5 million to provide affordable housing for more than 90 individuals that also offers healthcare, harm reduction services and addiction treatment.
While these initiatives are helpful, they are not nearly enough. Specialized strategies need to be developed for different subgroups of homeless populations. Prioritizing housing and financial support for those who do not require medical support is just one way to help. Partnerships between public, private, and not-for-profit services must be emphasized.
Neighbourhood concerns over increases in criminal activity after providing homeless individuals with accommodation must also be addressed. One homeless person voiced concern that all members will face the consequences due to the actions of a few. Deinstitutionalization has resulted in fewer longer-term care psychiatric facilities and can lead to an increase in incarceration if proper mental health support is not provided.
Governments at all levels need to invest in mental-health specific supportive housing. In particular, a high-support housing structure for people with severe mental illness and complex behaviours must be established. Such a system would allow for 24-hour, on-site support from specialized teams while providing access to meals and medications.
These aforementioned evidence-based options will help improve health outcomes for individuals experiencing homelessness but the government must take significant steps towards implementing them immediately.