A Home at the Crossroads
Visions Journal, 2017, 12 (3), p. 28
The ASK Wellness Society supports individuals in our community who are homeless and battling addictions, helping them find housing and medical care, addressing their addictions, stabilizing mental health issues and ultimately providing them with the skills to re-enter the work force. ASK Wellness assists clients with locating housing within our housing inventory or through rental opportunities in the community. We provide rental top-ups, damage deposits and rent subsidies. Our life skills workers assist clients with budgeting, cooking and navigating community resources and social systems. They also provide encouragement to those convinced they are incapable of achieving stable, meaningful lives.
In 2010, with financial assistance from the federal and provincial governments, ASK Wellness purchased the Crossroads Inn, a supportive housing unit with 50 program beds. In 2012, we reviewed our housing inventory, particularly the use of Crossroads, at the time reserved mostly for those working through recovery from addiction or seeking mental health services, and Henry Leland House, a 27-bed low-barrier unit.
We saw a need for an increased number of low-barrier housing opportunities for the vulnerable and marginalized in our community. In consultation with clients, staff and community partners, we determined that our agency would benefit from having a housing resource that would support a low level of drug and alcohol use. Crossroads Inn is ideal for this kind of housing.
Henry Leland House was chosen to become the site of a “second-stage,” transitional or stabilized housing program. Second-stage housing allows clients who are successful in their recovery to live in a sober setting for up to one year. Henry Leland House became the location for our Adult Addictions Supportive Housing (AASH) and Mental Health Supportive Housing Programs, operated in partnership with the Interior Health Authority.
The Crossroads environment
Each Crossroads suite is approximately 300 square feet and includes a full washroom, a kitchenette, cable television and housekeeping as needed. Many clients have lost previous housing due to their inability to say “no” to friends and guests, who often move in and take over the client’s apartment. Since Crossroads is staffed 24 hours each day, we can monitor who is coming into the building as visitors—and we can ensure that visits do not go on indefinitely. This alleviates the pressure on our clients.
The third floor of Crossroads is a floor for women only, which enables us to further support the privacy and security of our female clients. Our goal is to provide a safe home where clients can work towards personal wellness.
Housing support workers keep busy at Crossroads. Staff members check in with clients daily. We give schedule reminders and may take clients to medical appointments. Often, clients are struggling with severe medical conditions; we work alongside medical staff (psychiatrists, street nurses, case managers, and so on) to maintain client health and wellness, including providing encouragement and assistance with detox and treatment. We help with budgeting, personal hygiene, room care and clients’ day-to-day connections. We may also accompany clients to probation or court-ordered appointments. We keep daily case notes on each client so our night staff is in the loop. There is never a dull moment, and the days go by quickly.
Harm reduction in housing
About 60% of Crossroads clients experience diagnosed and undiagnosed concurrent disorders (a mental illness and a substance use problem at the same time). When clients enter our program, staff members help them create a wellness plan. This plan can include anything from reminders to take daily meds, attending detox and treatment to making sure to shower and eat daily. Many clients are motivated to make change but are at risk of falling back into old behaviours. Our role is to provide clients with follow-up and encourage them to work on the wellness plan they have created.
At Crossroads, we accept that there is alcohol and substance use among the residents, but we have a few ground rules: for example, there is no open alcohol or drug use in common spaces. If clients wish to drink, they are encouraged to do so in their rooms and will be asked to go to their rooms if they are impaired.
One of our most innovative programs is our managed alcohol program (MAP) for those who do not respond well to abstinence-based programs. MAP is designed for clients who would normally consume the alcohols found in hand sanitizer or mouthwash. Before the client can be considered for MAP, he or she must be given a clean bill of health by a doctor. Each participant is given a one-ounce shot of alcohol every four hours. This minimizes the negative effects that the client experiences when drinking constantly (such as run-ins with police, public intoxication and medical issues). Studies show that this program reduces the number of police incidents and hospital admissions.1
One of our most exciting programs is our Hepatitis C pilot program. Many marginalized individuals with Hepatitis C are often unable to follow through with treatment due to life challenges such as homelessness and addiction. Each client at Crossroads is now tested for Hepatitis C; those who test positive are able to receive treatment within the building. In collaboration with a community physician, Crossroads will be dispensing treatment daily to these individuals. We hope to see many of our affected clients free of the disease within 12 short weeks of starting regular treatment.
Our needle exchange program and our direct collaboration with street nurses provide the means for safe injection, education and harm reduction strategies. For clients who use intravenously, we supply clean equipment and dispose of used gear. With the recent influx of fentanyl in our community, staff has been checking on clients more frequently. We have also asked their permission to enter their rooms if we have concerns for their safety. Most clients feel comfortable agreeing to this; they know we provide help free from judgement.
Things do not always go smoothly, however, and we sometimes have to request the help of RCMP, emergency responders or mental health practitioners to remove a client temporarily from the building. There are certain times of the month, such as “welfare week,” when it is helpful to bring in extra staff to assist with managing clients.
What does a successful supported housing program look like?
Success looks different for every client. For some, it is as simple as following through with medical appointments. For others, it is the success of recovery.
The experiences of one particular client come to mind. A long-time sex worker who was continuously homeless due to her mental health and substance use recently moved into Crossroads. A trusting relationship evolved; eventually she was more willing to look at some of the personal barriers to her achieving wellness. We introduced her to the mental health outreach team and our local psychiatrist (who visits our clients in the building). A rapport developed, and the client agreed to look into medication. Today, her substance usage has diminished greatly, and she no longer works in the sex trade. She has found part-time work within our agency.
Success like this keeps us passionate about the work we do. We recognize that, with the right supports, everyone can be successful.
Collaboration is the key
One piece of advice I would give to funders is that all helping agencies must work collaboratively to assist folks with housing barriers. This includes working with the RCMP, the Ministry of Social Development (welfare) and Interior Health.
At Crossroads we also work very hard to be a good neighbour. We keep the area around the building clean and free of garbage, and we discuss with our clients the importance of showing awareness and consideration of their surrounding community—by returning used syringes for disposal, for example, rather than leaving them in the open. We do not allow clients or their guests to loiter around the building or in front of neighbouring businesses. And we have now created a clients’ smoking area away from the street.
I can’t emphasize enough the importance of volunteering with agencies like ours. Witnessing the daily struggles faced by our clients increases our understanding and our compassion. Volunteering also allows for real friendships to develop between clients and volunteers, which decreases the tension between our marginalized populations and the wider public.
Homelessness is a huge social problem in every city across Canada. But no one wants to see people sleeping in the park, or to see homelessness become the norm rather than the exception. Yet no single agency or individual can do this sort of work alone. We need many hands and the support of many individuals. Communities need to work together—to listen to each other and to find solutions. Just as it takes a village to raise a child, it takes communities to resolve the issue of homelessness.
About the author
Carmen is Operations Manager at Crossroads Inn in Kamloops. She has a diploma in human service work from Thompson Rivers University and is currently taking her concurrent disorders certification through the Centre for Addiction and Mental Health. Carmen is passionate in her work with those experiencing substance misuse, mental health and poverty
University of Victoria, Centre for Addictions Research of BC (CARBC). (2014). “UVic study provides evidence of impacts of managed alcohol programs in Canada” [Press release]. Retrieved from http://communications.uvic.ca/releases/release.php?display=release&id=1408.