Sunday, April 22, 2012

Sleep Programs: Conclusions & Recommendations

Conclusions: By attempting to service all our client populations under one roof we fail to properly serve anyone. The protocols we use to manage large and /or blended populations strips away what little dignity and sense of self may be remaining from people who are already fragile. As a group the current system provides adequately for the barest necessities, supervised and relatively safe places to sleep (spend the night).  For the individual client having to stand on public display (possibly in their hometown) is demeaning. There is a loss of autonomy in the tightly controlled environment of the shelter… to the point where one starts to wonder if they even remember “how” to make a decision for themselves. Uncertainty about the disposition (drunk/sober/crazy/sane/healthy/sick) of other the clients, causes people in sleep programs to isolate. This adds to the growing feeling of invisibility; which quickly erodes a person’s ability to reintegrate into society.

Recommendations: The easiest recommendation to implement would be separating the populations. Many sleep programs already separate the intoxicated clients for the safety reasons as given in the previous blog. Separation within the other population groups is of far greater concern when it comes to the delivery of reintegration services. Elimination of the line-up check-in process would be of benefit to clients from a mental health standpoint. Each agency would have to determine what would work best for it depending on several variables like size of population, number of staff, space etc. I would suggest designating a time (say the 2 hours prior to dorm opening) when clients could walk-in and sign-up for a bed.   Anyone not claiming their bed within 1 hour of dorm opening will be bumped. Anyone showing up intoxicated to claim their bed can be refused for the night, at the discretion of the staff. Exception would have to be made for people whose employment prevented them from attending early sign. Day labourers could phone-in their sign-up and confirm with a copy of their work ticket (employed should have a pay-stub on file with the shelter) when they present to claim their bed. Think of eliminating these humiliating line-ups as “harm reduction” for our sober clients.
Government funding for shelter sleep programs needs to change, these programs should be funded by the bed… NOT by the head. This change would result in more stable funding for the agencies from one year to the next. It would also encourage greater collaboration between agencies which would allow for the employment of a diversified shelter model where the various populations are sheltered in different locations. This change would reduce psychological damage and speed up reintegration of the homeless (poor).
 Also every single effort must be made to keep people housed… provincial social service agencies should NEVER tell someone to stay at a shelter because it is going to take 2 months to process their request for social assistance. This is an emergency…. and emergency protocols must be created to reduce the incidents of poverty induced homelessness in this country.

Saturday, April 7, 2012

Observations Part 2: Sleep Programs

Shelters (Sleep Programs):
          The main distinction between shelters is if clients are allowed access while under the influence of alcohol or drugs. Shelters which allow the intoxicated (under the influence of drugs or alcohol) have harm reduction designated sleep areas. I have never seen a shelter exclusively dedicated to harm reduction.  All common areas of the building are shared by all populations. Shelters which do not allow intoxicated people, do however allow clients in a state of withdrawal, or unmedicated, so the designation of “DRY” in no way reduces the level of chaos within the shelter environment.
         The rules around shelter use are meant to manage large numbers of people and equally important to provide the necessary “head count” for funding application to various levels of government. First you must stand in line sometimes for more than an hour to ensure you get a bed. Often these lines are outside the building where anyone driving by might see you. Once signed in your movements are restricted to specific areas and specific times. You are required to turn in personal property regardless of any consideration for your ability to manage your behaviour. Your work tools or personally purchased aspirins must all be accessed through the office and often on a limited schedule. Many places do not allow food in the dorm areas…so anything you bring in for yourself is unsecured in a publicly accessed kitchen area. Other places allowed no outside food at all… you eat only what is provided exactly when it is provided. You get up when you are told, leave when you are told (regardless of your mental or physical condition) and are allowed to return when you are told you can return. In most shelters personal property can be searched and seized by staff (something as innocuous as a nail-clipper can be seized as a weapon), a necessary evil in the current shelter system with our blended populations.
         Harm Reduction areas, for clients under the influence of drugs or alcohol, are designed more for safety than comfort. Matts placed on the floor or low lying cots prevent serious injury from falling out of bed. As much space as possible is allowed between matts so the staff or paramedics can respond to client emergencies. Clients’ belongs are kept next to their matt and carried in and out with them each day… only a handful of places provide storage for this group. Bag searches our done regularly… with smaller population everyone is searched both entering and leaving the facility.
        Transient beds are issued on a nightly basis for clients who are clean & sober… today. The smell of body oder, urine prevelant in Harm Reduction is decidedly less conspicuous in transient areas. A little more attention is paid to comfort here, with beds or bunks replacing matts. Clients do NOT have assigned beds; one must line-up and sign in each night and there is some storage available to regular users over the short term.        
 Transitional sleep programs are open to persons who return to the facility clean & sober on a regular basis. The bed is yours until you miss curfew, this varies from 9 p.m. to 12 a.m. depending on the facility. The advantage for the facility, of these quasi permanent beds; is the reduction in laundry, sheets need only be changed weekly. You are allowed to leave your property behind during the day and some shelters even have lockers to secure your belongings. This is a great benefit to client who have to keep appointments with professionals to assist in moving forward out of the shelter and back into the community. Lockers can always be accessed by staff and searched for contraband (a reasonable expectation). 
I cannot believe how hard it is to separate observations from conclusions and recommendation; it all kinda runs together in my head. This is just the first draft so I will continue with this format .... for now. Who knows what the final product will look like. If you have any thoughts or suggestions I am always happy to hear from you. It is all about creating a concise and readable report.
Have a joyous day my friends.