A preoccupation with numbers may be getting in the way of helping people to leave homelessness. This insight comes from a report that focusses on making homelessness services more accessible to Indigenous people who live in Canada.1
Information about services was gathered from Indigenous program participants, who shared and reflected on their experiences of leaving homelessness. The issue with numbers showed up at the intake phase, a beginning step that is common to many services.
As one participant relates, people who complete the intake process end up with a number, which scores the urgency of their need for services. The process of having someone assign a number is unpleasantly associated with the residential school system,2 where each student was identified by a number upon enrollment. Because of this association, Indigenous people are dubious about seeking out the services that are supposed to help.
The participants also reflected that the intake’s assessment criteria are based on deficits or failings. Prospective participants facing multiple challenges earn a higher score. This can also be a deterrent to entering services. Participants noted a reluctance to share their life with a stranger, even though they knew that telling all would mean a higher number. There’s also a self protection element, as the experience of recounting past life experiences can be traumatic. Knowing there is a cost to revisiting the past, even though it will pump up your number, can also be a deterrent.
The report recommends ways to make it easier for Indigenous people to access services, including a less formal intake process, which focusses more on starting a relationship and less on coming up with a number. This would allow participants to decide when and how they will share their lives with the people who are providing the services.
Some program experts oppose the less formal approach, arguing that the people with the greatest need should be the priority in providing service. However, as Indigenous participants relate, the people with the greatest need may be missing out altogether.
There’s an earlier evaluation that lends support the Indigenous participants’ advice. In this case, the evaluation compared approaches to assisting women who were experiencing homelessness in New York city. The Community Living Room project (CLR), which took an informal approach to intake and treatment, was compared with conventional approaches. The outcomes for CLR participants were significantly better than those in the conventional programs.
In a journal article, the people who evaluated the CLR reflect on elements of the program that contributed to its success. The evaluators remark particularly on the value of informal approaches to intake and assessment. They also noted the importance of having clients decide when and whether to revisit earlier life events.
Is this a wholesale rejection of numbers? Not at all. Numbers were essential to comparing the Community Living Room with other services. But these two reports do remind us that how people support people to leave homelessness is also an important consideration.
It also suggests that impacts of using rankings or numbers might extend to other program areas, and should be a consideration when designing, implementing and evaluating other programs and services.
Finally, this post has touched on only one aspect of services that would benefit two different client groups. Each of the articles linked below discuss much, much more, which may be insightful for people who are planning or providing services to people experiencing homelessness.
The full study about services for Indigenous people is available at the Homeless Hub: Revisioning Coordinated Access: Fostering Indigenous Best Practices Towards a Wholistic Systems Approach to Homelessness
The Homeless Hub also features a post outlining the special significance of Revisioning Co-ordinated Access in the Canadian context, where the federal government has just made a commitment to end homelessness.
The article about the Community Living Room is published in Women & Therapy. The full article requires a subscription, but there’s an abstract available on line: Safety, Trust, and Treatment: Mental Health Service Delivery for Women Who Are Homeless
Daryn David is the contact for Safety, Trust and Treatment. Daryn can be contacted at daryn.david@yale.edu
Footnotes
- Indigenous people comprise a small proportion of Canada’s population and are over-represented among the people who experience homelessness.
- Indigenous children were removed from their families to attend residential schools for much of the 20th century. A commission of inquiry documented horrible conditions, extensive physical and sexual abuse and involuntary medical experiments throughout the residential school system. The Canadian government has issued an apology to the former students and their descendants.
