Positioning Emergency Shelters To Give The Best Possible Support To Their Clients

Very few of us have the chance to work at an emergency shelter. If we did, we’d have a much better idea of what it is like to work alongside people who are homeless. The people experiencing homelessness would have faces and names. If we worked at an emergency shelter, we’d get to know the systems that shelter clients have to navigate, as well as where and when those systems break down. But, in the absence of direct experience, we can learn about how these systems work from shelter workers themselves. This post is about three reports that lift up their work.

Doubling down on discharges from hospitals

In Toronto, researchers recently sat down with shelter workers and hospital staff to talk about how hospitals discharge patients who are homeless. Using interviews and analysis, the researchers mapped how the transfer from the health care system to the shelter system is managed. The researchers looked closely at what happens when things don’t go well in order to identify system breakdowns and system failures. System breakdowns occur when protocols aren’t followed. System failures occur when protocols are followed but they don’t lead to the desired solution.

Before this research, hospital discharge had been a source of friction for shelter workers and hospital workers for some time. On a day to day basis, system failures can look a lot like system breakdowns. This research helped both groups to see the difference between system breakdowns, which was something they could work on, and system failures, which require advocacy and external action to fix.

Shining a light on work in emergency shelters

A second group of researchers surveyed and interviewed people who work in the emergency shelter system. Their purpose was to find out about the issues that front line shelter workers face and the work-based supports they are able to access to help them do their work. Many of the respondents had personally witnessed serious events at work (for example client drug overdoses, physical violence between clients, as well as experiencing verbal abuse themselves). Front line workers reported high levels of stress. They also expressed frustration that they were unable to connect shelter clients with appropriate treatment.

The research about emergency shelter staffing began in 2019 and continued through COVID. Front line workers at emergency shelters reported that COVID brought stresses and strains. It is also clear that working front line at an emergency shelter was challenging before the pandemic.

The researchers list a number of actions to immediately strengthen support to front line shelter workers, including more frequent supervision. The researchers also discuss that it’s important to acknowledge the difference between a system failure and a system breakdown, as this distinction could alleviate some of the pressure of front line work in the short term.

Changing the emergency shelter system

COVID brought big changes to the emergency shelter system in Toronto. Many people staying in congregate shelters were transferred to hotel rooms. Shelter clients enjoyed a level of privacy that they would never experience in an emergency shelter. It was clear from the beginning that these COVID-triggered changes were temporary.

The Toronto Shelter Network (TSN) represents the organizations that operate emergency shelters in the city. TSN initiated research to document the learning from COVID and other examples of best practices at emergency shelters. The results have been published in a report to assist in guiding decision making for planning the shelter system going forward.

The TSN’s research drew on interviews with 200 people who stayed in shelters. It also looked at shelter systems in other countries to identify promising operating models. It studied how shelter services could be designed to better meet the needs of the changing face of the shelter population, which was historically single white men, and is much more diverse today.

TSN’s report lists nine key features that should be incorporated in Toronto’s shelter system going forward. Here are three from the list:

• • coaching and support to enable potential shelter clients to avoid using the shelter system at all
  • bolstering assistance to clients with high needs
  • ensuring staff have the capacity to provide case management and housing supports to clients

Why does this all matter?

Each of these three research projects gets at different aspects of the emergency shelter system. They are Canadian based, but it seems likely that the findings would apply in other jurisdictions.

The first, which studies the details of the linkages between hospital and emergency shelters during the discharge process, is able to pinpoint system failures. Identifying system failures provides evidence for hospital and shelter leaders to advocate for change. Read more at SSM – Qualitative Research in Health: “We don’t have a good system for people who don’t have a home and don’t need a hospital”: Contextualizing the hospital discharge process for people experiencing homelessness in Toronto, Canada

The second is about working at shelters. Shelter workers have a unique blend of work, which requires managing large households, while coaching and supporting residents who are there because of an emergency. This report lays out why staffing is critical to the success of the shelter system and how to better support it¹. Read more at the Homeless Hub: Understanding Workplace Mental Health in the Homeless Service, Supportive Housing, and Harm Reduction Sectors

The third considers the role of emergency shelter system as a whole. The recommendations in the first two reports fit nicely in the key features of an emergency shelter system that is based on best practices. The Toronto Shelter Network’s report is also posted at the Homeless Hub: Re-Imagining Toronto’s Shelter System – Strengthening the Homelessness to Housing Continuum

1. See also this resource for shelter worker self care, which is posted at the Homeless Hub: Self-Care Essentials for Health and Well-Being