TDRC Reports

February 23, 2002

Limitations of the Shelter System
Kathy Hardill's Presentation

I was asked to spend a few minutes talking about the limitations of the shelter system – but as I thought about what I would say, it struck me that “limitations” sounds far too euphemistic to accurately reflect the problems caused by the shelter system.  It seems to imply that the system mostly works, but has a few shortcomings here and there, when the reality is that the shelter system has actually become a dangerous, overcrowded, infectious disease-ridden crucible that is actually causing harm to the people who are compelled to stay inside it.

Over a year ago, the TDRC researched and wrote a report describing the state of the homelessness disaster in Toronto.  We estimate that we are lacking approximately 1000 shelter beds.  Existing shelters are dangerously overcrowded and filled with seriously ill people.  Many shelters do not meet minimum United Nations standards for refugee camps.  It is not uncommon for 2, 3 or even 4 people to be sleeping in a space which the U.N. declares the minimum safe space for one person.  The City’s heavy reliance on using the Out of the Cold Program, which many homeless people appreciate and even prefer, nonetheless requires people with no money to travel, mostly on foot, to a different church or synagogue or temple seven nights a week. 

We have far too few shelter beds for couples.  I wonder if you can imagine the incredible stress and despair that comes with you and your spouse finding yourselves homeless, and then of having to make the choice of staying with your partner outside in the elements, or separating in order to obtain shelter.  People are also unable to enter the shelter system with pets.  I know a man who lives in a derelict, rain-flooded, PCB laden abandoned building with his 17 year old cat – a cat which he tells me was born on his bed.  He would never consider abandoning this life long companion – and again, how many of us would do so if in similar circumstances?

In shelters, food quality is poor.  There is little access to fresh vegetables, fruits or milk products.  As someone told us when we were doing our research, “people who rely on shelters for meals are being expected to exist on everyone else’s leftovers.”  The United Nations recommends that refugees be provided with high calorie food to help them to retain body heat.  We have no such standard in Toronto.

Inside shelters, people are crowded together with their stress, and depression, and anxiety – and little tiny things cause explosions of anger.  Violence is common.  Theft of belongings is common.  These things occur, not because homeless people have no common decency, but because weeks, and months, and years of living with no privacy, no refuge, no quiet place, no money, no freedom – takes a colossal toll on people.  Human beings need a minimum amount of personal space.  If they are under a lot of stress, they need even more.  They do not get it in Toronto’s shelter system.

People are seriously damaged by living in inhumane conditions.  No money to wash your clothes.  Waiting four hours to take a shower.  Constantly lining up for meals, for towels, for a bed to sleep in, to use the toilet which you may share with 60 or 70 other people.  No money to ride the TTC.  Not changing your socks for days.  No private place for anything.  Some shelters even have surveillance cameras in various rooms, including bathrooms.  Homeless people describe this as invasive and frequently cite lack of privacy as one of the hardest parts of shelter living.

Homeless people report very high rates of depression, anxiety and chronic stress.  Shelter living contributes significantly to this.  The Street Health Report, published almost ten years ago, revealed that 1 in 2 homeless people had thought about committing suicide.  1 in 4 homeless people had actually tried to kill themselves.  These are astronomically high rates, compared to the general population.  There are growing numbers of people now who are what we call “shelter intolerant” – that is, they are no longer able to tolerate the harsh conditions inside shelters and have had to seek a sort of refuge in parks, ravines, abandoned buildings, under bridges. 

There is now beginning to be some recognition of the effects of chronic stress and psychological trauma associated with long term homelessness – immunosuppression, depression, eating disorders, sleep disorders, substance use.  For some people, substance use becomes a coping strategy for dealing with overwhelming grief, sadness and despair.  We have a profound lack of shelter for people with substance use problems.  They usually have great difficulty getting in to shelters, and are frequently kicked out and often “barred” for long periods of time due to behaviour issues.  This results in the most vulnerable people being denied shelter. 

What even five years ago would have been unthinkable is now common practice in shelters.  Some shelters have filled former common areas with mats on the floor.  Some shelters do not provide bedding to those using mats.  Some shelters do not launder bedding between clients, leading to predictable outbreaks of skin infestations which then – perversely - cause infested people to be barred until they can prove they have been treated.

Shelters are full of people with serious physical health problems – HIV/AIDS, cancer, diabetes.  People are now requiring palliative care in our shelters.  By now, most of you will probably have heard about Toronto’s first TB outbreak in modern history – in our shelter system.  The serious overcrowding in shelters, combined with the forced movement of people from one end of the city to the next, has made getting this micro-epidemic under control a contact tracing nightmare.  It is now one year after the first case of TB was identified, and Toronto Public Health is still scrambling to get the outbreak under control.  Homeless people have now added to their list of things to worry about, the fear of contracting TB in the shelters.  I can tell you, it is a significant deterrent.

Living in a shelter makes it extremely difficult to work.  Many homeless people do work, and many more would love nothing more – but how do you work shifts, for example, when there is nowhere to sleep during the day?  Homeless people work at the dirtiest, most dangerous jobs no one else will do, such as tearing out asbestos doing indoor renovation, often with little or no personal protection.  I have treated homeless people over the years for chemical burns, respiratory problems and muscle injuries, all related to unsafe working conditions in jobs they are grateful to have.

But here is a picture of what it means to try to hold a job when you live in a shelter.  I know a many whom I’ll call Tony.  Tony works as a labourer.  He gets up at 4:00 a.m.  He leaves the shelter by 5:00 a.m., missing breakfast.  He travels for two hours by TTC to get to his job site.  He works doing heavy construction work for 8 hours.  He gets back on the TTC and travels for 2 or 3 more hours.  He arrives back at the shelter too late for dinner.  He spends a little of his hard earned money to buy something to eat.  He showers, unwinds watching TV and falls into bed, to start all over again at 4:00 a.m. the next day.  He spends 4 to 5 hours every day, just commuting.  He has to spend what little he makes buying prepared food because he misses shelter meals and has no cooking or food storage facilities. 

It is important as well to remember that homelessness affects children.  Sometimes they are forgotten when we think about homelessness, but in Toronto, 100 children enter the shelter system every single week – and have done so every week for the last 3 years.  These kids are suffering significant disruption – they lose their homes, their friends, their teachers, their classmates, their familiar routines, perhaps their pets.  They end up in crowded shelters or cramped motel rooms – entire families squeezed into one room for eating, sleeping, cooking, homework – one noisy, crowded room for all of the life of a family.  Parents are stressed and irritable, children are stressed and frightened.  Kids are almost always sick, with continuous colds, coughs, stomach flu or diarrhea.  These kids have to adjust to new schools.  Their education is interrupted a lot.  Their friendships never last because they move around so much.  In Toronto, 1 out of every 5 children coming into the care of child welfare agencies does so because of housing related issues.  It is impossible to predict the emotional and psychological toll of homelessness on children, including the long term effects, but it is with certainty that I say to you – it is not likely to be good.

What we have currently is a growing homelessness problem, and a shelter system which is crowded, over capacity, bursting at the seams.  Inside, are people who are being seriously hurt by the experience of shelter living, and outside, we have people who either cannot get in, or cannot tolerate the shelter system.  We have violence, theft and disease.  Last year, two men died of TB – of consumption – in downtown Toronto, in the 21st century.  They died of the oldest disease known to humankind, in Toronto’s shelter system. 

As someone who works with homeless people every day, and who witnesses the harms they experience, I have to say that it is tremendously exciting to be at a housing conference.  And it is an unbelievable relief to see you all here today, because you are interested in creating housing quickly.  Because housing is what we need.

Kathy Hardill
Street Nurse

Back to HomeMade Solutions Report