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Calgary Recovery Services Task Force
Presentation to
CACHC Conference 2017
September 26 | Calgary, AB
• Loretta Dobbelsteyn – The Alex Community Health Centre
• Darryn Werth – CUPS Calgary
Presenters
Homelessness -
a “health” issue
or
a “housing” issue?
Calgary Recovery Services Task Force
“In a city like Calgary, we each have important
social, civic, and economic roles which can
support the well-being of the community. What
affects one part of the community affects us all,
so it is imperative that we work together to
support our most vulnerable citizens.”
Calgary Recovery Services Task Force
Chronic Homelessness…
Physical Health…
Mental Health…
Addictions…
• Who We Are & Why We Came Together – Darryn
• What Homeless Calgarians Are Experiencing – Loretta
• 7 Key Recommendations – Loretta
• Moving Forward Together – Loretta
• How to Build Collaboration & a Common Agenda – Darryn
• Learnings & Questions – Loretta & Darryn
Agenda
• 26 Calgary agencies and government partners
• Collective impact approach
– Collaboration, common agenda, shared measurement, mutually
reinforcing activities, continuous communication
• Recognized that current systems and services are often
unable to provide homeless individuals with complex needs
the right coordinated support and appropriate care
Who We Are & Why We Came Together
Who We Are & Why We Came Together
• During the mid-1990’s, hospitals and mental health
facilities in Alberta were downsized or closed
• Reduced support for individuals struggling with concurrent
mental illness, physical health issues, and/or addictions
• These conditions contributed to, and exacerbated
experiences of homelessness
• Despite the progress being made using a housing first
approach, individuals still struggle with their health and
with access to services
Who We Are & Why We Came Together
• This negatively impacts their well-being and ability to
move out of homelessness
• Numerous research studies have highlighted the high cost
of prolonged homelessness
• For over a decade, service providers, along with the
Calgary Police Service, have recognized the need for
coordinated wrap-around health services and supports for
homeless Calgarians
Who We Are & Why We Came Together
Mayor’s Office
expresses
support for
hosting a
collaborative
conversation
September,
2014
United Way
facilitates a
collaborative
conversation
event
October,
2014
A Task Force
begins meeting
monthly
February,
2015
Cumming
School of
Medicine
commissioned
for a research
study
September,
2015
Timeline
Key Findings from Research - Dr. Katrina Milaney (Cumming School of Medicine)
• 300 Chronically Homeless Calgarians
– 27% female
– 72% male
– Two individuals identified as either transgender or two-spirited
• 73% have been homeless for 4 years or more
• 43% have been homeless for 10 years or more
• 30% identify as Indigenous (First Nations, Aboriginal, Inuit or Metis)
– 20% attended residential school
– 63% had family members who were residential schooled
What Homeless Calgarians Are Experiencing
• 43% of all respondents were either raised in foster care or had
been removed from the home as children (74% for Indigenous)
• 299 participated in ACEs questionnaire
– Average for all respondents was 4.43 ACEs
– Male = 4.2/Female = 5.02
– Average for Indigenous was 6.07 ACEs
– Male 5.88/Female 6.38
What Homeless Calgarians Are Experiencing
• 91% diagnosed with a physical
health condition
– Average of 4 diagnoses per
individual
– 62% indicate ongoing physical
health issues related to their
homelessness
• 44% diagnosed with a mental
health condition
– Average of 2 diagnoses per
individual
– 46% felt they had another
undiagnosed mental health
condition
– Dental problems 56%
– Chronic pain 38%
– Skin/foot problems 37%
– Arthritis 34%
– Depression 58%
– Anxiety 44%
– ADD/ADHD 34%
– PTSD 23%
– Learning Disability 20%
What Homeless Calgarians Are Experiencing
• 32% drink alcohol daily or
almost daily
• 62% diagnosed with an alcohol
addiction
• 34% used drugs other than
alcohol daily or almost daily
– 12% use drugs and alcohol at
the same time
– 15% have used non-beverage
alcohol such as mouthwash,
antifreeze, antiseptics and
aftershave
– Marijuana 53%
– Crack 31%
– Cocaine 25%
– Methamphetamine 22%
What Homeless Calgarians Are Experiencing
• 47% have been physically attacked in the last year
– 51% have been attacked more than once
– 53% of females reported being physically attacked
– 59% Indigenous females reported being attacked
• 30% diagnosed with a brain injury
– 48% have “lost consciousness” due to head trauma
• 62% have had thoughts of suicide
– 25% have attempted
What Homeless Calgarians Are Experiencing
Writing
committee
begins to
prepare a
report
June,
2016
Report
released to
community &
government
January,
2017
Steering
committee &
working groups
formed
March,
2017
Sr. Manager &
Coordinator
hired
August,
2017
Timeline
Recoveryyyc.ca
1. Access to health services should be available through the
entire homeless system of care including shelter, supportive
housing, and mobile outreach.
2. Ensure access to intensive case management and health
supports as homeless Calgarians transition into supportive
housing.
3. Integrate harm reduction approaches into the continuum of
recovery services in recognition of homeless Calgarians’
choice.
Seven Key Recommendations
4. Develop housing and health approaches that are responsive
to homeless Indigenous populations
5. Ensure open communication and access to information
amongst organizations and agencies serving homeless
Calgarians.
6. Develop specialized responses for homeless women and
children
7. Advance the development of a steering
committee/governance structure to provide leadership and
oversight for moving forward.
Seven Key Recommendations
• Valuing Mental Health Report
• AHS Community Paramedics
• Street CCRED (Street Community, Clinical, Capacity, Research,
Education, and Development) collaborative
• Alberta Association of Community Health Centres (AACHC)
• CUPS & Alpha House Connect 2 Care Team (C2C)
• Calgary Allied Mobile Palliative Program (CAMPP)
• Managed Alcohol Protocol (MAP)
Moving Forward Together
How to Build Collaboration & a Common Agenda
• Specialized Agendas
• Fragmented Measurements
• Independent Activities
• Sporadic Communication
• Unsupported Efforts
• Common Agenda
• Shared Measurement
• Mutually Reinforcing Activities
• Continuous Communication
• Backbone Organization
How to Build Collaboration & a Common Agenda
• Collective action begins with ourselves
– Awareness is not action
– Training is not action
– Information sharing is not action
– Action is action
• Collective action is to effectively mobilize & deploy resources
– Concrete & measureable progress towards aim  Achieve Aim
– Attract & engage new people  Build Capacity
– Build leadership through individual growth  Grow Individuals
– Building a relational foundation for action takes time!!
- Terri Jowers (Director of Health Columbia in
Columbia, South Carolina
How to Build Collaboration & a Common Agenda
Collaboration
• Convene around programs or initiatives
• Use of data to prove
• Addition to what you do
• Advocate for ideas
Collective Impact
• Work together to move outcomes
• Use of data to improve
• Is what you do
• Advocate for what works
- Striving for Change (strivetogether.org)
How to Build Collaboration & a Common Agenda
How to Build Collaboration & a Common Agenda
How to Build Collaboration & a Common Agenda
1. Collaboration is messy, but it is essential
2. No one gets exactly what they want
3. Systems work takes time, but it is likely the only way
4. The critical (and often missing) skill is emotional intelligence/political
navigation
5. Consensus + timing + data-driven decisions = results
Learnings
Questions
Questions

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CRSTF: Multi-sector Response to Homelessness in Calgary - CACHC2017

  • 1. Calgary Recovery Services Task Force Presentation to CACHC Conference 2017 September 26 | Calgary, AB
  • 2. • Loretta Dobbelsteyn – The Alex Community Health Centre • Darryn Werth – CUPS Calgary Presenters
  • 3. Homelessness - a “health” issue or a “housing” issue? Calgary Recovery Services Task Force
  • 4. “In a city like Calgary, we each have important social, civic, and economic roles which can support the well-being of the community. What affects one part of the community affects us all, so it is imperative that we work together to support our most vulnerable citizens.” Calgary Recovery Services Task Force
  • 9. • Who We Are & Why We Came Together – Darryn • What Homeless Calgarians Are Experiencing – Loretta • 7 Key Recommendations – Loretta • Moving Forward Together – Loretta • How to Build Collaboration & a Common Agenda – Darryn • Learnings & Questions – Loretta & Darryn Agenda
  • 10. • 26 Calgary agencies and government partners • Collective impact approach – Collaboration, common agenda, shared measurement, mutually reinforcing activities, continuous communication • Recognized that current systems and services are often unable to provide homeless individuals with complex needs the right coordinated support and appropriate care Who We Are & Why We Came Together
  • 11. Who We Are & Why We Came Together
  • 12. • During the mid-1990’s, hospitals and mental health facilities in Alberta were downsized or closed • Reduced support for individuals struggling with concurrent mental illness, physical health issues, and/or addictions • These conditions contributed to, and exacerbated experiences of homelessness • Despite the progress being made using a housing first approach, individuals still struggle with their health and with access to services Who We Are & Why We Came Together
  • 13. • This negatively impacts their well-being and ability to move out of homelessness • Numerous research studies have highlighted the high cost of prolonged homelessness • For over a decade, service providers, along with the Calgary Police Service, have recognized the need for coordinated wrap-around health services and supports for homeless Calgarians Who We Are & Why We Came Together
  • 14. Mayor’s Office expresses support for hosting a collaborative conversation September, 2014 United Way facilitates a collaborative conversation event October, 2014 A Task Force begins meeting monthly February, 2015 Cumming School of Medicine commissioned for a research study September, 2015 Timeline
  • 15. Key Findings from Research - Dr. Katrina Milaney (Cumming School of Medicine) • 300 Chronically Homeless Calgarians – 27% female – 72% male – Two individuals identified as either transgender or two-spirited • 73% have been homeless for 4 years or more • 43% have been homeless for 10 years or more • 30% identify as Indigenous (First Nations, Aboriginal, Inuit or Metis) – 20% attended residential school – 63% had family members who were residential schooled What Homeless Calgarians Are Experiencing
  • 16. • 43% of all respondents were either raised in foster care or had been removed from the home as children (74% for Indigenous) • 299 participated in ACEs questionnaire – Average for all respondents was 4.43 ACEs – Male = 4.2/Female = 5.02 – Average for Indigenous was 6.07 ACEs – Male 5.88/Female 6.38 What Homeless Calgarians Are Experiencing
  • 17. • 91% diagnosed with a physical health condition – Average of 4 diagnoses per individual – 62% indicate ongoing physical health issues related to their homelessness • 44% diagnosed with a mental health condition – Average of 2 diagnoses per individual – 46% felt they had another undiagnosed mental health condition – Dental problems 56% – Chronic pain 38% – Skin/foot problems 37% – Arthritis 34% – Depression 58% – Anxiety 44% – ADD/ADHD 34% – PTSD 23% – Learning Disability 20% What Homeless Calgarians Are Experiencing
  • 18. • 32% drink alcohol daily or almost daily • 62% diagnosed with an alcohol addiction • 34% used drugs other than alcohol daily or almost daily – 12% use drugs and alcohol at the same time – 15% have used non-beverage alcohol such as mouthwash, antifreeze, antiseptics and aftershave – Marijuana 53% – Crack 31% – Cocaine 25% – Methamphetamine 22% What Homeless Calgarians Are Experiencing
  • 19. • 47% have been physically attacked in the last year – 51% have been attacked more than once – 53% of females reported being physically attacked – 59% Indigenous females reported being attacked • 30% diagnosed with a brain injury – 48% have “lost consciousness” due to head trauma • 62% have had thoughts of suicide – 25% have attempted What Homeless Calgarians Are Experiencing
  • 20. Writing committee begins to prepare a report June, 2016 Report released to community & government January, 2017 Steering committee & working groups formed March, 2017 Sr. Manager & Coordinator hired August, 2017 Timeline
  • 22. 1. Access to health services should be available through the entire homeless system of care including shelter, supportive housing, and mobile outreach. 2. Ensure access to intensive case management and health supports as homeless Calgarians transition into supportive housing. 3. Integrate harm reduction approaches into the continuum of recovery services in recognition of homeless Calgarians’ choice. Seven Key Recommendations
  • 23. 4. Develop housing and health approaches that are responsive to homeless Indigenous populations 5. Ensure open communication and access to information amongst organizations and agencies serving homeless Calgarians. 6. Develop specialized responses for homeless women and children 7. Advance the development of a steering committee/governance structure to provide leadership and oversight for moving forward. Seven Key Recommendations
  • 24. • Valuing Mental Health Report • AHS Community Paramedics • Street CCRED (Street Community, Clinical, Capacity, Research, Education, and Development) collaborative • Alberta Association of Community Health Centres (AACHC) • CUPS & Alpha House Connect 2 Care Team (C2C) • Calgary Allied Mobile Palliative Program (CAMPP) • Managed Alcohol Protocol (MAP) Moving Forward Together
  • 25. How to Build Collaboration & a Common Agenda
  • 26. • Specialized Agendas • Fragmented Measurements • Independent Activities • Sporadic Communication • Unsupported Efforts • Common Agenda • Shared Measurement • Mutually Reinforcing Activities • Continuous Communication • Backbone Organization How to Build Collaboration & a Common Agenda
  • 27. • Collective action begins with ourselves – Awareness is not action – Training is not action – Information sharing is not action – Action is action • Collective action is to effectively mobilize & deploy resources – Concrete & measureable progress towards aim  Achieve Aim – Attract & engage new people  Build Capacity – Build leadership through individual growth  Grow Individuals – Building a relational foundation for action takes time!! - Terri Jowers (Director of Health Columbia in Columbia, South Carolina How to Build Collaboration & a Common Agenda
  • 28. Collaboration • Convene around programs or initiatives • Use of data to prove • Addition to what you do • Advocate for ideas Collective Impact • Work together to move outcomes • Use of data to improve • Is what you do • Advocate for what works - Striving for Change (strivetogether.org) How to Build Collaboration & a Common Agenda
  • 29. How to Build Collaboration & a Common Agenda
  • 30. How to Build Collaboration & a Common Agenda
  • 31. 1. Collaboration is messy, but it is essential 2. No one gets exactly what they want 3. Systems work takes time, but it is likely the only way 4. The critical (and often missing) skill is emotional intelligence/political navigation 5. Consensus + timing + data-driven decisions = results Learnings

Editor's Notes

  1. Physical health conditions Dental problems 56% Chronic pain 38% Skin/foot problems 37% Mobility issues 37% Arthritis 34% Mental health conditions Depression 58% Anxiety 44% ADD/ADHD 34% PTSD 23% Learning disability 20%
  2. Drugs use Marijuana 53% Crack 31% Cocaine 25% Methamphetamine 22% Hashish 13% OxyContin 12%
  3. #1 – C2C, CAMPP, Opioid Fentanyl Crisis Response #3 – MAP, Supervised Consumption Services