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Home is in your heart and mind: How has the pandemic impacted youth experiencing homelessness?

From the Canadian Institutes of Health Research

Mardi Daley is an advocate, entrepreneur and Peer Specialist who recently founded Lived Experience Lab to support ethical engagement of people with lived experience in community-based research and workforce development. Mardi brings 6 years of experience working across youth-serving agencies in and outside of Toronto with a special focus on youth homelessness and mental health.

Naomi Thulien is a nurse practitioner and researcher dedicated to tackling the social and structural inequities that cause and perpetuate youth homelessness. She is a staff scientist at the MAP Centre for Urban Health Solutions – a research institute at St. Michael’s Hospital in Toronto. Naomi is also an Assistant Professor (Status-Only) at the Dalla Lana School of Public Health at the University of Toronto.

Two members of the youth advisory council for the CIHR Institute of Human Development, Child and Youth Health interviewed Mardi Daley and Naomi Thulien, investigators on the COVID-19 Mental Health Knowledge Synthesis project, Pandemic-Proof: Synthesizing Real-World Knowledge of Promising Mental Health and Substance Use Practices for Young People Who Are Experiencing or Have Experienced Homelessness.

Interview

What is homelessness, and what does it mean to be home?

Naomi offers a holistic perspective of what it means to be home: “Our Indigenous colleagues understand this the best – to be ‘housed’ is different than to be ‘home.’ And to be home is not four walls and a roof, it’s something in your heart and in your mind”. Homelessness is also not a linear experience. “There is a mentality and psychological impact associated with living in survival mode for so long. Feeling homeless in your own home is a real threat,” explains Mardi. We need to look at upstream factors we can improve as well as long term solutions we can implement, looking beyond shelters and towards long term housing and employment outcomes. Tangible solutions such as rent subsidies and post-housing wrap-around supports have been successful; however, intangible solutions focused on fostering inclusion, belonging, and sense of purpose are just as important. “Youth facing homelessness experience a different type of boredom – an existential crisis of meaning and belonging. And when transitioning out of homelessness, there is a spike in this existential crisis of boredom, exacerbated by feelings of loneliness and isolation,” says Naomi.

Dr. Gillian Booth elected as a Fellow with the Canadian Academy of Health Sciences

From the Canadian Academy of Health Sciences

Dr. Gillian Booth has been elected as a Fellow this year with the Canadian Academy of Health Sciences (CAHS). With this list of individuals, CAHS is proud to recognize excellence in health sciences and these new Fellows reflect a rich and varied expertise.

Dr. Booth is a practicing endocrinologist and Tier 1 Canada Research Chair in Policy Solutions for Diabetes Prevention and Management. She investigates the socioeconomic, environmental and health-care factors behind Canada’s diabetes epidemic.

Election to Fellowship in the Academy is considered one of the highest honours for individuals in the Canadian health sciences community and carries with it a covenant to serve the Academy and the future well-being of the health sciences irrespective of the Fellow’s specific discipline.

“Becoming a member of the Canadian Academy of Health Sciences recognizes Fellows’ dedication to health sciences,” says Dr. Chris Simpson, President, CAHS. “We are proud of their accomplishments and we are honoured to welcome them to the Canadian Academy of Heath Sciences.”

Researcher says Halifax modular units require social supports for residents

From the Global News Article:

“From a public health perspective, and from a health care perspective, and from a well-being, and caring about humans perspective — there are no benefits to what has happened, there are only downsides,” Jesse Jenkinson said, a public health researcher with the MAP Centre for Urban Health Solutions in Toronto.

Jenkinson’s research focuses on the widening gaps in health and social services for people who experience houselessness.

She says the increasing number of forcible, police-led evictions of people sleeping rough in encampments across Canada highlights the need for governments to start investing in supportive housing.

“What we really need to do is just create spaces that people can move into. Encampments exist because there’s nowhere else for people to go,” she said.

Jenkinson says residents who move into social housing settings, like modular units, need a wide range of social supports in order to help them stabilize their lives.

 “Case manager supports, harm reduction supports, mental health supports, these are all really necessary social services to help keep people housed and keep their well-being supported. Without these supports, people can fall back into homelessness,” she said.

New data shows that homelessness is a women’s rights issue

THE CONVERSATION

Co-written by Dr. Jesse Jenkinson

Visible homelessness during the COVID-19 pandemic has highlighted the housing crisis across Canada. For women, girls and gender-diverse people, homelessness is often hidden, meaning that they are more likely to avoid shelters, couch surf or remain in abusive relationships than end up on the streets. Because of this, we know less about their experiences.

New data from the Pan-Canadian Women’s Housing and Homelessness Survey, the largest gender-specific data collection of its kind in Canada, tells us a clear story.

Lack of access to housing has gendered causes and effects, and gender equality in Canada depends on fair access to adequate housing. This survey, completed by 500 women and gender-diverse people in 12 provinces and territories, shows us why housing is a women’s rights issue.

Opinion: Vaccine for kids under 12 by Halloween? Research shows it could happen. Now, Canada needs to plan for an equitable rollout

TORONTO STAR

By Tara Kiran, Noah Ivers, Sabina Vohra-Miller

We all want the pandemic to be over. Last week, that dream came closer to reality.

Pfizer released a statement showing an effective and safe vaccine in children aged 5 to 11. Pfizer will soon submit the full data package to Health Canada and If the data is considered sufficient, and no concerns are identified, the vaccine could be approved for this age group as early as Halloween.

A COVID-19 vaccine for children is a game-changer. It not only protects our kids from getting COVID-19 and its related complications, it also protects their loved ones and the wider community. It will limit transmission of the virus—preventing classes from being sent home, allowing a return to sports and other activities, and reduces the risk of unknowingly passing the virus on to someone more vulnerable like a grandparent.

But the vaccine only works if people get it.

We must work quickly to get the largest number of kids vaccinated as fast as possible—and ensure an equitable roll-out prioritizing those most at-risk. The most efficient and effective way to do so is by bringing vaccines to schools.

90 per cent of adults who are homeless experienced childhood trauma, meta-analysis shows

UNITY HEALTH TORONTO

A new paper published by Unity Health Toronto researchers found most adults experiencing homelessness have faced an incredible burden of childhood trauma.

The paper, published in Lancet Public Health, found nine in 10 homeless adults have been exposed to at least one adverse childhood experience and over half have been exposed to four or more adverse childhood experiences. Previous research in the general population has shown that those exposed to four or more childhood traumas were 17 times more likely to have attempted suicide than those who had not experienced trauma in childhood.

Michael Liu, MAP Centre for Urban Health Solutions

Michael Liu, lead author of the study, is a research coordinator at St. Michael’s MAP Centre for Urban Health Solutions, a medical student at Harvard University and a Rhodes Scholar. We spoke with Michael, a Toronto native, about the systematic review and meta-analysis and why he says services must be trauma-informed and there must be a greater emphasis on early-intervention.

The paper sought to answer the question: how often have adults experiencing homelessness had an adverse childhood experience? Why is this important to investigate?

There’s lots of literature on adverse childhood experiences in the general public, but I think this is a really under-appreciated aspect of homelessness. Adverse childhood experiences encompass potentially traumatic events occurring before the age of 18 years, such as abuse, neglect, and household dysfunction.

In the late 1990s, studies showed us that early trauma affects health throughout one’s entire life course. The accumulation of toxic stress affects just about everything – from our mental health to chronic disease. We know that toxic stress can lead to disrupted brain development, with long-term consequences for learning, behaviour, and broad social outcomes. So we wanted to understand how big of a problem is early trauma in the homeless population, and if it is, what can we do about it? What do policymakers need to know?

Were the findings surprising to you?

We thought that adverse childhood experiences in this population would be an issue, but it’s even more prevalent than we expected. For it to be that high is really shocking, and is just further evidence of how strongly adverse childhood experiences are tied to homelessness and poor health.

While adverse childhood experiences are major risk factors for homelessness, they are not deterministic on their own. Other factors such as poverty, poor health, and systemic racism are also strong risk factors. The data challenges the pervasive narrative that homelessness is a culmination of individual choices. This is a population that is already suffering so much in the present, and what the analysis did was confirm that many have suffered a great deal in the past, too.

Where do we go from here?

We need to redouble our efforts to support this population. We know that this population has experienced an incredible burden of trauma, so this should change how we serve and support this population. When 90 per cent of your population have been exposed to an adverse childhood experience and over half have been severely affected, that should alter how we think about the problem.

First, services must be trauma-informed. Staff who work in the system should be fully trained in providing trauma-informed care. For example, understanding how adverse childhood experiences affect health, reducing practices that might inadvertently re-traumatize someone, prioritizing physical and emotional safety, and fostering collaborative and trusting relationships.

Second, we need to offer people the basic right to housing without any preconditions, such as sobriety or committing to seeing a psychiatrist. Conditional housing is not trauma-informed.

Third, there should be greater emphasis on early intervention. Given that adverse childhood experiences are common risk factors for homelessness and poor health, policies and interventions to prevent adverse childhood experiences from occurring early in the life course should be implemented. We need to address homelessness at the root.

Is there anything else you’d like to add?

The findings could have a lot of implications for public health practice, prevention of homelessness, and early interventions as a whole. There’s a lot more work that I hope MAP Centre for Urban Health Solutions and Canada will do to create actual systemic change to alleviate adverse childhood experiences and homelessness.

Living in encampments is more than just a pandemic issue, researchers find

Lire cet article en français

HEALTHY DEBATE

By Zoë Dodd, Samantha Young, Lisa Boucher, Abeera Shahid, Melanie Brown, Kimia Khoee, and Ahmed Bayoumi

While people have been living in encampments for decades, they have never been as visible as during the COVID-19 pandemic. The City of Toronto has also been dismantling encampments for a long time – more than 700 were dismantled in 2019 – but never as forcefully as this year. Yet, in all of the discussions about how politicians, police and city workers should respond to encampments, there has been little effort to understand why encampments exist and what they mean to people living in them.

As researchers at MAP Centre for Urban Health Solutions at Unity Health Toronto, we have been studying outreach services provided to people who live in encampments. As part of a large study of the effects of the response to the COVID-19 pandemic on people experiencing marginalization, we surveyed 127 residents of Toronto’s Trinity Bellwoods, Alexandra Park, Lamport Stadium, Moss Park, Cherry Beach and Sanctuary encampments between March and June 2021 (and before the most recent evictions in July 2021). While our full report will be released in October, we believe it pertinent to release these preliminary findings to add to the current conversation on encampment evictions.

Overall, our findings suggest that the story of encampments is complex. Five results of our survey are especially important and may contradict commonly held assumptions.

La vie dans les campements est bien plus qu’un simple problème lié à la pandémie, selon des chercheurs

Par Zoë Dodd, Samantha Young, Lisa Boucher, Abeera Shahid, Melanie Brown, Kimia Khoee et Ahmed Bayoumi

Bien que des gens vivent dans des campements depuis des décennies, ils n’ont jamais été aussi en évidence que pendant la pandémie de COVID-19. La Ville de Toronto démantèle depuis des années des campements (plus de 700 l’ont été en 2019), mais jamais d’une façon aussi énergique que cette année. Malgré toutes les discussions sur la façon dont les politiciens, la police et les employés municipaux devraient réagir à la présence de campements, peu d’efforts ont été faits pour comprendre la raison d’être de ces derniers et ce qu’ils signifient pour les personnes qui y vivent.

En tant que chercheurs du Centre MAP pour des solutions de santé urbaine de Unity Health Toronto, nous avons étudié les services de proximité fournis aux personnes qui vivent dans des campements. Dans le cadre d’une vaste étude sur les effets des mesures liées à la pandémie de COVID-19 sur les personnes en situation de marginalisation, nous avons interrogé 127 résidents des campements de Trinity Bellwoods, d’Alexandra Park, du Lamport Stadium, de Moss Park, de Cherry Beach et de Sanctuary à Toronto entre mars et juin 2021 (et avant les expulsions les plus récentes en juillet 2021). Notre rapport complet sera publié en octobre, mais nous pensons qu’il est pertinent de diffuser ces conclusions préliminaires pour enrichir le débat actuel portant sur le phénomène des expulsions de campements. Dans l’ensemble, nos résultats suggèrent que le dossier des campements est complexe. Cinq résultats de notre enquête sont particulièrement importants et sont susceptibles de démentir des hypothèses largement répandues.