Pubdate: Thu, 29 Nov 2007
Source: Gauntlet, The (CN AB Edu)
Copyright: 2007 Gauntlet Publications Society.
Contact:  http://gauntlet.ucalgary.ca/
Details: http://www.mapinc.org/media/2652
Author: Cam Cotton-O'Brien

STATE OF MIND

Calgary's Homeless Problem Not Just About Housing

Eight days before I found myself in the underground parking garage of 
the Drop-In Centre listening to a social worker practice his 
bagpipes, I drove downtown with Gauntlet photographer Chris Pedersen, 
an audio recorder and vague notions of the insidious link between 
mental illness and homelessness. In mid-September, I had explored 
homelessness for a piece focusing on the lack of affordable housing 
in Calgary.  While conducting research for that article I kept coming 
across another pair of issues exacerbating the problem--mental 
illness and substance abuse. The deeper I delved into this issue, the 
more it became apparent that there is an entirely different world in 
this city: a desolate world where people live on the street, where 
drugs and alcohol are abused by many and where a significant number 
suffer untreated mental illness. A world where a man playing bagpipes 
in the basement of a homeless shelter no longer seems strange.

I have always taken an interest in society's treatment of its poorest 
segments and the inconceivably bad conditions to which they seem 
abandoned. As a white, middle-class male, raised in a highly-educated 
family, there was no way I could come to understand or even really 
appreciate the plight of these individuals. This was readily apparent 
as I went downtown on the second Wednesday of October with Pedersen 
to begin working on this article.

We lacked even a vague notion of what we were doing and my 
carelessness was exposed when I realized that I had not bothered to 
spend even a single minute thinking about what I would ask a homeless 
person. This turned out not to matter as I was so nervous about 
approaching anyone that I spent the first hour or so wandering 
around, not even able to properly observe people, let alone actually 
approach them. In the parking lot of the liquor store behind the DIC, 
Pedersen and I had a bit of an encounter with a drug dealer and two 
ladies who were not pleased with us taking photos (the photos were 
not of anyone, but of a pile of bottles and other refuse). But not 
even this was enough to force me into the reality of the situation. 
That occurred some minutes later when I finally worked up the courage 
to approach a man and ask him if he would talk with me.

We had walked back from 10th Ave., where my car was parked and where 
we had just dropped off Chris's camera to avoid any further trouble, 
to Seventh Ave., where we were certain we would find a host of 
individuals to approach and ask questions near the C-Train. There was 
a man pushing a shopping cart and picking bottles out of the trash, 
who I deemed a good candidate for my inquiry. Still nervous, I 
stalled for a few moments, walking past the man while madly 
scrambling to come up with something to ask him, before finally 
turning back and talking to him. He was at the corner of Seventh Ave. 
and Second Street when I approached him.

"Hi," I said. "I'm a writer with the university newspaper and I'm 
doing a story on homelessness in Calgary. I was wondering if you 
would mind speaking with me for a few minutes."

I wish I had remained too nervous to approach him. He was somewhere 
between 40-50 years old, had a beard that looked to have been trimmed 
recently and was about my height. As I asked the question he looked 
ahead and adjusted the latex surgical gloves that he wore while 
pulling cans and bottles from the garbage can. I could see, as I 
spoke, that my question was terribly affecting him. It was clear that 
what I was asking was offensive in the highest order. After I 
finished speaking, he continued looking away. The look of hurt that 
came across his face was so profound, that for the next few days I 
would frequently find myself lost to the world, ignoring anyone or 
anything around me as I was haunted by how deeply I had offended him. 
He seemed to be fighting back the urge to cry and trying to gain 
control of his voice for a period of some ten or so seconds, which to 
me stretched on for an eternity, before he finally responded.

"I'm kind of busy right now," he said.

"Okay," I said, feeling horrible and trying to leave the man alone as 
fast as possible. "Thank you for your time."

Walking away from the man, I felt as if I had deeply violated him. I 
was plagued by uncertainty that I would ever be able to deal with 
this story. I wondered if my question had been malicious. Had I 
awakened in him some misery about his station in life? A sense of 
guilt about some past decision that had left him in that place? A 
frustration at the abandonment he had received from society? I don't 
know, but that incident served to jangle me enough that I finally 
began to realize that there was real and intense human emotion 
involved with this situation. It was not right to approach this 
article without investing anything into it.

There is no way that I will be able to explain the depth of this 
problem and the utterly horrifying realities that its victims, in the 
strictest sense of the term, live through on a daily basis. Despite 
this, I will attempt to examine, as best as I can, this abhorrent 
situation and the reasons it claims the victims it does.

Mental Illness in the General Population

Mental illness is far more prevalent amongst Canadians than most 
people realize. In the Standing Senate Committee on Social Affairs, 
Science and Technology's Kirby report, it is noted that nearly 20 per 
cent of Canadians experience some type of mental illness each year: 
17 per cent mild, three per cent severe. That means that on an annual 
basis, given the country's population of roughly 33 million, 
approximately 5.6 million Canadians will face mild mental illness and 
990,000 will suffer severe mental illness. There needs to be 
infrastructure in place to help these individuals receive the 
treatment they need to allow them to continue to function as 
productive members of society.  Unfortunately, in Calgary this 
infrastructure severely lags behind need.

"It's overburdened," said Calgary Health Region coordinator of mental 
health housing Bettie Yanota.  "There's the beginning structure 
there, but it needs to probably grow as the whole city has been 
growing over time."

Calgary Health Region clinical operations manager of mental health 
services and addictions Irene Myrah noted there are only three 
hospitals in Calgary. Calgary is also the only major Canadian city 
that lacks a psychiatric hospital.

Prevalence of mental illness amongst the homeless population

The homeless population experiences much higher rates of mental 
illness than the general population. The percentage of homeless 
individuals suffering mental illness hovers somewhere between 60-70 
per cent. This number includes both severe and mild illness, as well 
as addictions.

"I've seen different ranges of things," said Calgary Health Region 
patient advocate David Chakravorty. "A common number is 60-70 per 
cent [of homeless] have some form of mental illness. Someone with 
schizophrenia is far worse than someone suffering depression due to 
their situation. There are treatments for all forms of mental illness 
and the treatment varies in terms of effectiveness."

Myrah and Yanota both stressed that the prevalence of mental illness 
amongst the homeless population is on the rise. In addition, they 
advocated that it is wrong to stigmatize and blame people 
experiencing mental illness.

"Initially, [the] homeless were homeless, but now I think they're 
saying about 60 per cent [are mentally ill]," said Myrah "In some 
types of mental illness, your judgement gets a bit impaired. Your 
brain does not function the same way. The stigma is there far more 
than for any other illness. The biggest thing is to get over that you 
didn't choose to have this. You didn't say 'my god, I'm going to be 
mentally ill.' When your brain doesn't develop the way it should 
because of what's happening with all the synapses and everything 
else, that's not your fault."

Yanota pointed out that the prevalence of mental illness amongst the 
homeless population means that there are about 2,000 mentally ill 
people living on Calgary's streets.

Substance Abuse

The issues of substance abuse and homelessness cannot be separated. 
Yanota noted that roughly 75 per cent of the homeless population are 
addicted to drugs or alcohol. Of this group, two-thirds began using 
after they hit the streets.

"If you've got a tendency to abuse drugs or alcohol, if you get a 
hundred bucks in your pocket it'd be tempting to go and slug back a 
few," said Yanota. "You can't blame [them] if they don't have 
anything else in their life."

Discussing the issue of substance abuse and homelessness, Canadian 
Mental Health Association Calgary Region program manager of street 
outreach and stabilization Jennifer Finley, gave the most candid response.

"Some people drink when they're having a bad day," said Finley. "If 
you're permanently having a bad day, what are you going to do? I 
probably would be a hardcore user if I lived on the streets."

Concurrent Disorders

Concurrent disorders are the dual affliction of mental illness and 
addictions. There is a great deal of ambiguity involved in these 
disorders and mental health professionals are often unable to 
determine which one developed first--the proverbial chicken and the 
egg.  This creates tremendous difficulties for individuals trying to 
help the sick person as the two problems cannot really be separated, 
one influencing, aggravating or perhaps causing the other. Despite 
this, many programs attempt to treat mental illness and addictions separately.

"It makes it so difficult to treat," said Myrah. "If you're trying to 
treat [someone] with medicine for example and [they've] got an 
addictions problem, one interferes with the other. If your whole 
issue that day is to get enough money to get a fix, it makes it very 
difficult to treat your depression or your mental illnesses. The 
homeless [issue] is more than just housing."

Though often people start using drugs after they hit the streets to 
cope, some become mentally ill as a result of the drugs.

"Some people have drug-induced psychosis," said Yanota.  "They will 
go from doing quite well to using drugs and then having a psychotic 
illness. Some people will develop a psychotic illness and then take 
drugs in an attempt to self-medicate. People that have drug-induced 
psychosis, we don't really know if they would have developed an 
illness without the drugs."

Treatment, a lack of capacity and the wait list from hell

The homeless community, beset by a much larger prevalence of mental 
illness and substance abuse than the general population, require a 
great variety of services. The services specifically aimed at this 
portion of the population while numerous, are drastically short of 
resources. Treatment facilities, perhaps the most important component 
in getting people off drugs, have stupefying waiting lists.

"[There are] very long waitlists," said Calgary Urban Project Society 
director of operations Robert Perry.  "[For] men's addiction 
treatment centres, I think it's almost two months."

"For a city the size of Calgary, you have one detox centre," said 
Myrah. "Detoxing is a medical condition.  It's dangerous to detox 
from some of these things.  Bettie mentioned the [Assertive Community 
Treatment] teams and it's a well known fact that we have one team in 
a city of a million people. We should have probably 10."

Not all people who require help are willing to seek it.  If they are, 
their initial willingness to cooperate with treatment may taper off, 
causing them to fall back into the same problems as before.

"I think many of them are getting treated to the level of their 
required treatment," said Perry. "Then there are those who were 
treated and then stop their treatment, get off their meds and they 
have a little bit of a spiral down, [as well as] those who are just, 
frankly, too paranoid to go get any help."

In 2006, the most recent homeless count was conducted, finding 3,346 
persons living in shelters or on the streets on the night of May 10, 
2006. The next homeless count will be conducted a few months from now 
in the spring and is expected to find an increase in the homeless 
population anywhere between 23-35 per cent.  Calgary is a city 
bursting with money and we have a growing number of people without a 
house, the majority of whom are mentally ill.

The DIC

The Drop-In Centre is one of the only shelters in the city that will 
take people in while under the influence. I went to tour it with 
Chris Pedersen a week and a day after our initial excursion downtown. 
The staff was kind enough to conduct a tour, but they were busy and 
told us to come back in a half hour.

We set off towards the East Village while we waited, finding 
ourselves at the St. Louis Hotel. It is suggested that this hotel, as 
well as similar older buildings downtown, would be ideal to open up 
as low-income housing. Apart from a few burnt out letters, the sign 
remained lit, but the building was boarded up--a tragi-comedy in a 
city crying for affordable housing.

Back at the DIC a staff member gave us a tour. The building is quite 
large with six floors and an underground parking garage. It opened 
Sep. 11, 2001, replacing the old DIC which sheltered Calgary's 
homeless for many years. Along with Alpha House, the DIC is the only 
shelter in the city that will accept someone who is using. While the 
upper floors have areas set aside for those who are clean and trying 
to get themselves into a better situation, the first floor has a 
large room for those under the influence.

The sheer number of people there was surprising. Row upon row lay 
sleeping in a massive room and more lay down on the floor near the 
doorway. The shelter was so crowded on this evening in the third week 
of October that there were people sleeping on the concrete floor of 
the lobby. We were told that, as the weather gets colder, the shelter 
fills up earlier and earlier. If this is the case in late October, 
what will it be like when the snow hits the ground and the 
temperature drops well below zero?

It is apparent that, though the DIC is doing an admirable job with 
the resources they have, it is not enough to adequately serve the 
homeless population of the city. Especially now as the harsh winter 
sets in. I can only imagine how desperately insufficient the old 
building was. I've heard that spending the night here is worse than jail.

In the underground parking garage of the DIC we saw a social worker 
practicing his bagpipes. He began playing there a few years back, 
after the police were called by an angry Brentwood community and 
asked him to cease the racket. Interestingly, the homeless, eyesores 
to much of Calgary's public, are sometimes treated in the same way. 
On our first excursion downtown, Pedersen and I saw three police 
officers approach an obviously homeless man drinking a cola in 
McDonalds on Stephen Ave. to make sure that, once he was done, he 
would leave. Like the sound of bagpipes, the homeless incur disdain. 
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MAP posted-by: Richard Lake