By Jon Herriot
On my first day up in La Ronge during my rural family medicine rotation, I heard a story of a man who was found dead in a small homemade shack. His shack lit on fire and he burned to death, presumably during an attempt to heat his small shelter during a cold winter night.
I soon learned that in La Ronge there is an AIDS Saskatoon-affiliated organization named Scattered Site that provides outreach and harm reduction services to folks in La Ronge. While it is impressive that a service like this exists in the small community of La Ronge, it also reflects a need for the services that is concerning. While there are some experiencing true primary homelessness in La Ronge, much of the housing crisis manifests itself in couch surfing, daytime shelter use, and crowded housing conditions. This crisis has only been exacerbated by recent inflation in the housing market. It may be time that La Ronge followed the example of larger centres by surveying and counting those without housing, to document the extent of the problem.
According to the National Healthcare for the Homeless Council in the United States, homeless people are 3-4 times more likely to die prematurely and their life expectancy ranges between 42-52 years, compared to roughly 80 years in the general population. A large proportion of this early mortality in the homeless can be attributed to HIV infection, violence, and drug overdoses. Homelessness is certainly an issue that puts the health of the population in La Ronge at risk.
Underhoused individuals are also expensive for taxpayers. In my short time here I have seen folks without homes who have come into the emergency department with the RCMP. After their care is complete, they have the RCMP drive them around La Ronge looking for a family member who will take them in for the night, costing society expensive RCMP work hours, or they will ask to stay the night in the Emergency Department which occupies an expensive hospital bed and takes time and energy away from health care professionals. If these people get into legal trouble while on the street, you can add further costs for them entering the criminal justice system.
Last year, The United Way partnered with the City of Saskatoon to successfully provide housing for 17 chronically homeless people, and in the first 6 months they saved $668,000. For 10 of the participants, hospital visits decreased from 317 to 37, ambulance rides 263 to 24, and police intoxication detention 108 days to 1. This approach is called “Housing First” and it is catching on around the world. After embracing this strategy, the state of Utah found that the homeless in Salt Lake City were costing $20,000 per year on the street, but only $8,000 to provide both housing and case managers. Slightly closer to home, Medicine Hat is on track to end homelessness this year using the same approach, all while saving public money.
A home can provide stability in lives that can be very hectic otherwise
“Housing First” is not only good for saving money, it helps the people themselves. A large proportion of homeless and underhoused individuals struggle with their mental health and addictions. First and foremost, getting somebody a house gives them a sense of stability in a life that is often very hectic otherwise. Having a stable address can make it easier for social workers to manage their case and get them the social supports, health care, mental health and addictions treatment and counseling that they might need.
An alternative to developing a “housing first” strategy or perhaps a realistic first step in housing policy for this municipality would be a 24-hour homeless shelter. There has been a lot of work on this issue in the past. Not too long ago, funding for a shelter was in place through a partnership between government and local industries. A shelter was all but approved, but the nearby community of Air Ronge would not agree to the idea. I was told that they felt that operating costs would risk tax increases in their community. I have heard that new petitions have been circulating to again generate public support for a homeless shelter, but this time on Lac La Ronge Band land. Similar barriers may be faced with this campaign, but I am glad that they haven’t given up.
For a few weeks following my rotation, Scattered Site has extended its hours to include 24-hour service. While they were still not allowed to let people sleep overnight, hopefully this temporary extension helped to prove the demand for this sort of service in the community. A homeless shelter isn’t the solution to the housing crisis in La Ronge, but it would help ease the suffering while the community works on a more stable solution.
There are different approaches to solving problems, but inaction isn’t one of them
Like most bold new political ideas, “Housing First” proposals are bound to face strong opposition. Giving housing to the homeless is commonly perceived as a costly and undeserved handout to people that don’t contribute to society. However, as explained above, it works to save money for the public purse while also improving people’s lives. I get the impression that political will for this sort of idea is also missing in La Ronge. Public education around the topic, followed by public pressure on local politicians can help politicians evolve on the issue. Unfortunately, a lot of the political will would need to come municipally while much of the cost-saving benefits would be seen in the provincially and federally funded areas of healthcare and RCMP services. Perhaps partnering with other levels of government will be necessary to make the project financially viable.
Scattered Site has expressed interest in operating housing facilities for the homeless population in La Ronge. With the right funding in place and partnerships with local municipalities and industry, Scattered Site would be the natural organization to take on the operation of housing units using the “Housing First” model. Nearby organizations such as the Saskatoon United Way would be happy to support the idea and share best practices. Other groups that might support this work are front line health care and RCMP workers who see the health and budget costs of homelessness every day. Affordable housing is something that needs a lot of work province-wide, and it took less than a day to discover that La Ronge has a housing problem of its own. There are different approaches to solving it, but inaction isn’t one of them.
This piece was originally published on Jon's blog - Thoughts for
Jon Herriot is a 3rd-year medical student at the University of Saskatchewan. He is an indie music enthusiast and a fan of healthy public policy. You can find him @JonHerriot on Twitter.
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