It is an unacknowledged fact that the majority of people experiencing homelessness, and long-term homelessness in Toronto are disabled people. In the context of neo-liberalism, it is challenging to discuss this because many believe that the state ‘takes care’ of disabled people through benefits programs like the Ontario Disability Support Program, charities or the insistence by many that “well, ‘they’-the homeless- must be able to go somewhere!”
That is a myth built up and sold by systems of government; including, city, province and nation that all is well. More to the point, Canadians like to believe that we treat disabled people with dignity and respect.
The facts of the matter appear to be very different. A 2006 study conducted by Street Health in Toronto found that 55% of people experiencing homelessness had a serious health condition, and of those, 63% had more than one. In a study by The Daily Bread Food Bank, it was reported that 49% of people using Toronto food banks have disabilities.
It is well known that by virtue of experiencing disability this leaves people at risk of living below the poverty line, being caught in a cycle of underemployment or no employment, and being at a much greater risk of experiencing homelessness. Homelessness can also be impacted by other systems of oppression such as racism, poor-bashing, homophobia and misogyny. Since disability impacts all diversity groups, this can leave folks in a persistent state of dispassion due to interlocking states of disadvantage.
The Ontario Disability Support Program needs to be exposed as a system that includes disincentives to work. As an example, recipients of ODSP get employment insurance deducted dollar for dollar, despite having paid into that system, and folks with high medical needs are reluctant to seek paid work. This is due to people being afraid that they may not be able to make enough money to cover drug and equipment costs on their own.
When all of these challenges to living are considered, the result is often a further degradation of health for people often dismissed as outliers and misfits. This is so often the case that people are denied adequate health care and social services assistance due to being labelled as ‘too complex’, ‘too unstable’, or ‘not appropriate’ for various health and social services programs. That is, if the program exists and if it has space.”
In my recent experience as a disabled community member and social worker, many programs and spaces in those programs do not exist, and the long waitlists do nothing to advance health justice.
Shelters in Toronto are at over 90% capacity, there are not enough warming centres in the city, and there is an unconscionable struggle to keep the Moss Park and Fort York Armouries open despite much community activism.
We need to be asking more questions. How did we get to a place and space in the City of Toronto where asking for more shelter space would be such a challenge? In 2017, Toronto lost over 70 residents, many of them disabled, due to a lack of shelter. I do not want to live in a world where that is the standard of the day!
When disability is considered many people needing mental health services to stay healthy can’t gain access to such supports because of existing long waitlists for services and often restrictive diagnostic criteria. Detox beds are full as well. It is a cruel trick, that when people feel worthy of support and thus ready to change there isn’t a detox space that can take them right away, and try to gain access to follow-up care is a challenge of equal measure.
A philosophy closely tied to improved health and many lives saved, is that of harm reduction. Not all shelters and supports use a harm reduction philosophy and this can be dangerous.
As a harm reduction practitioner and advocate, I do understand why not all shelters are considered harm-reduction facilities but, I believe that all shelters and shelter services must use a harm reduction philosophy. Harm reduction can be defined as a policy or program that reduces harm. This includes shelters, housing-first-policies, and affordable housing to name a few. All shelters need to use a harm-reduction philosophy because shelters are put in place to reduce harm. By definition, harm reduction is on a continuum from abstinence to no change and the most widely understood example of this is its application to substance abuse. It is the case that even in ‘dry’ shelters and ‘dry’ housing options, which folks can relapse even when they try their very best.
This means that harm reduction can be useful when faced with a mental health or substance use crisis because relapses are a common and human experience. Furthermore, a core value of harm reduction always seeks to engage the population that it serves. If shelters and related supports anywhere in Toronto are failing to engage their clients, they are denying the wisdom and experiences of the people they are attempting to support. Folks in need of services and supports are integral to the governance systems of these agencies. Yet, few agencies include systems of governance that include the people they want to be helping.
How is it that we can all help each other? This is a crucial question since disabled people are often seen as the ‘ones to be helped,’ rather than people that can and do contribute and even help able-bodied folks. In a society, where discrimination has less of a foothold, everyone has a valuable role. Toronto can and must do better.
Support services often deny people with disabilities considered to be ‘too complex’. For some people, often with multiple disabilities, such as mental health issues, a trauma diagnosis, developmental disabilities, physical and medical disabilities, this is often because support services and medical services alike are often diagnostic specific with exclusion criteria. This system of the medicalization and individuation of very social problems demands change because medical services and social services need to treat people and not the diagnosis. These services need to be as responsive as possible to what people are telling them they need.
This devilish trick of turning social problems into problem peoples is designed to evade social responsibility for community-derived suffering. For example, less than 50% of Toronto’s shelters are physically accessible. Although the lack of access to shelters is clearly the problem, the wheelchair-user who can’t get in is denied services by virtue of the building space and is deemed too ‘high needs’ by shelter staff. It is also important to point out that there is no shelter in the city that explicitly provides attendant care for disabled occupants if needed.
With physical access being a barrier there are other things that degrade the health of disabled homeless people as well, and that is a lack of a universal pharma care program. The lack of access to medications, should not be a barrier to optimal health and yet, it is.
Since the lack of services, including access to shelters and housing and the lack of care, and health care are disproportionately impacting disabled people in Toronto I think that it’s imperative for community groups supporting homeless disabled people to prepare a submission to the Optional Protocol of the United Nations Convention on the Rights of Disabled People that was signed by Canada on November 30th of 2017.
We must let the United Nations know about the plight of disabled people in Canada, such that there are such high rates of homelessness in the disability communities. This is ableism at its very best and a violence against disabled people. Since housing, food and warmth are human rights this requires a humane and compassionate response.
Last year, more than 70 homeless people died due to a lack of collective care and deep-rooted systems of disadvantage in Toronto. This is unacceptable and it could not be more despicable and inhumane.
Terri-Lynn Langdon is a PhD student in Social Justice Education at the University of Toronto and a housing and disability advocate in Toronto.