Christensen: An effective Northern mental health strategy must include housing

Guest contributor Julia Christensen on why housing should be a priority if Canada’s national mental health strategy is to be effective.

[dropcap_1]T[/dropcap_1]he recent release of a national mental health strategy by the federal government was largely praised in the Canadian North, where mental health is highlighted by health care practitioners, front line workers, and NGOs alike as an urgent, and fundamental, area of concern that is inextricably tied to social cohesion and community wellbeing.
In the Northwest Territories (NWT), we now wait with baited breath for the announcement of a territorial mental health strategy, something that GNWT Health Minister Tom Beaulieu has promised will be tabled in the next legislative sitting. Beaulieu has hinted that the new plan will address key gaps in services to small communities as well as the lack of a treatment facility geared specifically towards promoting mental health. These same gaps have been illustrated in several recent studies on northern health services, as well as in my own research on homelessness and northern housing insecurity. While Beaulieu has mentioned some important gaps that the strategy will aim to address, housing must also feature front and centre in his Department’s vision for promoting mental health in the territory.

[dropcap_1]I[/dropcap_1]n 2007, I began a four-year doctoral research project on homelessness in two northern urban centres: Inuvik and Yellowknife. The project, and resulting thesis, is titled Homeless in a homeland: housing insecurity and homelessness in Inuvik and Yellowknife, Northwest Territories.
While the initial focus was to understand the factors contributing to visible homelessness in those two communities, this study also shed significant light upon what is taking place in other northern communities, the reason being that many (the majority, in fact) of homeless men and women in both locales call other, smaller northern communities ‘home’. Not only did this study illustrate the rural-urban geographies of northern homelessness, it also exposed a common relationship between collective and personal traumas and homelessness in individual experiences. Overwhelmingly, homeless men and women linked their experiences with homelessness to residential school and its intergenerational impacts, apprehension by the child welfare system, or domestic violence.
This link was made in a profound way in Inuvik, where Aboriginal Healing Foundation support was sought specifically to address the role of residential school and intergenerational impacts in the homelessness of men and women in the community. It is clear that chronic threats to mental health form an integral component of many homeless men and women’s experiences. For many, mental health and housing are closely linked. However, critical gaps in support services, including housing, continue to perpetuate homelessness in the territory.
Over the past few months, I’ve had the chance to talk with many of the men and women who participated in my doctoral research in Yellowknife. Each person I have reconnected with is still staying at a shelter in town, and most continue to struggle with addiction, which research tells us is inextricably tied to mental health. Many of these men and women have been through local detox programs several times (either the two-week withdrawal management program in Yellowknife, or the 28-day detox program in Hay River), but each time exited the program and walked right back into the life they were leading beforehand.
I have spoken to several people in those first days out of the detox program: full of hope but also trepidation, wanting to stay on the path to sobriety, and worried about how they will be able to keep it together. But without stable housing, and without the social supports one often needs to continue sobriety efforts, and with only 28 days of abstinence under their belts (a weak cure against the years of experience that lie beneath addiction), a continuum of support that is desperately needed is not currently in place.
A critical part of the problem stems from the fact that housing has not been included in the spectrum of mental health and addictions policy in the NWT. Recent changes to northern public housing policy and provision do not indicate any attempts to coordinate with health support needs or services. At the same time, emergency shelters in the NWT have not seen their funding increased since 2006. Meanwhile, the demand for beds, meals, and other shelter services has been growing exponentially. Services for homeless people in the territory continue because the people who work there refuse to give up. But that can only last for so long. We place a huge burden on the shoulders of front-line staff by expecting them to address what is a growing concern with funds that have not grown in unison. We are in a holding pattern now that cannot even maintain the status quo.
However, emergency shelter services are only part of the solution. The subsidized housing stock in NWT communities, large and small, remains largely at a standstill. Overall, 19 per cent of NWT households experienced core housing need in 2009. But when we eliminate the larger centres from the picture and look only at the 28 smaller, settlement communities, the number goes up to 35.5 per cent. In fact, some smaller communities reported as many as 77 per cent of households experiencing core housing need. In my own research, core housing need and other social factors complicated by housing issues, was one of the main motivating factors behind a rural-urban move of someone vulnerable to homelessness. Overcrowding and a lack of available housing in smaller communities exacerbate violence and other forms of social tension, a prominent feature in many homeless peoples’ experiences. A northern housing strategy that actually adds to housing stock, rather than simply aims to repair already existing units, is desperately needed.
Critical housing gaps persist in larger northern communities as well, which present significant obstacles for the potential for success of any mental health strategy that does not include changes to housing policy and provision. In northern urban centres, homeless men and women encounter a lack of available and appropriate public or private rental housing, limited mental health and addictions support options, employment insecurity and emergency shelter services that are struggling to keep up with demand. As Nick Falvo wrote in his 2011 report, Homelessness in Yellowknife: An Emerging Social Challenge:
The Yellowknife Housing Authority administers roughly 60 percent of all public housing units in Yellowknife. The Authority administers a total of 312 public housing units, and their waiting list prioritizes persons from specific subpopulations. In fact, of the 17 bachelor units and 24 one-bedroom units, all are prioritized for persons with either a physical disability or who are over the age of 60. No single, unattached person, unless in one of those two categories, has ever or will ever get into a public housing unit administered by the Yellowknife Housing Authority, under the current system (p. 12).
There is a tremendous need for not only increased support to emergency shelters and subsidized housing in the NWT, but also for supportive housing programs that address the gap between shelter living and rental housing. This is part of the continuum of support that is needed for people exiting, or engaged in, treatment who are not housing secure. Because of the lack of subsidized housing for single adults, individuals who are making the transition out of emergency shelters in Yellowknife or Inuvik often must turn to private rental housing, which is in extremely short supply in both communities, where vacancy rates are incredibly low, and where there are a large number of well-paid professionals who also rent. While there are a few supportive housing programs that already exist in Yellowknife (and BETTY House in development), we need more. In Inuvik and other hub communities that are experiencing an increase in visible homelessness, the same thing applies: supportive housing programs are urgently needed.

[dropcap_1]I[/dropcap_1]t is promising to hear Minister Beaulieu acknowledge that a sound mental health strategy needs to look at mental health at a territorial scale, including services in both smaller and larger communities. At the same time, there are forces at play in the North that suggest that urbanization is a growing reality. For example, as Frances Abele (2006) writes, urban flows are accelerated by resource development, which draws people and activities to larger centres and tends to create a highly variable, boom-bust economy. Therefore, a comprehensive mental health strategy must build supports at the small community level for those who wish to, or indeed need to, access local services. But at the same time, we need to acknowledge that shifting social, cultural, economic and community dynamics are contributing to urban movement, and that increased supports are needed in northern urban centres for local residents as well as to support the resettlement of those who have recently made a rural-urban move. This includes an expanded approach to assisting northerners vulnerable to homelessness in northern urban centres through supportive housing programs.
As northerners, we must prioritize the wellbeing of all northerners—and this includes increased shelter funding and supportive housing programs, as well as expanded addictions and mental health resources in all communities, large and small. These areas are integral to the health of our communities, and to the inclusion of all community members in the northern social fabric. Then, we need to call on our governments—municipal, territorial, Aboriginal, federal—to prioritize these areas along with us and collaborate with one another on effective solutions to address homelessness in the territory. This includes interdepartmental cooperation. A northern mental health strategy is a significant step in the right direction, however it must include significant housing goals as well in order for such an initiative to be effective.
Dr. Julia Christensen is a SSHRC Postdoctoral Research Fellow in Geography at the University of British Columbia and a Research Associate at the Institute for Circumpolar Health Research in Yellowknife. Her PhD thesis and other information on her work can be found at
For further reading:

Abele, F. 2006. Education, training, employment, and procurement. Submission to the Joint Panel Review for the Mackenzie Gas Project. Prepared on behalf of Alternatives North.

Christensen, J. (Forthcoming 2012). “They want a different life”: rural northern settlement dynamics and pathways to homelessness in Yellowknife and Inuvik, Northwest Territories. Forthcoming in The Canadian Geographer 56.

Falvo, N. 2011a. Homelessness in Yellowknife: an emerging social challenge.
Ottawa, ON: Social Economy Research Network of Northern Canada.

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