The results provided some specific information regarding the effectiveness of the Emergency Warming Shelter in Inuvik, including suggestions for future endeavours. This section summarizes key findings before outlining the emergent themes and subthemes. For Inuvik, this and previous research indicate there is a clear migration of homeless men and women into Inuvik from surrounding areas. Earlier research by Young and Moses [43] supports the claim that services for this population are fragmented, inadequate or ill prepared to cope with the special needs of this population. It supports the observation that mental health and addiction issues are common within the population experiencing homelessness and that mental health issues are often undiagnosed and/or untreated. This is partially due to a lack of service. Similarly, there is a severe lack of supportive housing designed to support a population with specific and often numerous issues. For example, there is an evidence of multiple intersections of violence and trauma, including post-traumatic stress disorder, intergenerational trauma and experience of residential schools, which exacerbate the potential for mental health and addiction issues.
Emergent themes
Rich information was gathered from the qualitative data. While the findings were not necessarily representative, they painted a picture of life for the respondents and other service users of the EWC. The themes and subthemes that emerged were categorized as (1) typical day, (2) use and appreciation of centre, (3) obstacles to recovery (including “resiliency, physical and mental health of guests”), (4) substance use, (5) housing and other services needed,(6) dearth of professional support and accessing help, (7) sense of connection, (8) challenges and successes at the centre, (9) vision, policies and roles, (10) sense in change in service provision and future ideas and (11) experience of homelessness in Inuvik.
Interviews with stakeholders and guests suggested that overall alcohol or drug consumption for most guests declined with their attendance at the centre. In addition to interviews, the superintendent of the RCMP was asked to share data regarding changes noted by police during the operation of the EWC. Notably, the superintendent reported a decrease in the number of admissions to the cells over the period of EWC operation and thus a corresponding decrease in charges against the guests of the centre.
Typical day
As the shelter is only open overnight, days for guests are long. Despite their generally upbeat attitudes, they also painted a picture of boredom and disenfranchisement. The majority of respondents said that they spent most of their days walking the streets or shorelines of the Mackenzie River. Some suggested they spent some time with their family or friends, on the streets or in their homes. Most respondents suggested that they spent time drinking each day. Some respondents had casual work or family obligations in which to attend. Alternatively, a few mentioned that they visited either the library or the soup kitchen during part of the day. One respondent said he used the recreation complex to shower. At night, those who did not stay at the centre slept in tents, cubby holes, under buildings, in utilidors and sometimes with friends or family members or in bush camps during the warmer months. On rare occasions, respondents suggested they stayed at either in the other homeless shelter or the women’s shelter, the hospital or the police station lockup. The pattern did not change significantly between interview periods, although several did suggest in the second period they spent time waiting for the EWC to open.
Use and appreciation of the centre
Use of the centre
There was a continuum of use of the shelter. Some guests used it nightly, where others used it occasionally when other options ran out (for instance if they were kicked out by family or by the other shelter).
Appreciation of the centre
Guests reported a high level of appreciation for the provision of the service. The main reasons respondents gave for appreciating the EWC included the following: allowing them to stay independent and “not to cause a nuisance” to friends and family, providing them with a warm, safe, dry place to sleep and a place to store their belongings and not freezing to death. They also appreciated having someone to talk to and not being watched. For some, it also offered a sense of hope for things to improve. One guest suggested:
Well this warming shelter is good, I do like the fact that it is here to help people cuz in Inuvik it’s very harsh… it’s a good thing that this is here. You know like people aren’t sleeping under buildings freezing to death.
Another guest said “They can’t shut it down…they are great guys here.” Another guest reflected:
I feel a lot better because you know I know I am here and I am safe and you know… so it’s really difficult to you know everyday try to struggle to you know keep your spirits up…
Obstacles to recovery
Staff and other stakeholders identified a number of barriers to recovery for guests. Their list was slightly different than guests. For them, key issues included lack of identification for travel for guests and more fundamentally, a lack of local services, coupled with either a duplication of services or a lack of service coordination in town.
Obstacles identified by guests have been grouped in five subthemes–resiliency, physical and mental health issues; substance use; housing and other services; lack of professional support and accessing help.
Resiliency, physical and mental health
Overall, respondents demonstrated a high degree of resiliency. They reported significant levels of physical health issues, ranging from chronic to acute illness and injuries, but these issues were minimized by the guests themselves. A guest suggested “nothing in my body is working right”. Similarly, although most reported having no mental health issues or current problems, a number of respondents disclosed multiple traumatic experiences and significant losses. A number of experiences of psychological and physical violence were shared. One guest spoke about experiencing violence in the past to the degree that it “tortured me enough to live on painkillers”. Despite this observation, most described their mental health as good. However, this may relate more to their fear of stigma or to a lack of knowledge than to their mental health.
Substance use
According to the staff and other stakeholders, most of the guests were alcohol users (usually Sherry). Some occasionally used marijuana, but other substance use was uncommon. Towards the end of the period, there were some groups that appeared to be using crystal meth.
A guest claimed that alcohol was used as self-medication so extensively that it had become chronic. “For the past couple of years, a typical day is looking for my next drink.” Another guest suggested:
I am an alcoholic, it’s an addiction. Right, and like I said it’s my choice whether I want to or not and if you had other support though, maybe you wouldn’t so much that’s oh that’s a factor of boredom also, there’s nothing to do.
While guests did not identify any problems with other substances, opinions were split on whether they believed the EWC could or would impact their drinking. Some said it would reduce or regularize their drinking and make it safer, but others felt it would not make a difference on levels of consumption. Most respondents had optimistic but realistic perspectives on their ability to stop drinking.
Housing and other services
According to respondents, two main themes emerged when looking at obstacles to housing and general recovery. One was the lack of accessible or permanent housing, and the other was alcohol addiction. The housing insecurity that respondents felt included not only a lack of access to basic shelter but also to warmth, food and storage. It also involved a lack of respite from boredom, disrupted sleep, a lack of access to facilities to maintain basic hygiene and insecurity of belongings. The EWC offered some respite to these areas, but not to all of them. For instance, respondents suggested that even with the support of the EWC, they had nowhere to store their personal belongings during the day, nowhere to go in the day and no access to wash themselves or their clothes.
There was scant evidence that respondents were drawing on many services. However, most suggested that they had applied for housing and were on a waiting list. One guest said “I wish I had my place, if I could find a place, I could try to get my life back together.”
Some noted that they used the soup kitchen and, occasionally, the hospital. A few mentioned that they had gone to counselling in the past but were not currently doing so. Some noted they had previously gone to detoxification treatment or substance abuse counselling but were not currently accessing these. A few noted they occasionally accessed Alcoholics Anonymous meetings or church support. Only one respondent noted the need to seek legal help. A few respondents occasionally worked casually, although one respondent appeared to work more regularly.
Dearth of professional support
Respondents noted that they needed more access to appropriate counselling, housing support, detoxification, a programme on the land and support for obtaining identification (which is difficult to do with no fixed abode). A few noted that they had been encouraged to go back to school, but none suggested that they were currently attending classes. One respondent said:
They say oh you should go back to school but it is not easy being homeless and try to go back to school. It’s not easy trying to get a job and not have anything to eat or anywhere to wash your clothes or have a shower or you know. That’s tough.
According to the staff and other stakeholders, there were gaps in services both within the centre and across the town. They highlighted activities during the day, bathing and clothes washing facilities; community based supports; access to rehabilitation and mental health services as the most critical gaps.
Accessing help
Although some services exist in the community, according to the staff and other stakeholders, the guests reported both having little access to services, either by choice or availability and rarely utilising services that exist. Staff and other stakeholders suggested that once accessing a service, guests had a difficult time using the services consistently for a variety of reasons.
In answer to “do you access any services in town”, one guest suggested “NO, I’m pretty much lost in the dark”. Another suggested “No, I just live day by day by myself. Work when I can for the day”.
Some did not bother to access services, or they were on waitlists or they used them and found they were not appropriate. Almost all suggested they were on a housing waitlist. The most common source of support was found with family or social networks, but anecdotally, this appeared more common for females than males. A couple of guests suggested that they used the centre staff for support. Overall, the picture for accessing formal or informal support was haphazard.
Social support and connectedness
In terms of social support, respondents were mixed. For the most part, female respondents were more likely to suggest they had good social support networks with family and/or friends and that they both gave and received support from others.
Analysis of guest’s statements illustrates that a sense of connection to family, friends and Aboriginal band was mixed. Most suggested they felt reasonably connected to the centre but noted that they had experienced prejudice within the wider community. One respondent suggested:
it’s frustrating like to live in you know you set up a tent and make your little spot somewhere and someone comes along and destroys it, ignorant kids or ignorant people doing that. I don’t know. I never caught anyone destroying my stuff before. Pretty sneaky.
Another stated “they see you as a lowlife alcoholic… you are still a human being…you still have feelings”. Despite this, respondents generally felt a connection to Inuvik.
Challenges and successes at the centre
Several behaviour issues emerged that required good policy and practice. The prominent concerning behaviour was lack of respect for some centre staff and an occasional violent disruption towards the latter half of operation. A high turnover of staff, board members and management escalated this issue and did not support an environment where problems were dealt with consistently. One guest suggested:
There’s also the um, conflict of people coming drunk and causing trouble and you know…, it’s tough. You know cuz, cuz they, they allow it. But, nobody wants to put up with somebody that’s cranky when they are drunk. All they do is constantly run their mouth.
Staff and other stakeholders identified key systemic issues that limited the efficacy of the centre. These included turnover of staff in wider health and social service systems in town, lack of comparative information on rural and northern homelessness and appropriate interventions, inconsistent commitment from, and reliability of, staff, visible community support for the centre including from the church, insufficient training for staff and staff expertise, lack of transition system out of homelessness, staff, volunteer and board turnover, and varying commitment from the Inter-Agency Committee.
Overall, the key success of the centre was that none of the guests died while using the centre. Staff and other stakeholders accounted for the success for the centre by highlighting good practice, such as strong managerial support for staff, celebrating the examples of success of some guests, consistency in the availability of the centre and strong support from police and ambulance services.
Vision, policy and roles
Vision
Stakeholders illustrated a common understanding of the overarching vision and purpose of the centre, i.e. to ensure survival of guests by offering a safe place to sleep and some food. Similarly, they expressed a clear idea of the target population, chronic to transitional homeless with addiction issues. In short, one staff member suggested the centre “is just aimed at being that safe place for people even if they are intoxicated”. Another stakeholder suggested the purpose was “to keep people alive and this has been successful”.
Policy
Staff and other stakeholders suggested that the development of policies for the EWC was slow in coming. This was complicated by a high level of turnover by staff and board members. Initially, attempts were made to bring some policies in, for instance a “no violence” policy, while other policies such as washing laundry and cleaning responsibilities developed with time and experience. Another example that was trialled was a token system to promote prosocial behaviour, but this was never fully implemented. In reflecting on what was going well, a staff member suggested:
We know what to expect, and by keeping it consistent from night to night, it just allows us to build that rapport with the clients because there are no surprises. And they know the drill.
Roles
The staff, management and board members outlined some of the key roles of staff. These included the ability to set boundaries, enforce rules, supervise guests, manage intake, clean the centre and prepare food. In thinking about what the centre could be, visions included an increase of services offered and better integration with services in Inuvik. They also saw the need for a new location and an expansion to include transitioning support.
Sense of change in service provision and future ideas
Respondents reported that little had changed in Inuvik in terms of services, other than the introduction of the EWC. They offered a number of ideas for services or supports that could help the community experiencing homelessness to move to independence. These included “someone to talk to”, “a place to live”, help in accessing housing, support with obtaining identification, “warmth”, “a laundromat”, work, detox and a graduated wet-dry shelter that moved people to independence.
In exploring options for future iterations of the centre, staff and other stakeholders suggested that they could explore using an external agency with experience in the field to manage the centre and to find a new and more appropriate space for the centre that allowed longer hours of operation. Other focus areas included exploring the possibility of charging for bed nights and continuing to build community support for the centre.
Experience of homelessness in Inuvik
Respondents to the interview demonstrated their tenacity, resiliency and survival instincts. Although a few noted a lack of compassion they had experienced in the town, they were grateful for the support they had experienced from the EWC. One guest suggested that they felt that their opinion did not matter and that it was perceived as uniformed.
Respondents articulated the complexity of the homelessness situation in Inuvik. When asked, what could be done to help, one guest illustrated how challenging it is to find solutions by suggesting:
I couldn’t tell you. To tell you the truth I think about it and I really don’t know. Couldn’t tell you. Like I think about it and it just seems like…
Other guests identified some of the barriers to accessing permanent housing, issues with battling substance abuse and the elemental challenges posed by living in the Far North.