1.2 Hurtubise Et Al - Shelters for the Homeless

Roch Hurtubise, Pierre-Olivier Babin, & Carolyne Grimard. Shelters for the Homeless: Learning from Research. In: Hulchanski, J. David; Campsie, Philippa; Chau, Shirley; Hwang, Stephen; Paradis, Emily (eds.) Finding Home: Policy Options for Addressing Homelessness in Canada (e-book), Chapter 1.2. Toronto: Cities Centre, University of Toronto. www.homelesshub.ca/FindingHome Cities Centre, University of Toronto, 2009 ISBN 978-0-7727-1475-6

Chapter 1.2

Shelters for the Homeless: Learning from Research

ROCH HURTUBISE, PIERRE-OLIVIER BABIN, AND CAROLYNE GRIMARD

Inspring2006, inaregionalroundtablediscussiononhomelessness inQuebec,wenoticedthatmanypractitionerswereworriedabouttheroleofsheltersandof their importance inaddressing theproblem.What isthemissionof these shelters?Are they the solutionordo theymerelyreproduceconditionsonewouldfindinanasylum?Cantheyofferawayout from the street? The questions are numerous.What canwe learnfromtheresearchinsocialandhumansciences?

What is a shelter?Definitions ofhomelessness arenumerous andsubjecttodifferent interpretations(Gaetz,2004;Roy&Hurtubise,2007,2004).Thedefinitionofashelterisnolessproblematic.Initsinitialsense,ashelterisaplacewhereonegoestoavoiddangeroraplacewherepeoplewhohavenoplaceelsetogocangather.Abriefsurveyofthetermsinuseshedslightonthediversity:shelter,hostel,emergencyshelter.InFrench:refuge,maisondhbergement,auberge,hbergementdurgence.

The shelter canbedefinedby thenumberofbeds (from a few toseveralhundred)orbythenatureoftheservicesoffered.Inmostcases,theservicesofferedbytheorganismsarenotlimitedtotemporaryhous

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Roch Hurtubise, Pierre-Olivier Babin, & Carolyne Grimard 1.2 Shelters for the Homeless: Learning from Research

www.homelesshub.ca/FindingHome

Cities Centre, University of Toronto, 2009 ISBN 978-0-7727-1475-6

ing and food.Moreover, some organizations offer emergency housingserviceswhile refusing to be associatedwith shelters. For example, inmany cities,onemay find shelters that servebothabusedwomenandhomeless families,while inQuebec thenetworkof shelters forwomenwhoarevictimsofdomesticviolenceare largely independentof thoseforhomelesspeople. Itwouldprobablybemoreappropriate touse theterm emergency housing measures (Hopper, 2004). However, the largersheltersremainthebestknownrepresentativesoftheservicesavailabletohomelesspeople,astheyarefrequentlymentionedinthemedia,particularlyincrisissituations,whentheyareoftenovercrowded.

Whousesshelters?Thereseemstobeaconsensusonthenecessityofdistinguishingthepopulationofthesesheltersandthepopulationofpeoplewithoutahome.Notallhomelesspeopleareshelterusers,andreducing the former to the latter often renders part of the homelesspopulationinvisible.

Thisreviewisinfoursections:(1)ahistoryofshelters;(2)aportraitof shelterusers; (3) intervention practices associatedwith the primarymissionofshelters;(4)criticismsofshelters.

AhistoryofsheltersTraditionally associatedwith resources offered to beggars by religiouscommunities, shelters have evolved over the years. The first shelterswere created in citieswhere an influxof individuals seekingwork increasedthenumberofpeoplewithouthousing.Thistemporaryhousingdevelopedinparalleltoothersolutions likeshantytownsorcamps.Initially established as temporary services for the homeless population,theyeventuallybecamepermanent(Dordick,1996).

Thedevelopmentofsheltersattheendofthe19thcenturyisrelatedto developments in the economy (industrialization and urbanization)and theethicofworkasaway todistinguish thehonestworkingmanfrom the idler.Twowavesofmodernizationofsheltersoccurred in thefirsthalfof the20thcentury.The first improved thehygienicandsanitaryconditionsoftheareabyequippingthefacilitieswithbasicsanitaryequipment;thesecondredefinedthemissionofthesheltersbyservicestohelpshelterusersreintegrateintosociety(Aranguiz,2005;Aranguiz&Fecteau,2000). In thepostwarperiod, shelterswere reaffirmed in their





more traditionalroleofemergencyhousing,with theresponsibilitiesofreadaptationrelegatedtotherealmofpublicservices.

Deinstitutionalization policies designed to maintain people withphysicalormentalhealthproblemsinthecommunitychangedthepopulationusingsheltersandcommunityservices.Forexample,from1984to1988, thenumberofpeopleusingshelters inNewYork increased from5,000to8,000.Mostsufferedfromaddictionormentalhealthproblems.

Visions of the role of shelters differ: is it emergency housing intended tobeusedonly intheshort term,orsupportandprotectionofferedinthelongterm(Gounis&Susser,1990)?Towardstheendofthe1980s,thecreationbythecityofMontrealofareferralcentreforhomelesspeoplecausedmanyproblems:first,thechallengeofsettingupthecentre; second, ensuring the safetyof theusers; third,opposition fromthe residentsof theneighbourhood (Charest&Lamarre, 2000).Today,whennew sheltersarebuiltorwhenoldones relocate, theyoften faceoppositionfrom localresidents,merchants,propertyowners,andNIMBYists(notinmybackyard).Inthesedebates,thepeoplewhohavethestrongestvoice,whoareabletoblocktheseprojects,aregenerallyownersoflargeprivateproperties(Ranasinghe&Valverde,2006).

In the 1990s, critics of shelters becamemore harsh. Shelterswereperceivedaspartofasystemthattriestohidethehomelesspopulation.Because thepresenceofhomelesspeople inpublic areas is seen as anannoyanceandamenace,twostrategiesforfixingthisproblememerged:designingthesespacessothattheyarelessattractivetohomelesspeople(architecture, streetscape) and controlling the behaviour of homelesspeople through litigation.This effort to rid citiesofpeopledeemed asundesirableencouragedthedevelopmentofsheltersasawayofshieldingthepopulationfromhomelesspeople(Johnsenetal.,2005).

APortraitofShelterUsers

TheNumbersIt is important todistinguish thehomelesspopulation from thepeopleusingshelters.Toooften,thenumberofnightsinsheltersisusedasanindicatorofthehomelesspopulation.Thus incertaincities,theabsenceofshelterswouldleadtoanunderestimationofthehomelesspopulation.





Followingafirstgenerationofstudiesbasedontheopinionsofexpertsandwitnesses,asecondbasedoninterviewswithshelterusershasemerged.Amorecomplexarrayofinvestigativeprocedureshasyieldedmore precise approximations (Firdion&Marpsat, 1998).Attempts areunderwaytostandardizeproceduresandfacilitatecomparisonsamongcitiesforexample,thecreationofaninformationsystemonpeopleandfamilieswithoutahome(HIFIS).In2001,StatisticsCanadaestimatedthenumberofpeople in sheltersat14,150oncensusday,but thisnumbermustbeinterpretedwithcaution.

Although the numbers vary, statistical studies help identify theconvergingtrendsoftheuserscharacteristics.Threetrendsareclear:theincreaseinthehomelesspopulation,thediversecharacteristicsofhomelesspeople,and theaggravationofproblems linked to the situation. Ifcertaincensusesshowstabilityinthenumberofusersfrom1990to2000(UnitedStatesCensusBureau,2001),othersshowaconsiderableincrease(Goldberg,2005).Thehomelesspopulationwhichusessheltersdoesnotconstitute a homogenous group (Hecht & Coyle, 2001; Novac et al.,2002).Generally,youthsarelessinclinedtousepublicservicesandsheltersforhomelesspeople,andpreferlifeonthestreets(Brooksetal.,2004;DeRosaetal.,1999).

Use of shelters varies among different groups. InCanada, immigrantsandAboriginalpeopleareunderrepresentedinshelters(Distasioetal.,2005;Fiedleretal.,2006),whereasintheUnitedStates,BlacksandHispanics are overrepresented (Gondolf et al., 1988). The number ofmenusingshelterswhoareinvolvedinthejudicialsystemisfourtimesgreaterthaninthegeneralpopulation(Tolomiczenko&Goering,2001).

People in sheltersmay expressmore satisfactionabout their environmentthanthoseonthestreetanddonotassociatetheshelterswithalossoffreedom(LaGoryetal.,1990).However,youthsmayseesheltersastoorestrictive,andoftendistrustthestaffandassociatedsocialworkers.Thecommunitynetworktakesoverforotherservices(Levac&Labelle,2007;Poirier&Chanteau,2007).

Profilesofusersenableustodeterminedifferenttypesofhomelessness: chronic, cyclical,or temporary (Acorn,1993).Certaingroups (theelderly,or those suffering frommentalhealthproblems,addictions,orphysical problems) stay for prolonged and repetitive periods. A few





situations seem to be particularly problematic: users who have exhaustedtheirpersonalandfamilyresourcesandwhoarealsorejectedbythepublicsystemoftenexpressaggressivebehaviourtowardsaidworkersandotherusers.

Racialoriginseemstobestronglyassociatedwiththelengthofthestayintheshelters;CaucasianpeoplestaylessthanhalfaslongasBlackpeople (Culhane&Kuhn,1998).However, inwinter, staysareusuallylongerbecauseofharsherweather.Simard(2005)estimatedtheaveragestayinalargesheltertobe355days.Mostbeds(60percent)areusedbyindividualsstayingmorethanthreemonths,and30percentareusedbythosewhostaymorethanayear.

Usersof sheltersarenotnecessarilyunemployed; somemayhaveprecariousor lowwage jobs.Researchhasestablishedprofilesofusageaccording to peoples needs: transition towards stable housing, rest,emergency,usageinadditiontodaycentreuse(Grella,1994).

In 2006, the tent crisis inParis raised the question of homelesspeople refusing touse shelters.The initiativeofahumanitariangroupconsistingindistributingtentsduringthewinterseasontoimprovethelivingconditionsofhomelesspeopleprovokedasocialcrisis.Homelesspeople spokeoutpubliclyabout life in sheltersand explained that thelife inside the tent presented a better alternative (de Fleurieu&Cambaud,2006).Elsewhere,homelesspeoplealsorefuse touse thehousingresourcesavailablebecausetheyaredeemedconstrainingandthreatening(Hopper,2003).

EpidemiologicalProfileThehealth statusofpeopleusing shelterspresents a serious challenge(Carrireetal.,2003,Hurtubiseetal,2008).Theuseofshelterscanevencausehealthproblemsthroughsleepdeprivation,personalhygienedifficulties,or limitedspace forstoringpersonalgoods (Poweretal.,1999).Users are often hesitant to use normal health services, treatment andpreventionpractices,andsufferhealthproblemsasaresult(Frankishetal.,2005;Harris,1994).Themortalityratevariesfromtwotimestoeighttimes higher than that of the general population (Barrow et al., 1999;Hwang,2000).





Despite a decrease in schizophrenia cases (Geddes et al., 1994),some studies suggest that between 40 and 60percent of the homelesspopulationsuffersomeformofmentalhealthproblem,suchasanxiety,depression,or suicidal tendencies (Fournier&Mercier,1996;Poirieretal., 2000).Drug and alcoholproblems are common. Sheltersmay contributetothespreadofinfectiousdiseasessuchastuberculosisorparasitessuchas lice (Marksetal.,2000).Thequestionofhealthcalls forabetterunderstandingofthestrategiesusedbypeoplewhoarehomeless(Waddetal.,2006).

Homelesspeoplehavedifficultyaccessingresourcestotakecareofthemselves(Boydelletal.,2000;Laberge,2000).Often,theyalsoendupaddingtotheirhealthproblembywaitingtoo longbeforeseekinghelp(Desai& Rosenheck, 2005). They often use the emergency services ofhospitals (Kusheletal.,2001;Marksetal.,2000;Steinetal.,2000;Thibaudeau,2000).Despitetheirobviousneeds,homelesspeoplearepoorlyservedwhen itcomes tohealthservices,eitherpreventionor intervention(Royetal.,2006;Webb,1998).

UsersandAppropriationsFirdionandMarpsat(1998)pointoutthatthedifferencesbetweenshortandlongtermshelterusersarenotclearlydefined.Amoredynamicapproachthatfocusesonuserscharacteristics ishelpful.Fourgroupscanbedistinguished:(1)thosewhomakemaximumuseofresourcesduringmedium and longterm reintegration into society; (2) thosewho findtheir own solutions to problems,without the use of resources for thehomeless;(3)thosewhomakeadhocuseofemergencyshelterresources;(4) those in precarious housing situations (cars, trailers, squatting).Apersonwhohasusedupallhisorherpersonal,family,andcommunityresources,mayturntoashelterasalastresort(Poole&Zugazaga,2003).Afocusonunderstandingthedifferentsolutionsusedbythehomelesstocompensatefora lackofhousingallowsus tobetterstudy thesurvivalmethods of those involved (Elias& Inui, 1993).According toHopper(2003),understanding the history of the people in homeless situationsenablesustoproposemorecompleteinterventionmodels.

Lifeinsheltersisfarfromideal,andlivingconditionsareoftendescribedassimilartothoseintraditionalasylums(Simard,2000).Theatti





tudesofworkersandtheorganizationalstructureofsheltersmaycreateacontextfavourabletoviolentbehaviouramongusers(Liebow,1993).

Dordick(1996)proposesadescriptionofthesocialworldinshelters.Forexample,sexualpractices,seldommentionedinscientificliterature,areanimportantpreoccupation,eveninareasthatofferlittleornoprivacy.Couplesmayforminshelters.Ritualsofengagementhavebeenobserved among these couples, which imply support and comfort insheltersaswellasoutsidethem.

BeyondEmergencySheltering,InterventionPracticesResearchonprograms forhomelesspeople that involveshelterscanbedividedupintofourcategories:(1)functionsandapproaches;(2)shelteringandhousingasasteppingstonetosocialreintegration;(3)sheltersasaplaceforintervention;and(4)programevaluations.

FunctionsandApproachesStudiesofhowsheltersareorganizeduse twoperspectives: (1) thedesiredapproachofprofessionalworkersandvolunteers,and(2)therulesandguidelinesthatregulatelifeinshelters.

Shelterstaffmaydevelopanunderstandingofthelifeconditionsofthehomelessandof the stateofmindandcharacteristicsdisplayedbyshelterusers.Flexibility,understanding,theabilitytolistenandtoadapttoapersonsneedsareallqualitiesthatarevaluedinpractitionerswhohavetoconstantlyadapttoverydiversifiedneeds.

Mostsheltersset rulesand regulations thatoutlineacceptableandunacceptablebehaviourforbothshelterusersandpractitioners(Nealeetal.,1997;Royetal.,2000).Forexample,permission toenter thesheltermaydependon thepersonsmental state (intoxication,aggressiveness,undertheinfluenceofdrugs),personalcharacteristics(gender,age,culturalbackground),orhistorywiththeshelter(limitednumberofvisits).Once inside the shelter, there are rules governing personal hygiene(showering, changing clothes), curfew and wakeup times, respectingothers(noise,aggressivebehaviour,violence),andparticipationingroupchores (foodpreparation,dishwashing, chores).Repeated failure to re





specttheruleswillresult inapenaltysuchastemporaryorpermanentexclusion,extrachores,orreducedaccesstoservices.

Studiesofinterventionpracticessometimestaketheformoftypologies of shelter operations (MosherAshley & Henrikson, 1997; Pelge,2004).Sheltersgatherinformationfromusersandcantargetproblemstorefer residents to appropriate resourcesor services.Some shelterspromote jobreadinessthroughinhousetrainingcentres,socialenterprises,orbyemploymentgroups.Othersfocusonhealthneedsandorientuserstowards services that correspond best to theirneeds.The challenge ofaccessibility is a central point; there are numerous examples of caseswhereneedswereclearlydefined,butaccessibilitywas limitedbycultural, organizational, or administrative barriers (Roy et al., 2006). Servicesarenotavailable inall sheltersand the complexproblemsof thehomelessarenotalwaystakenintoconsiderationinthoseoffered(Berg&Hopwood,1991).Forexample,manyof thehomelesssuffering frommental health problems use shelters as a substitute to permanent andmoreappropriatehousing(Hopperetal.,1997).

ShelteringandHousingasaSteppingStoneforSocialInsertionHousing is a right, a social norm, a behaviour stabilizer, and a statussymbol (Dorvil&Morin, 2001;FullerThomson et al., 2000;Laberge&Roy,2001).Ahomeisasocialanchorpointforindividuals.Thismeansdistinguishingbetweenshelterandhousing:thefirstimpliesatemporarywayoflifethatoffershelpthatmayincludesomeformofrehabilitation,the second is a stablewayof life that innoway impliesany socialortherapeutic needs (Dorvil et al., 2002). Numerous projects in sheltershavetriedtofacilitatehousingforthehomeless.

Astay inashelterconstitutesan idealoccasion toworkonapersonsability tomanage theirownhome.Sheltersallowusersa temporary experience in a stable and safe environment (Peled et al., 2005).From thispointofview, the roleof shelters is to favour the transitiontowardsstablehousing,amovethatimpliesnotonlyfindingaplacetolive but also building a solid foundation and a social network in thecommunity (Friedman, 1994).Followup after leaving the shelter is anessentialconditiontothesuccessofreintegration,andisalengthyprocess.By all accounts, residential stability isvery fragileduring the first





yearandonlyinthesecondyeardomostpeoplesettledown(Dunlap&Fogel,1998).

Duringthe1990s,advocatesforthehomelessfocusedontherighttohousingasanalternative tosolutions that reliedessentiallyonaquickresponsetoacrisisandpovertysituation.Therighttohousingtookprecedenceoverthesimplerighttoshelterintheplatformsofmanyhumanrightsgroups (Bresson,1997;Hopper,1998).Subsequently, theCouncilofEurope in itsfinaldeclarationtotheCongressofLocalandRegionalAuthorities (1994,p.183)noted:The rightofallhumanbeings todecent,affordablehousingofacertainstanding,adaptedtoessentialneedsisafundamentalrightrecognizedby,amongothers,theUniversalDeclarationofHumanRightsandwhereimplementationisanobligationforallofsocietywithoutexceptionordiscrimination (translated from theFrench).

Research on housing rights includes comparative analyses of thecostsoftheservicesusedbythehomeless(shelters,publicservices)andthecostsassociatedwithlongtermstabilityinadwelling.Forexample,investmentsinsubsidizedhousingforthehomelesswoulddecreasethecosts of other services for thehomeless.The savings generatedwouldlargely cover the financingof subsidizedhousing.Moreover, improvements in the quality of life of homeless people suffering frommentalhealth problems can translate into a reduction in shelter use, hospitalvisits,andthenumberofpeopleincarcerated(Culhaneetal.,2002).Theimpactsofthistypeof initiativearenumerous:betterqualityof life,increased selfesteem, development of selfaffirmation skills and rightsadvocacy,developinganetwork,rightsofcitizensandsocialparticipation(Metrauxetal.,2003;Novac&Brown,2004;Royetal.,2003).

SheltersasPlacesforInterventionEvenifitisdifficulttodeterminejusthowefficienttheyare,itisobviousthat the interventions takingplace insheltersoftensucceed inreachingout to apopulation consideredmarginaland fearfulofpublic services(Levinson,2004).Researchtendstofocusontheresourcesandtheinterventionmodelsthattargetspecificsubgroups:women,youths,theelderly,andindividualswithmentalhealthproblems.Thereislessresearchfocusedontheinterventionswithadultmales.

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Mentalhealthtopsthelistofproblems.Sheltersofferbasicsupport,but it isdifficult todo so for those suffering frommentalhealthproblems.Grella(1994)suggeststhatsheltersshouldofferoptionsrelatedtohelpingthehomelesspopulationsufferingfrommentalhealthproblems.Afollowupaftertheinitialintervention(Hall,1991)andlongtermservicesareusefulwhendealingwithhomelesspeoplesufferingfrommentalhealthproblems.Applebaum (1992),Dattalo (1991),andHall (1991)suggest removingbarriers toservices,coordinatingservices,emphasizingpatientparticipation,modifyingruleson theprotectionof information, lobbying for social andpsychiatric services, raising shelterworkerssawarenessofmentalissues,andimprovingtraining.

Morementalhealthservicesareoffered insidesheltersthanphysicalhealth services (MosherAshley&Henrikson,1997).This fact raisesquestionsabouttheresponsibilitiesofcommunityorganizationsrelativetopublicservices.Someexpertsfearthedevelopmentofaparallelhealthsystem for homeless people. The intervention practices developed insheltersmust be analysedwithin the context of the transformation ofhealthandsocialservices(Racine,1993).

Whatare thebestplacesand themoststrategicmoments to interveneandavoidarelapse?Thepostshelterperiodisconsideredparticularly crucial and followup to ensure the continuity of the process ofemerging from homelessness is essential. Interventions through a networkofcommunityservicescanprevent thereoccurrenceofhomelessness(Susseretal.,1997).

Numerous programs have focused on reducing homelessnessthrough amore intensive approach.Min,Wong, andRothbard (2004)looked at the Access to Community Care and Effective Services andSupport(ACCESS)programintheUnitedStatesfrom1993to1998.Theprogramadopteda treatmentmodel in thecommunitycombinedwithindividualmanagementofeachpersonscase.Theobjectiveof theprogramwas tohelphomelesspeople suffering frommentalhealthproblemsemergefrompoverty.Theresultssuggestthatmanagingeachpersons case individually can reduce the risk of chronichomelessness inpeoplesufferingfrommentalhealthproblems.

Health practices usually consist of guiding the person towardsavailableresources.Somenurseshavedevelopedapracticethatinvolves





regularvisitstosheltersandfollowupwithshelterusers.Strategiesfocus on the resolution ofproblems, empowerment,workwith networkpersonnel, and sharing resources (Denoncourt & Bouchard, 2006; DiMarco,2000;Thibeaudeau,2000).Somestudieshaveevaluatedtheeffectivenessofhealthservices forhomelesspeople.Forexample,ashelterbased convalescence facility can help workers supply health serviceneedsbetteradapted to individualconditions,ensureamorecompletetreatmentofmedicalandmentalhealthproblems, favourcontinuityoftreatment, reduce drug dependency, and help individualswith socialreintegration(Podymowetal.,2006).

Many interventions target subpopulations, particularly women,youth,andtheelderly.Workwithhomelesswomenmaycallforanewapproach inspired by the feministmovement that focuses on offeringsafelivingconditions,valuingtheautonomyofwomen,andestablishingatrustingrelationship(Goldberg,1999;Gondolf,1998;Svigny&Racine,2002).Most youth crisis centres follow similar goals: respond to basicneeds(food,clothing,showers,aplacetosleep,entertainment)andworkto endmarginality by helping youths develop everyday skills, find aplace to live,manage a budget, use available resources, find employment,and,incertaincases,reconcilewiththeirfamilies.Approachesthatcombine educationandbehaviour change througha copingand stressmanagementstrategyfacilitatetheresolutionofthecrisis(Dalton&Pakenham,2002;Teare&Peterson,1994).

Afewstudiesaboutservicesforelderlyhomelesspeopleindicateasignificantincreaseinthispopulation.Physicalhealthproblemsaresignificantandthebarrierstoservicesarenumerous(AbdulHamid,1997).Inthesecases,homelessnessisoftenassociatedwithalossofautonomyandadecreaseinsupportnetwork;turningtoasheltermayincreasetheeffectof these losses inelderlypeoplewhosecognitiveabilitiesaredeclining(Elias&Inui,1993).

Researchershavealsodocumentedoriginalinitiativestheadditionofjudicialservicesinshelters(Binder,2001),theintroductionofoccupationaltherapyprograms(Herzberg&Finlayson,2001)ortheuseofethnographic approaches in clinical work (Grisgby, 1992). These studiestendtobedescriptiveanddonotidentifythemosteffectivepractices.





ProgramEvaluationsTheliteratureincludesevaluationsoftheimpactandtheefficiencyoftheservicesaswellastheroleofsheltersinthefightagainsthomelessness.

Numerousstudiesexaminethecontributionofastayinasheltertoallowing individuals toescapehomelessnessandfindpermanenthousing.Therearemanycontradictoryviews.Shorttermimprovementsmaybe followed bydeterioration (the change is often temporary); in othersituations, the transformations seemmorepermanent, especiallywhenthereiseffectivefollowup(Glissonetal.,2001;Peledetal.,2005;Pollioetal.,2006).

Incertainsituations,specificservices insheltersareevaluated, forexample,adecreaseinbehaviouralproblemsinchildrenofwomenparticipatinginaconflictmanagementprogramincentresforabusedwomen(McDonaldetal.,2006).

Theroleofsheltersinendinghomelessnesscanbelookedatintwoways: (1)sheltersaspartners in intersectorialalliancesnetworks in thefightagainsthomelessness;(2)sheltersaspartofthecontinuumofcare.Shelteradministratorsusediversestrategiestomaintainservices,suchastighteningaccessibilityrules,orbridgingwithotherresources(Goodfellow,1999).Withsuchadiverseclienteleexpressingcomplexproblems,collaborationswithexternalresourcesandthediversificationofpracticesbecomesanecessity.

Developingpartnerships involves relationship building, clarifyingexpectations, identifying needs, sharing expertise, and evaluating thecollaboration(Snyder&Weyer,2002).Shelterscanbethefirststepintoasystemof services,aplace fromwhich it ispossible to evaluateapersons needs and begin implementing interventions.Coordination by acasemanagercanensurefollowupandthecontinuationoftheinterventions(Feins&Fosburg,1999).Effectivenessdependslargelyontheintegrationofmany resourcesaround theneedsof the individual:prevention, outreach, emergency shelter, transitional housing, supportivehousing,andaffordablehousing(Burt,2004;Carter,2005).Thecontinuityofservicesseemspromisinginhomelessness,butthisapproachpresentsethicalchallengesthatshouldbescrutinizedinfutureresearch.





CriticalAnalysisofSheltersAbodyofresearchquestions theroleand theplaceofsheltersassolutionstohomelessness.Thesestudieslookatthehomelessproblemfromadifferentangleandrevealsomelessthanpositiveaspects.

ATotalInstitution?Some authors favourGoffmans approach for analyzing homelessness(Pichon,2002).Fromthispointofview,sheltersareviewedastotalinstitutions, consuming all the time of their users and depriving them offreedom.The rules established to control thephysical and social environmentofsheltersshapetheusersandreinforcetheirmarginalidentity.Thecultureoftotalinstitutionstendstoalienateanddepersonalizeusers,whoselivesaredefinedbytheirbelongingtotheshelter.Forusers,thistranslatesintoalossofautonomyandthefeelingofdominationandenclosure.Thisperspectiveallowsus tounderstand conflicting rolesandallegiancesthatareoftenviewedasirreconcilable(Stark,1994).

Therulesofsomesheltersshowhowencompassingshelterlifecanbecome.Undergroundpracticesmayaddablackmarketeconomyofsorts, such as food reselling networks, protective services, control ofprivileges,andodd jobs.Threeother factorsaffect life inshelters: (1)amajorityoftimeisspentonorganizinglivinginshelters,whichleaveslittletimeforotherthings;(2)personalnetworksandfriendshipsmaybefragileandshortterm;(3)obligationstowardsotherpeoplemustberespected,andleavingthesheltermaybeseenasabandoningtheseobligations(Dordick,1996).

ForMarcus (2003), this analysisneglects the roleof collectivity inthelivesofhomelesspeople.Theideathatsheltersisolateusersobscuresthefactthatforhomelesspeople,sheltersareoneresourceamongmany,andtheirstrategyforsurvivalandescapefromhomelessnessdrawsonpublic,community,family,andpersonalresources.Shelterusersarenotcompletely defined by a subculture; they share values, beliefs, andnormswiththegeneralpopulation.





Shelterization:ConfinementinaMarginalAreaMarginalaffinity,theproximitybetweenshelterusersandprofessionals,denotes sharing of a common surrounding and the development of asenseofbelongingtoamarginalenvironment.Thisproximityisapparentintheparticipationofhomelesspeopleindailychores,thefluidityofthe rolesof interveners, and the absenceof standards. In fact, servicesintendedtoaidinrecoveringfromhomelessnessactuallyfavourthereproductionandmaintainingofshelterlife.Personalfailuresencounteredbyusersduringtheireffortstofindstablehousingsometimesreinforcetheirsenseofbelongingtoshelters,theplacethatacceptsthemforwhotheyareanddoesntjudgethem(Gounis&Susser,1990).

TheideaofshelterizationhasbeendiscussedbyNovac,Brown,andBourbonnais(1996)andKozol(1988).Acertainsocialpathologyengulfspeople in lethargic situations, so that theybecome incapableof takingresponsibility for their lives,neglectpersonalhygiene,and lose interestinescapingtheirsituation.Forusers,thissituationisdefinedbyalossofautonomy,alackofselfrespect,andalossofresponsibilities.Confiningrules,thedifficultyofbeingabletocareforoneself,andpersonalproblemscancreatealargerdependencyontheservicesandanenclosureinhomelessness(Elias&Inui,1993).

Shelterizationalsoemphasizes the socialprocessesofenclosure inhomelessness,similar to theconcentrationofpoorpopulations inghettos.Theabuseofshelters isnot justapersonalproblem.Usersbecomepsychologicallyandeconomicallytiedtosocialassistanceprograms,andadapt by developing survival mechanisms that keep them homeless.Shelterization creates a subculture based on a common language andtheassimilationofsharedideasandvalues.Furthermore,toleratingdelinquentbehavioursmayleadtoaredefinitionofwhatisnormalbehaviour.Regardlessofthedangersandthedepersonalization,usersarereluctanttoleavetheshelters(Grunberg&Eagle,1990).

SocialRegulationsandtheRoleofPoliciesSheltersarenotneutralsites, they represent thebordersofmarginalitywherestreetrulesapply (ZeneidiHenry,2002).Manyauthorsquestiontheroleofthestateinperpetuatinghomelessness.Thereductionofser





vices has resulted in a housing crisis that forces certainpeople touseemergencyshelters(Layton,2000).Atthesametime,themedicalizationof problems or assertions that certain situations represent individualfailuresmasktherealcausesofpeoplesdifficulties(Damon,2002;Marcus,2003).

Studies focus on two areas: housing policies and urban planningandsecuritypolicies.Someauthorsbelievethatpoliciesfocusingonaccesstohousingshouldbereinforcedandcouldhelpsolvehomelessness(Roman&Berg,2006).Hereweseethedebatebetweentargetingtheclienteleasanecessaryconditionforthe implementationofefficientsolutions,andtheadaptationofexistinggeneralservicesbyfavouringaccessibilityandsupportforpeople(Dattalo,1991;Fontaine,2000).

The shelter plays an intermediary role between homeless peopleandthecommunity;itbecomes,forsome,atypeofaffordablehousing.Thesheltersystemcanbeseenasanofficialwillingness toneutralizeaproblem. In fact, the locationofa shelter, its structureandoperationalmodalities influence the typeofreintegration thathomelesspeoplecanexpectinacommunity.Offeringmanyserviceswithinasheltercontributes topeoples isolation,because there isno incentive for them touseoutside services or to familiarize themselves with the location of resourcesandservices(Hartnett&Harding,2005).

Therearetwotypesofshelter.Someofferlittlecomfortandfewfinancial resources, and refer users to other services.Others offermorecomfortandbetter resources,providingapersonalapproach topeoplewhohavethepotentialtomakethetransitiontopermanenthousing.Theemergencyshelternetworkisthereforehierarchal.Theshelteredpopulationisnotanarbitrarilyformedgroup;itistheresultofaselectionprocess.Homelesspeoplewhocanconvinceofficials that theyhave thepotentialtobenefitfromservicesoftengainaccesstobetterqualitycentres(Soulie, 1997). The hierarchy represents a social control process that,throughprioritizationandtargetingcertainclientele,allowsserviceproviderstodistinguishgoodhomelesspeoplefrombadhomelesspeople; thegoodgroupmayqualify for intensive interventions,becausetheirproblemsareoftenlessintractable(Hurtubise,2000).





ResearchChallengesSheltersvarywidely.Theirhistoryandtheirdevelopmentrevealthevariouswaysthatindividualshaveprotestedtofightagainsthomelessness.Forhumanandsocialscienceresearch,sheltersare importantpartners.Shelterworkersarekeysourcesof information for theevolutionof thefaceofhomelessness andhelp researchers reflecton and analyse theirapproach.

Someresearchsuggeststhatsheltersarethebestwaytohandlethehomelessproblem.However,moststudies indicate thatanysolution tohomelessness must include many participants and involve numeroussectors: community organizations, city governments, health and socialservices institutions, law enforcement agencies, and private and communitypractitioners.Research should continue todescribe thevariousexperiencesof shelters anddocument their transformation.Studiesarealsoneededtoanalyseprogramsandpracticesandidentifythemosteffective interventions. Furthermore, critical analysis must continue toquestionideasthataretakenforgranted.Sincethehomelessproblemissocomplex,solutionsmustbeadaptedtothediversityofthecontextstowhichtheyareapplied.RochHurtubiseandPierreOlivierBabinarewiththeDpartementdeservice social at the Universit de Sherbrooke. Carolyne Grimard is at theDpartementde sociologie at theUniversitdeQubecMontral (UQM).They are associated with CRI Collectif de recherche sur litinrance, lapauvretetlexclusionsociale(www.cri.uqam).

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Documents

1.2 Hurtubise Et Al - Shelters for the Homeless