Let me begin by, once again, thanking those of you who have been reading my blog and taken such an interest in this series. While I do not know exactly who is tuning in, I do know how many, and the numbers of engaged Londoners is growing exponentially each week. Obviously, the subject matter is of considerable interest to our community and I am pleased to be both shedding some more light on the problem and exploring ways to help resolve it.
If it is not evident through this series of posts focused on London’s Underground, I am in the process of writing a Game Plan for what I hope can play a meaningful role in identifying and overcoming the multiple hurdles our community and, in particular, our most vulnerable face living in our city.
For example, the first three parts of this series have attempted to qualify and quantify the size and magnitude of the issue. Today’s post begins to focus on our response and specifically what issues need to be addressed to improve our service. Next week, I propose a series of strategies and tactics to help resolve the key barriers to success and in the series’ final post, I outline the investment required.
Let me preface this part of the discussion with the following observations:
First, I firmly believe that all of the people and organizations in London who work daily to help resolve the challenges associated with London’s Underground are committed, hard-working, and incredibly caring. For example, I know firsthand how hard our Police, EMS and Emergency Room teams work to provide aid to our most vulnerable, despite often being limited by regulation or the law. I also have always been impressed by the level of care and compassion offered to our most vulnerable by such organizations as the Salvation Army, Mission Services, and the multitude of local churches and daily food banks providing rations throughout the city.
During the course of my review, I have also come to assimilate and greatly appreciate the work of a number of other impressive organizations that offer services targeted specifically at Underground members with particular needs, including; My Sisters’ Place, the InterCommunity Health Centre and the London CAReS program to name a few.
All of these organizations toil largely without fanfare or complaint, in a collective effort to make the lives of our most challenged and traumatized citizens a little easier to endure and, ideally, revive.
Second, I believe that while the community is already making a remarkably large investment in efforts to better deliver services to the Underground and aid its members, more resources may actually be needed in the short term if we hope to reverse the growing trends in mental health, addiction, poverty and homelessness; and fill the gaps in the current continuum of care.
Finally, I believe that we will need to ask and answer some tough questions, about our approach, funding priorities and our capacity for care; a topic that I plan to cover in the last post of the series.
For now, the purpose of today’s article is not to assess and/or assail our current care model as much as to understand where gaps exist so that we may begin to outline what we need to materially improve our offerings and the lives of those most in need.
Thankfully, I am not alone in the pursuit of this overarching purpose. Thanks to the kind input from a number of subject matter experts that I greatly respect, I am able to highlight below with some confidence, a continuum of care model that has been successfully deployed in communities around the globe and one worth mimicking if we hope to meet our shared care objective.
Specifically, the continuum of care model must include people, programs and services in each of the following:
- Prevention – education, public outreach, investigation and arrest of supply channels, and addressing the social determinants of health including: poverty, education, employment, food security, housing, access to health services.
- Harm Reduction – appropriate safe injections services (with locations to be determined), and support services.
- Immediate Intervention – crash beds, short term housing and clinical intervention to address addiction
- Prolonged Support – extended housing, employment or paid volunteering, continued counselling focused on addressing all of the client needs rather than just the medical issues.
- Transition – prep for re-introduction into community, housing support, employment support, and ongoing counselling
Fortunately, London’s social services network offers an impressive range of programs and services across a number of these areas. However, most would acknowledge that these services could be better coordinated. There are also some gaps, most notably in the area of harm reduction beyond current levels and immediate intervention. London currently does not have the resources in place to provide complete support in these two key market needs. London also lacks a sufficient cache of affordable, care-based housing available to accommodate our most vulnerable. London also has gaps meeting the needs of select demographics toiling within the Underground, especially among young people and indigenous people, who comprise approximately 20% of this hurting population. There are also small gaps in the services themselves. For example, some of our service providers do not always have access to nor can provide clinical expertise. The sharing of information is a barrier as well. However, these issues and other minor variances can be managed with further refinement in the existing care plan.
Now, to the credit of London’s social service leaders, the City has made significant inroads filling some of these gaps. For example, London has embraced and effectively employed a Housing First strategy, which provides recipients with a safe, secure and dignified place to reside. This initiative has improved the recipient’s state of mind and encouraged them to embrace other support services. It also has substantially reduced the frequency of contacts each recipient might require from police, health care, and emergency services. Unfortunately, the process of finding available and reliable housing for the homeless remains a barrier.
The other initiative now underway that I believe shows great promise is the development of an affordable housing centre and youth hub under the leadership of London’s Youth Opportunities Unlimited (YOU). This impressive organization is well positioned to deliver a full-service intervention program targeted specifically at our most vulnerable youth, giving them an opportunity to turn their lives around at an early stage. YOU is a significant player in London’s social services network, having delivered over 35 years of service to vulnerable youth. This newest initiative builds on YOU’s track record, having successfully managed a cooperative housing project on the city’s east side since 2009.
Both efforts serve London well and should continue to be supported to the fullest.
London can also help itself by continuing to develop job creation strategies locally, and working to secure more resources from its government partners provincially. However, London also needs to spend time and resources in the development of strategies and tactics to directly address each of the following key issues.
- Development of a Harm Reduction strategy complete with intervention and intense care facilities and support services. This also must include clinical resources to address addiction needs of the clients to understand and treat the cause.
- Development of a comprehensive suite of education and prevention programs complete with credible and sustained delivery models to diagnosis potential problems and/or mitigate trial. This includes addressing the social determinants of health.
- Expansion of the Housing First initiative complete with client care services.
- Introduction of a youth-centric support services program.
- Expansion of the work undertaken in support of our indigenous community. The SouthWest Ontario Aboriginal Health Access Centre, N’Amerind and At lhosa do a terrific job, but they need more resources and civic support.
- Development and deployment of a client identification and tracking system to understand and help those who are utilizing London’s social service network.
- Reengagement and/or expansion of past public awareness campaigns to help Londoners understand and respect the need for this level of proactive investment and client engagement.
What follows next week is a breakdown of the strategies and tactics designed to address the above issues and ideally improve the lives of London’s most vulnerable.
In my opinion, London has the resources and expertise to resolve this problem. It now needs to focus its collective efforts on more proactive responses so that it does not spend as much reacting to it. To do this, our community needs to exercise the humility, selflessness, willingness, leadership and accountability to deliver on this promise.
Next week – Part 5 – The Game Plan