Eight days before I found myself in the underground parking garage of the Drop-In Centre listening to a social worker practice his bagpipes, I drove downtown with Gauntlet photographer Chris Pedersen, an audio recorder and vague notions of the insidious link between mental illness and homelessness. In mid-September, I had explored homelessness for a piece focusing on the lack of affordable housing in Calgary. While conducting research for that article I kept coming across another pair of issues exacerbating the problem–mental illness and substance abuse. The deeper I delved into this issue, the more it became apparent that there is an entirely different world in this city: a desolate world where people live on the street, where drugs and alcohol are abused by many and where a significant number suffer untreated mental illness. A world where a man playing bagpipes in the basement of a homeless shelter no longer seems strange.
I have always taken an interest in society’s treatment of its poorest segments and the inconceivably bad conditions to which they seem abandoned. As a white, middle-class male, raised in a highly-educated family, there was no way I could come to understand or even really appreciate the plight of these individuals. This was readily apparent as I went downtown on the second Wednesday of October with Pedersen to begin working on this article.
We lacked even a vague notion of what we were doing and my carelessness was exposed when I realized that I had not bothered to spend even a single minute thinking about what I would ask a homeless person. This turned out not to matter as I was so nervous about approaching anyone that I spent the first hour or so wandering around, not even able to properly observe people, let alone actually approach them. In the parking lot of the liquor store behind the DIC, Pedersen and I had a bit of an encounter with a drug dealer and two ladies who were not pleased with us taking photos (the photos were not of anyone, but of a pile of bottles and other refuse). But not even this was enough to force me into the reality of the situation. That occurred some minutes later when I finally worked up the courage to approach a man and ask him if he would talk with me.
We had walked back from 10th Ave., where my car was parked and where we had just dropped off Chris’s camera to avoid any further trouble, to Seventh Ave., where we were certain we would find a host of individuals to approach and ask questions near the C-Train. There was a man pushing a shopping cart and picking bottles out of the trash, who I deemed a good candidate for my inquiry. Still nervous, I stalled for a few moments, walking past the man while madly scrambling to come up with something to ask him, before finally turning back and talking to him. He was at the corner of Seventh Ave. and Second Street when I approached him.
“Hi,” I said. “I’m a writer with the university newspaper and I’m doing a story on homelessness in Calgary. I was wondering if you would mind speaking with me for a few minutes.”
I wish I had remained too nervous to approach him. He was somewhere between 40-50 years old, had a beard that looked to have been trimmed recently and was about my height. As I asked the question he looked ahead and adjusted the latex surgical gloves that he wore while pulling cans and bottles from the garbage can. I could see, as I spoke, that my question was terribly affecting him. It was clear that what I was asking was offensive in the highest order. After I finished speaking, he continued looking away. The look of hurt that came across his face was so profound, that for the next few days I would frequently find myself lost to the world, ignoring anyone or anything around me as I was haunted by how deeply I had offended him. He seemed to be fighting back the urge to cry and trying to gain control of his voice for a period of some ten or so seconds, which to me stretched on for an eternity, before he finally responded.
“I’m kind of busy right now,” he said.
“Okay,” I said, feeling horrible and trying to leave the man alone as fast as possible. “Thank you for your time.”
Walking away from the man, I felt as if I had deeply violated him. I was plagued by uncertainty that I would ever be able to deal with this story. I wondered if my question had been malicious. Had I awakened in him some misery about his station in life? A sense of guilt about some past decision that had left him in that place? A frustration at the abandonment he had received from society? I don’t know, but that incident served to jangle me enough that I finally began to realize that there was real and intense human emotion involved with this situation. It was not right to approach this article without investing anything into it.
There is no way that I will be able to explain the depth of this problem and the utterly horrifying realities that its victims, in the strictest sense of the term, live through on a daily basis. Despite this, I will attempt to examine, as best as I can, this abhorrent situation and the reasons it claims the victims it does.
Mental illness in the general population
Mental illness is far more prevalent amongst Canadians than most people realize. In the Standing Senate Committee on Social Affairs, Science and Technology’s Kirby report, it is noted that nearly 20 per cent of Canadians experience some type of mental illness each year: 17 per cent mild, three per cent severe. That means that on an annual basis, given the country’s population of roughly 33 million, approximately 5.6 million Canadians will face mild mental illness and 990,000 will suffer severe mental illness. There needs to be infrastructure in place to help these individuals receive the treatment they need to allow them to continue to function as productive members of society. Unfortunately, in Calgary this infrastructure severely lags behind need.
“It’s overburdened,” said Calgary Health Region coordinator of mental health housing Bettie Yanota. “There’s the beginning structure there, but it needs to probably grow as the whole city has been growing over time.”
Calgary Health Region clinical operations manager of mental health services and addictions Irene Myrah noted there are only three hospitals in Calgary. Calgary is also the only major Canadian city that lacks a psychiatric hospital.
Prevalence of mental illness amongst the homeless population
The homeless population experiences much higher rates of mental illness than the general population. The percentage of homeless individuals suffering mental illness hovers somewhere between 60-70 per cent. This number includes both severe and mild illness, as well as addictions.
“I’ve seen different ranges of things,” said Calgary Health Region patient advocate David Chakravorty. “A common number is 60-70 per cent [of homeless] have some form of mental illness. Someone with schizophrenia is far worse than someone suffering depression due to their situation. There are treatments for all forms of mental illness and the treatment varies in terms of effectiveness.”
Myrah and Yanota both stressed that the prevalence of mental illness amongst the homeless population is on the rise. In addition, they advocated that it is wrong to stigmatize and blame people experiencing mental illness.
“Initially, [the] homeless were homeless, but now I think they’re saying about 60 per cent [are mentally ill],” said Myrah “In some types of mental illness, your judgement gets a bit impaired. Your brain does not function the same way. The stigma is there far more than for any other illness. The biggest thing is to get over that you didn’t choose to have this. You didn’t say ‘my god, I’m going to be mentally ill.’ When your brain doesn’t develop the way it should because of what’s happening with all the synapses and everything else, that’s not your fault.”
Yanota pointed out that the prevalence of mental illness amongst the homeless population means that there are about 2,000 mentally ill people living on Calgary’s streets.
Substance abuse
The issues of substance abuse and homelessness cannot be separated. Yanota noted that roughly 75 per cent of the homeless population are addicted to drugs or alcohol. Of this group, two-thirds began using after they hit the streets.
“If you’ve got a tendency to abuse drugs or alcohol, if you get a hundred bucks in your pocket it’d be tempting to go and slug back a few,” said Yanota. “You can’t blame [them] if they don’t have anything else in their life.”
Discussing the issue of substance abuse and homelessness, Canadian Mental Health Association Calgary Region program manager of street outreach and stabilization Jennifer Finley, gave the most candid response.
“Some people drink when they’re having a bad day,” said Finley. “If you’re permanently having a bad day, what are you going to do? I probably would be a hardcore user if I lived on the streets.”
Concurrent disorders
Concurrent disorders are the dual affliction of mental illness and addictions. There is a great deal of ambiguity involved in these disorders and mental health professionals are often unable to determine which one developed first–the proverbial chicken and the egg. This creates tremendous difficulties for individuals trying to help the sick person as the two problems cannot really be separated, one influencing, aggravating or perhaps causing the other. Despite this, many programs attempt to treat mental illness and addictions separately.
“It makes it so difficult to treat,” said Myrah. “If you’re trying to treat [someone] with medicine for example and [they’ve] got an addictions problem, one interferes with the other. If your whole issue that day is to get enough money to get a fix, it makes it very difficult to treat your depression or your mental illnesses. The homeless [issue] is more than just housing.”
Though often people start using drugs after they hit the streets to cope, some become mentally ill as a result of the drugs.
“Some people have drug-induced psychosis,” said Yanota. “They will go from doing quite well to using drugs and then having a psychotic illness. Some people will develop a psychotic illness and then take drugs in an attempt to self-medicate. People that have drug-induced psychosis, we don’t really know if they would have developed an illness without the drugs.”
Treatment, a lack of capacity and the wait list from hell
The homeless community, beset by a much larger prevalence of mental illness and substance abuse than the general population, require a great variety of services. The services specifically aimed at this portion of the population while numerous, are drastically short of resources. Treatment facilities, perhaps the most important component in getting people off drugs, have stupefying waiting lists.
“[There are] very long waitlists,” said Calgary Urban Project Society director of operations Robert Perry. “[For] men’s addiction treatment centres, I think it’s almost two months.”
“For a city the size of Calgary, you have one detox centre,” said Myrah. “Detoxing is a medical condition. It’s dangerous to detox from some of these things. Bettie mentioned the [Assertive Community Treatment] teams and it’s a well known fact that we have one team in a city of a million people. We should have probably 10.”
Not all people who require help are willing to seek it. If they are, their initial willingness to cooperate with treatment may taper off, causing them to fall back into the same problems as before.
“I think many of them are getting treated to the level of their required treatment,” said Perry. “Then there are those who were treated and then stop their treatment, get off their meds and they have a little bit of a spiral down, [as well as] those who are just, frankly, too paranoid to go get any help.”
In 2006, the most recent homeless count was conducted, finding 3,346 persons living in shelters or on the streets on the night of May 10, 2006. The next homeless count will be conducted a few months from now in the spring and is expected to find an increase in the homeless population anywhere between 23-35 per cent. Calgary is a city bursting with money and we have a growing number of people without a house, the majority of whom are mentally ill.
The DIC
The Drop-In Centre is one of the only shelters in the city that will take people in while under the influence. I went to tour it with Chris Pedersen a week and a day after our initial excursion downtown. The staff was kind enough to conduct a tour, but they were busy and told us to come back in a half hour.
We set off towards the East Village while we waited, finding ourselves at the St. Louis Hotel. It is suggested that this hotel, as well as similar older buildings downtown, would be ideal to open up as low-income housing. Apart from a few burnt out letters, the sign remained lit, but the building was boarded up–a tragi-comedy in a city crying for affordable housing.
Back at the DIC a staff member gave us a tour. The building is quite large with six floors and an underground parking garage. It opened Sep. 11, 2001, replacing the old DIC which sheltered Calgary’s homeless for many years. Along with Alpha House, the DIC is the only shelter in the city that will accept someone who is using. While the upper floors have areas set aside for those who are clean and trying to get themselves into a better situation, the first floor has a large room for those under the influence.
The sheer number of people there was surprising. Row upon row lay sleeping in a massive room and more lay down on the floor near the doorway. The shelter was so crowded on this evening in the third week of October that there were people sleeping on the concrete floor of the lobby. We were told that, as the weather gets colder, the shelter fills up earlier and earlier. If this is the case in late October, what will it be like when the snow hits the ground and the temperature drops well below zero?
It is apparent that, though the DIC is doing an admirable job with the resources they have, it is not enough to adequately serve the homeless population of the city. Especially now as the harsh winter sets in. I can only imagine how desperately insufficient the old building was. I’ve heard that spending the night here is worse than jail.
In the underground parking garage of the DIC we saw a social worker practicing his bagpipes. He began playing there a few years back, after the police were called by an angry Brentwood community and asked him to cease the racket. Interestingly, the homeless, eyesores to much of Calgary’s public, are sometimes treated in the same way. On our first excursion downtown, Pedersen and I saw three police officers approach an obviously homeless man drinking a cola in McDonalds on Stephen Ave. to make sure that, once he was done, he would leave. Like the sound of bagpipes, the homeless incur disdain.