Integrating Healthcare and Housing Supports in Shelters: Understanding the Problem
This post is the first in a series highlighting House of Friendship’s work on ShelterCare. Over 70% who seek emergency shelter in Waterloo region are navigating addiction, mental, and/or physical health challenges. Through the ShelterCare Solutions Lab, we will work together on designing solutions to better meet these needs through responsive and relationship-based healthcare and housing supports in emergency shelter.
When we sought to use the Solutions Lab approach to develop a new model for ShelterCare, our main objective was to design a model that would help us get community buy-in (and, yes, funding) to better support people accessing the emergency shelter system in an integrated way. That was before the pandemic hit Waterloo region, and before we moved the entirety of the Men’s Shelter to a hotel in less than 24 hours. In many ways, we are now iterating on the ShelterCare model—instead of designing a new one from scratch—because so many aspects we wanted to see in ShelterCare exist at this new location.
For the first part of the work, we have been focusing our efforts specifically on this new location for the Men’s Shelter, which has been operating at the Radisson Hotel in Kitchener since the beginning of the lockdown. This location has healthcare onsite and a dedicated isolation floor.
Our first few steps to understand and improve upon the ShelterCare model include:
Narrow down the key problem this Solutions Lab will focus on
Hear the perspectives of a variety of stakeholders
Generate ideas about the needs we’ve heard once engagement is complete
Develop and test prototypes once we have a set of strong ideas
Understanding the Root of the Problem
To unpack, discuss, and create better alignment on the problem we are addressing, the Solutions Lab team brought together key stakeholders that support the work at the Radisson to create a problem tree. We started by evaluating some of the major problems we saw before ShelterCare and discussing which of these problems we think will most benefit from the ShelterCare model.
As part of this discussion, the group landed on the “lack of continuity of care” as the focus of the problem tree. We then used the problem tree framework (or “causal analysis” methodology) to name the causes and symptoms of this problem.
Coordination/collaboration, relationship building, and a lack of time were common themes across the problem tree. In terms of root causes, participant trauma, stigma, and the resulting lack of funding for this population mean we don’t have an integrated approach to meeting the needs of participants accessing emergency shelter.
Validating our Assumptions Through Engagement
We also wanted to hear directly from participants about their experience and use the things we heard to ensure we got the problem tree right. Our original plan was to visit participants in-person and use ethnographic techniques to understand exactly what they were experiencing. As a result of the lockdown, we improvised.
We used postcards with one to two short questions on them and left these in common areas in the hotel. We also handed out a more in-depth engagement tool in the formal of a journal. The staff helped us identify the participants that would be interested in answering reflective questions over a two-week period.
Postcards used as a form of engagement to reach those in shelter.
Lastly, we have been putting up questions on chart paper in the staff areas to capture staff perspective on participants’ experience at the Radisson.
Generating Ideas and Next Steps
Next, we will analyze the engagement data and use what we have learned to identify the gaps we are still seeing in the ShelterCare model and generate new solutions for iterating on the model.
If you are interested in learning more or even supporting this work, check out the ShelterCare website for more information.
Read Part 2: Integrating Healthcare and Housing Supports in Shelters: Developing Design Principles
As a Solutions Lab Provider, Overlap Associates partners with organizations to work through complex housing issues and scale potential solutions. A Solutions Lab is a collaborate initiative to solve complex housing problems using innovative methods and tools. For the organizations participating, a Lab is an opportunity to develop innovative solutions to a complex housing problem, as well as build capabilities for design, collaboration and problem-solving. Learn more about our Housing Solutions Labs here.
