The on-going pandemic has been nothing if not pervasive; affecting people’s livelihood, mental health, physical health, and social support networks. It has caused ripples in our communities, our homes, and our faith in our world leaders as we scramble to support not only ourselves, but our medical workers and our at risk populations. One such population, the homeless, are impacted in ways that many will never experience first hand. To detail the impact of Covid-19 on some of this at risk population, I interviewed Josée Kreese from the Canadian Mental Health Association based in Kelowna, BC.
Josée Kreese: I currently occupy two jobs. Firstly, I work for the Canadian Mental Health Association and my job title is ‘Tenant Support Worker’, meaning that I work in Supportive Housing with tenants that have either been homeless before or have been at risk of homelessness. Between all three of our sites, we house approximately 120 tenants. My day-to-day typically involves supporting the tenants in everyday tasks: budgeting and financial management, helping them access information online, assisting with their Ministry services paperwork, and really anything that someone who hasn't had these experiences might need guidance with.
Secondly, I am positioned at Work BC, which provides resources for anyone that is unemployed or facing unemployment. This job can also pose challenges during the pandemic we are living through, as many people have lost their jobs or are unable to find employment, and my sole job is to find people sustainable employment.
Josée Kreese: There is a significant range of tenants at the CMHA. Some have lived on the street for 20-plus years, while others had a change in circumstances and were at risk of being homeless. It is extremely important to be cognisant of our attitudes towards the tenants because some of them have literally never had a bed in their lives, while others have previously had houses and their own families. These diverse experiences cause discrepancies between tenants in their perceptions of society and the world around them, as well as which supports they may benefit from the most.
My coworkers also come from all walks of life. Some have had similar experiences with homelessness before getting back on their feet. Others come from highly professional and educational backgrounds with accreditations such as their Masters and/or PHD. It is valuable to have this range of workers; pairing extensive knowledge in their respective fields with those who can directly relate to the tenants with experience, and empathize in a very personal and profound way.
Josée Kreese: A significant amount of the homeless population have an underlying mental health concern or condition. The most common mental health conditions and concerns that my tenants face are anxiety and depression. Depression is probably the most common. Once you’ve experienced homelessness for extended periods of time and then had this lifestyle disrupted, you must adapt to living on your own and to a potential loss of companionship from others who were also living on the streets with you. Now that you have your own kitchen, bed, and possessions, it can be very disorienting. These changes can cause all forms of depression, and not just situational depression. Anxiety often accompanies this due to the novel stresses of living in a community with 40 + people. On-top of that, tenant support workers like myself are periodically checking-up on you and your well-being. It can be overwhelming.
Another prevalent issue is addiction, whether it be an abuse of drugs or alcohol. This can evoke as well as aggravate many other mental health concerns. Although CMHA is a harm-reduction/overdose prevention site, the necessary monitoring of these tenants can cause tension with support workers, especially when they may be experiencing symptoms of withdrawal.
This is closely linked with schizophrenia and symptoms of paranoia that are heightened by illicit substances, the attentiveness of the workers, and managing their own medication.
Schizophrenia is quite prominent in the homeless population, particularly in young males. They may have been alienated by their families due to their disorder. Oftentimes, their families did not have the resources or the information to fully understand their symptoms and behaviours. Unfortunately, this may cause abandonment and victimization at very young ages.
Josée Kreese: It has had a huge effect on my tenants. Not only do they already feel isolated because they now live on their own and lack an established support network, but they are also unable to engage in their usual routines. For example, one tenant's ritual may be to go downtown and have breakfast by themselves every Saturday morning, or walk around the mall so that they were in the presence of people. Of course, this can no longer happen due to social distancing. Many of their tools and activities to cope with their mental health symptoms have been taken away.
They also no longer have the same access to us as support workers. Before they were allowed to come into our offices and common areas, and would regularly sit down and chat with us; sometimes all day long. They could come in and play pool, cook, use the computer, use the phone, whatever they wanted to do in our communal safe-space. Because of social distancing, the common areas and offices are no longer open. Our relationship has become very transactional now: they come through the front door, they stay in the entrance area, we talk to them through the door to ask them what they need, and if it's a meal then they step back and we open the door and place the food there. It lacks the connection that we normally would have, like with anyone engaging in social distancing. This has caused a shift in the workers as well. It’s difficult for them to really let you know how they're doing since many of us now work from home. Their mental health symptoms are heightened, but it is harder to identify them early and provide them with proper care. There is less community, which has been replaced by mostly solitary confinement in their rooms.
Josée Kreese: Yes, of course. As I said, we are a harm-reduction/overdose prevention site. We still have in-person staff monitoring our overdose prevention site 24/7.
Access to illicit substances is more or less the same, but the supply of substances that are in the markets are potentially more dangerous due to limitations on imports. Of course, these have consequences that we are as equipped as possible to mitigate.
Josée Kreese: One thing that we in the general population may not consider is our steady and uninterrupted access to a phone, or the Internet. Everyone in my support network has Wi-Fi, or at the very least knows someone who does that they can use. People that live in Supportive Housing and people in the homeless community do not have the funds nor the access to these same amenities. So, even though Covid-19 has significantly affected someone like me, I am still able to pick-up my phone and FaceTime my friends everyday, or give my grandma a call. As it stands right now, being able to pick up your phone and see a face on the other side of it is a commodity; it’s how we stay connected in isolation. You can imagine the loneliness of lacking these resources to communicate and being confined only to your bedroom.
Another point that I’d like to highlight is the fact that
the individuals within the homeless population are much more frequently the victims of violent crimes than the perpetrators.
I know that the stigma surrounding these at-risk individuals often describes the opposite, but that is simply not true. I think that it is sometimes easy to ignore their issues when we may lead very different lives, but it is important to be informed and understanding to these marginalized groups.
Josée Kreese: Due to their lack of internet, they certainly have less access to breaking news updates than you or I. The majority of their information comes from us, the workers, and the health and safety protocols put in place by BC housing. However, with new reports constantly developing, they will continue to learn new information second or third-hand due to the necessary limits on computer and internet access.
I would say that over 60% of our tenants do not have family doctors, which may be difficult for them to obtain. Their main health care resource is the emergency centre at the hospital. Of course, the trend is understandably to avoid non-essential visits to the hospital at this time. Therefore, many of them have not seen/will not see a doctor for some time.
After the onset of the pandemic, there were a couple of very gracious doctors that opened up some time slots for Zoom meetings if requested by a tenant. However, a lot of them aren't tending to their health care needs because of their limited access to the emergency room.
At this time, no one in our units has tested positive for Covid-19.
Yes, we are always at capacity and it can be difficult to engage in proper social distancing as it is a novel problem for all Supportive Housing organizations, or any organization for that matter. On the occasion that it would be necessary (e.g., they’re showing symptoms, need assistance or need to be in close proximity to someone else) we may provide masks to the tenants, but there are hardly enough supplies for the staff which does not allow us to have them readily available for others. Because of the limited availability of housing and funding, there is always a long list of people waiting to get in.
Josée Kreese: BC housing has been diligent with their health policies and procedures and with keeping us all informed and safe. The government has also increased the tenants’ monthly income assistance by $300 a month (from $1200-$1500); this applies to the majority of our tenants in our housing units.
The repeated exposure to high-stress environments definitely takes a toll on our mental health. It is also very difficult not to take these things home with us.
It's really important that myself and my coworkers practice self-care, exercise, take mental health days, and see a regular therapist or counsellor to debrief. A lot of what we experience on the job is confidential, so having someone that can respect client-practitioner confidentiality is extremely valuable. We sometimes do not realize the importance of debriefing until we’re really struggling, but it is an extremely powerful tool that can alleviate a lot of the stress that we carry with us. We have to always take care of our own physical and mental health to be able to do our job well.
Josée Kreese: If people have the means to donate, a great organization is the Food Bank. My tenants frequently utilize this resource and it makes a huge difference in their lives and their ability to function at their potential.
Moreover, staying informed and cognisant of the different issues that are quickly arising within marginalized groups is very important. As a community it is our responsibility to be informed in order to prevent harmful stigma, and to hopefully come out on top after this pandemic.
Mental health affects everyone, not just people who have diagnosed mental health conditions or people who are struggling with housing, addictions, or grief.
It is so important to reach out to someone you can trust, or a professional to be able to manage your own mental health, in order to continue to serve and help others. Seeing a therapist or counsellor is not something to be ashamed of, in fact it is something that needs to be celebrated because you can’t pour from an empty glass.
Josée has her BSc. in Psychology, and will be attending the University of British Columbia for her Masters degree in social work in the fall. She is also a certified yoga instructor, and teaches free virtual classes on her Instagram @Josee_Kreese as well as on her website.