In/Out: the first six-weeks

Where to start?

Maria has replaced sleep for alcohol and is intermittently yelling and crying, “I can’t feel, I can’t feel.”

Ed and Abi are on the streets again, using crack to cope. “We’ve got to stay in control so we can get through this.”

Zoe is in her second trimester, hoping this time – the fifth time – will be different. This is the baby she will (finally) hold onto.

Dustin isn’t sure he wants to go through another Christmas. The cold concrete is more familiar than his apartment. Has been since he was ten. “You wouldn’t believe what I’ve seen. You just wouldn’t believe it.”

It is hard to believe the depth of human resilience. In the face of egregious childhood abuse, sudden deaths, forced family break-up, longstanding addictions, petty and not-so-petty crimes, repeated evictions and virulent violence, Maria, Ed, Abi, Zoe, Dustin and the nearly 5,000 other “street-involved” Torontonians are still standing. Even if they are entangled in a frayed safety net infested with bedbugs.

Should our focus, then, be to repair the safety net? We at InWithForward say our mission is to transition our safety nets into trampolines, but what happens when the safety net is so threadbare it is no longer providing basic protection? Do we have to fix it before we can flip its function?

We’re now into week six of our six-month In/Out project in partnership with West Neighbourhood House and their Meeting Place drop-in centre. Our ambition was to prototype new practices & supports to enable street-involved adults to flourish. To feel safe, accepted, and able to move forwards – out the other side of the revolving service door. 

Our ambition has not been shared by all staff members or by all members of the drop-in centre. At a time when so many street-involved adults cannot even get in the door of detox or housing services, how can we think beyond that? Does asking questions about what else people need to flourish let the service system off the hook? When the bureaucratic red tape is so sticky and the structural reasons for homelessness are so entrenched, does talking about practice become a conservative cop-out?

It’s the first time our values have clashed so directly with a prevailing value set. That’s made for a pretty tense, but existentially enriching start to the work. Rather than jump into prototyping alternative support models, we’re pausing to name the tensions and to construct a shared space for fresh conversations, fresh routines, and over time, we hope fresh outcomes.

Are we after a world where drop-in centers are not needed? Where people’s needs and wants are met by their family members, their workplaces, their neighbors, and interest-based communities? What if people’s sense of belonging didn’t only come from bonding over a traumatic childhood or a shared set of destructive behaviors, but from re-engaging with their cultural histories and life aspirations? Can shelters, drop-in centers and stopgap services curate multiple sources of belonging? In other words, can they be a home for people’s present-day selves and their future selves? Or do we need additional spaces & networks to develop and reinforce the future self?

What happens when people can’t envision a future self? Or when their version of a future self doesn’t involve the bulwarks of modern society: a job, stable housing, a functioning family? Adults like Ed and Dustin have never had a legitimate job, a consistent house, a functioning family. Nor do they purport to be interested in these things. A minimum wage job with a boss has little appeal. Sure, a house would be nice. But not if it comes with strings attached. Once you’ve lived outside ‘expected’ social norms – and ingeniously survived – what’s the way back in? In a co-design approach, how much do we accept people’s stated desires, and how much do we shape aspirations? What research and prototyping methods can we use to drill beneath the surface to get at what people might want?

Drop-in centers, unlike most social services, are open to all. There is no eligibility criteria. Any one can spend the day playing pool or catching up with friends. Any one can use the laundry, shower, and kitchen facilities. Any one can access case management support. They can get brokered to housing, to welfare benefits, to a psychiatrist, to a doctor, to a law clinic, to a detox bed. In this way, drop-in centers are really the critical catch-all beneath the fraying safety net.

As a catch-all, there is little differentiation between people seeking the means to change their lifestyle; people seeking the supports to maintain a changed lifestyle; or people seeking the substances to continue their same old, same-old lifestyle. What happens when the ‘pull’ of the same-old, same-old lifestyle is stronger than any alternative? Or when the supports for the alternative lifestyle address the practicalities, but not the deeper-seated psychological needs?

Are we setting people up to fail by securing a detox bed or subsidized house, but not also enabling them to recast their personal stories and to build new kinds of relationships? Stories that aren’t just based on trauma and catastrophe, and relationships that aren’t just tied to their past behaviors? In other words, should we continue to work in the same sequence where ‘basic’ needs are addressed before psychological or relational needs? Or do we need to consider another order for the supports we provide?

Nearly all of us who work in the social sector want to help. We’ve opted for lower salaries and resource constrained environments in order to make a difference. This feels particularly true in the drop-in centre context, where so many of the paid staff have relevant lived experience. There isn’t the usual divide between professionals and the people they support. The lines are blurrier. Staff expertise comes less from credentials and more from practice.

Excitedly, this is what we’ve advocated in so many of our past projects: ways to validate people’s backgrounds and acquired know-how. And yet, the risk is that personal experience becomes the only lens through which we look at others’ experience. How do we give a platform for lived experience, whilst also recognizing that there are a multitude of lived experiences? How do we prevent myopia from setting-in? What are ways we can take a step back and look at where our own biases and assumptions might be holding people back, or inadvertently feeding our need to help? Where does the need to help serve us well? And where does it serve to create co-dependencies?

None of these questions have a clear cut answer. But naming them gives us the opportunity for deeper exploration – not just with dialogue, but with very small-scale experiments. These experiments are not ‘the’ intervention – but they just might have elements worth incorporating into intervention sets.

We’ve wondered how to bring psychological needs to the surface – alongside all the other critically important needs people have for a bed, for a shower, for a hot meal. How might we engage the mind – both the intellectual and emotional parts – and find fresh ways to think and act? So we’ve tried using stickers with emotion words, teaching mindfulness techniques, using props & metaphors to contextualize where emotions and memories come from, and passing out excerpts of philosophy and neuroscience books.

We’ve had good take-up – not across the board, but from a segment of people seeking a change in their situation. Next, we want to test how to build up a much deeper (and less superficial) resource base. Can we recruit and support philosophers, retired psychologists, poets and musicians to work with folks 1:1? Can we create a database of stories, films, podcasts, art work, music pieces, meditations and strategies that might be distributed to people with different moods and levels of distress?

We’ve wondered about how to create one space with multiple social norms co-existing? Can the people seeking a change connect with likeminded peers, and not be derailed by folks not (yet) at that stage of change? How might we figure out where people are at when they walk in the door? That’s led us to revise the sign-in sheet. Rather than asking folks to just leave their name, each day we’ve asked a different set of questions to gauge their moods, their reasons for being there, their appetitive for change.

On day one, about 13% of the 70+ people who signed-in were wanting a change. On day two, over 55% of the 55+people who signed-in were feeling anxious. Each day, we visualize and publicize the statistics from the day before. The goal is to start to validate & promote the many reasons why people are at the center. Next, we’re wondering about creating a distinct physical space for those seeking change. With this space might come an alternative menu of activities and peer workers who play more explicit coaching roles.

We’ve experienced just how all-consuming frontline work in a shelter, detox, and drop-in center context is. It’s had not to get drawn into the drama. Crisis is real and constant. Beyond periodic staff meetings, there’s not dedicated time to check-in; to reflect on practice; to learn a new strategy; to read an article; or to get inspired by international practice.

So over the past week, we’ve had a different staff member join our daily morning meeting. We’ve shared our hunches, asked for their input, and shared excerpts of a book we’re reading. We’ve not (yet) managed to make it a particularly reflective moment – but over the weeks to come, the opportunity is to test ways to engage staff 1:1, in small groups, and even across organizational boundaries. How might we design some interventions where staff are the end user group so we can recognize and buttress their hard work?