the woman who pioneered housing first – by Travis (2018)
Three decades ago, one nurse came up with a radical idea: Give homeless folks suffering from addiction and mental illness a safe place to be themselves.
no more unauthorized homeless ness.. no more hoop jumping
On paper, her job was to support 10 tenants at the Portland Hotel who were diagnosed with severe mental health issues. In fact, the entire hotel was hers to run as she saw fit.
There were a lot of empty rooms in the hotel, so Evans also began to fill them up, taking people in off the street who were blacklisted from everywhere else. After just a few weeks, Evans was responsible for 60 or 70 people. “People who came with mental health issues, HIV, criminal histories, and drug use,” she says. “That is who needed the support.”
Everyone who lived at the Portland was severely addicted to drugs or alcohol. Evans estimates that 95 percent were injection users. “They were treating themselves badly and treating each other badly because they didn’t feel like their lives were worth much,” she says. “I was getting to know people and listening to their stories. And always the common denominator was, ‘My life is worth shit, and I don’t matter.’ That was the piece that really made me think about my mum and think, ‘Well, fuck, these are just people in the world who don’t feel like their lives have a right to occupy space.’”
Her tenants were the hardest to house in Vancouver. A survey she conducted that year found that Portland tenants had lived, on average, 11 different places during the previous 12 months. “They literally moved every month because they were so complex to deal with,” she says. At the Portland, Evans found ways for those people to keep a roof over their heads. “That meant, when people were psychotic, not forcing them into a hospital,” she says. “When people were doing eccentric things, it meant not arresting them for it, and learning how to accommodate a lot of different, eccentric behaviors and characteristics.” Instead of pushing people to fit into the rules of the hotel, Evans bent the Portland’s policies and safeguards to fit around its tenants.
Evans bolted his television set to his dresser so Joe could not throw his television out the second-story window. To prevent him from punching through the windows, she installed large sheets of fire-grade Plexiglas that were impossible to shatter. The same measures were taken throughout the hallways on Joe’s floor.
“We did lots of crazy things like that,” she says. “It was about accommodating people, really understanding who people were and creatively making space work for them.”
tenants just took a little getting used to. In these cases, behavior that would have resulted in an eviction somewhere else simply became a personality quirk.
The Portland’s staff and tenants realized that Linda’s shouting didn’t actually signal that anything was wrong. It was just an involuntary outburst. “When she moved into the hotel, there was a process of getting used to her,” Evans says. “But after about a week, I remember her walking through the lobby and screaming and everybody just going, ‘Oh, that’s just Linda.’
The primary goal was not to fix people, but to give them a space to live in the greatest degree of comfort that the Portland could create.
There were a lot of unhappy endings at the hotel, but endings that would have been worse had they occurred on the street. And Evans was able to give many tenants enough time to reconnect with family.
“I thought, ‘Holy fuck, there is no difference between me and Tilly, except that she had nothing and no one and no support, and I did,’” Evans says.
“In so many people’s minds in those days, what we did was seen as without value,” Evans remembers. “Because people only respected interventions that led to recovery or to rehabilitation.”
Evans was simply giving a home to people who, up until then, had been told they weren’t good enough to have one
“We accommodated people, no matter who they were.”
“housing first.” It posits that by giving a person a roof over their head, you begin to stabilize a person’s life to a point where they can then work on their addiction issues, mental health problems, prospects for employment, and relations with family and friends. If you first give a person a home and ensure that they can stay there, research shows that this degree of stability will give them the space and the time that they require to figure out the rest.
Evans found that when she told tenants they no longer needed to fear eviction—that they would not been thrown out to the streets for using drugs or disrupting others with symptoms of mental illness—her tenants often used less drugs and experienced fewer mental health outbursts. When she gave tenants a home that was truly theirs and removed the intense feelings of stress that they had previously felt from the constant threat of homelessness, their mental health improved, sometimes significantly so.
Through the 1990s, The Portland Hotel grew from the one building in Vancouver’s Downtown Eastside to the Portland Hotel Society and then to PHS Community Services Society, now one of the largest nonprofit social-housing providers in Canada. Evans left Vancouver and moved on to New York in 2014, but the tradition of kindness that she began at the old Portland Hotel continues there and at more than a dozen buildings that PHS came to operate across Vancouver and beyond.
30 min video interview 2018 – [https://www.youtube.com/watch?v=ih7HoJFUTsg]
The Washington Heights CORNER Project is doing what it can to deal with this crisis by offering support to people who are suffering the ravages of drug addiction. Its strategy: harm reduction, has been controversial in the past. But Liz Evans, the executive director of the Corner Project, is here to tell us HOW harm reduction works, and just how well it is working.
2 min – on harm reduction – at any given time 1 in 10 active drug users is engaged in some kind of treatment program.. so 9 are no.. so many.. have no supports.. vast majority of treatment is abstinence based.. harm reduction is targeted to meet people where they are at.. trying to meet a human being as a human being.. lowering that expectation and not trying to engage in fixing/curing.. means i’m not putting my hopes/dreams on you.. i’m actually listening to you.. and that makes a big diff.. esp to many who have failed at treatments before..
6 min – (on how many needles do you give them..) – we just give people what they need.. once anonymous registration.. have an id.. and carrying paraphernalia isn’t illegal
8 min – no legal injection sites in us yet
18 min – from quote above p 47 (she did say 70% injectors)
22 min – in about only 20% of patients does opioids successfully manage pain.. but used because what medicaid/ins cover.. there’s a variety of things to do w/for people w chronic pain.. we’re not truly looking at treating the whole person
24 min – the issue of addiction is global.. but america is late to the table in terms of harm reduction strategies.. over 30 countries around the world who have had supervised injection sites for many many years and have seen opioid use go down.. ie: switzerland.. 30 years.. opioid use drop by 80%
until we start to think differently about what the problem is we’re going to continue to implement solutions that don’t work..
25 min – in this country it’s been a war on people of color and people who are poor.. what’s convenient is to blame the drugs.. then don’t have to consider all the harm that has occurred because of all the policies for how we treat people who use drugs
harm reduction just says.. let’s look at those harms.. including incarceration.. including banning services/spaces.. whatever exclusionary policies that has occurred as a result of this demonization of people who are struggling w drug use.. it’s politely called stigma but it’s so deep in the dna of how we think about people who use drugs.. i think stigma is far too soft a term because we’re really brutalizing people and we’re allowing them to die.. we treat them worse than we would treat a stray cat..
26 min – if you’re a drug user and you go into emergency.. often times (hospital is a hard job and they try very hard) but it is not uncommon to be treated highly disrespectfully and to be dismissed.. not considered as a real person.. which leads people to use more drugs
on harm reduction international site (2018): https://www.hri.global/contents/1609
Liz Evans trained as a nurse, and in one of Canada’s poorest postal codes worked for 23 years to envision and create numerous services that changed the way drug users are seen and treated. People who were previously dying from overdose deaths and being infected with HIV can find dignity in housing, care and supports – including North America’s only supervised injection facility as a result of a radical shift in approach.
Liz is currently a fellow with the Open Society Foundation in New York and works as a consultant with “Insite for Community Safety”. Liz has received a number of awards and recognitions most recently in 2013 being awarded the Red Ribbon Award by CAHR and in 2012 the Queens Diamond Jubilee Award for Community Service.
Bud Osborn – down here (doc)