Nelson’s Street Culture Collaborative Tackles the Systems that Influence the Health of its Street Culture Population

In Nelson, BC, the Nelson Street Culture Collaborative, a multi-sectoral group, has launched a one year Street Outreach Pilot Project. This innovative group is engaging in a process for re-examining the complex systems that influence poverty, homelessness and create the barriers to an improved quality of life for Nelson’s street culture population.

STREET OUTREACH PILOT PROJECT

Banks of plowed snow and the blue shadows of Monday morning crowd narrow Herridge Lane in Nelson, BC. Ryall Giuliano, one of three street outreach workers, shoves his hands deeper into his pockets, careful with his footing on the snow, while he searches for clients: those people “who rely on the streets to survive”. Giuliano is part of a one-year Street Outreach Pilot Project - developed by the Nelson Street Culture Collaborative. The project has three goals:

  1. To assist individuals in the target population to make the transition to an improved quality of life.
  2. To increase understanding among community stakeholders about the target population and street related challenges.
  3. To identify and address service gaps and systemic barriers for people in the target population.

Giuliano spots two men he knows huddled against the cold on the steps out front of Boomtown Sports. It’s a relaxing spot to watch the city wake-up. The first cars and pedestrians creep down Baker Street, and to the north, Elephant Mountain, wooded with dense green firs and dusted with snow, receives the first morning sun.

The men spent the night in the emergency shelter run by Nelson CARES, temperatures had dropped below zero, but everyone must hit the streets when the morning arrives. Now, the two men wait and try to keep warm until ten, when The Salvation Army opens for its free breakfast, where the men have a warm place to rest.

Giuliano asks if they need a snack or a pair of gloves. He carries a backpack with him that contains a first-aid kit, naloxone, harm reduction supplies like vitamins and clean needles, as well as hygiene products like toothpaste, shampoo and tampons. About fifty percent of these products the community has donated, while the Pilot Project funds supply the rest. The products are tools for connecting with the street culture population, however, the longer-term shifts stem from addressing systemic gaps that help people transition out of poverty and homelessness.

One of the men has recently signed the waiting list at Turning Point in Vancouver, a treatment center, and Giuliano passes him a cell phone. “The higher frequency that you call,” says Giuliano, “the higher you move up the list.”

Having people like Giuliano out in the community has already started increasing the well-being of the street culture community by offering people opportunities to make needed changes in their lives. Since the Street Outreach Pilot Project’s inception on October 11th, 2016, Giuliano, and the two other team members, have helped six people start treatment for substance abuse.

TOWARD AN INNOVATIVE AND UPSTREAM SOLUTION

Before the Street Outreach Pilot Project began, the Nelson Police were often first responders and mediators between the street culture people and the rest of the community. Yet, the City of Nelson’s own research showed that emergency responses to these situations, “e.g. holding people in cells to deescalate or sober up, conveying to hospital, or laying criminal charges, are generally ineffective and costly”.

The police themselves felt overwhelmed, so in response to this situation, brought the issue to the Chief’s Diversity Advisory Committee (DAC). In October 2015, the DAC gathered community stakeholders such as business owners and non-profits, including the local government and the Interior Health (IH), to advise the police on Nelson’s growing street culture issue.

Rona Park, Executive Director of Nelson Community Services and a participant of DAC, describes the group’s first meeting: “there was some blustery talk and finger pointing. Business owners were mad because they had people disrespecting their properties or hampering their business. The Mayor said many residents felt too uncomfortable to visit downtown to shop, and worried about the perceptions of tourists.”

Everyone wanted a solution, but disagreed on what it would look like. Nelson Police felt that the street culture population was outside their specialization, and that other organizations, particularly Interior Health’s Mental Health and Substance Use Integration and Strategic Services (MHSU), should fund and provide services.

“These were issues that nobody had a mandate to deal with. We needed to come up with a solution” - Tina Coletti

However, as Tina Coletti, MHSU Manager, said, the problem that the DAC had identified fell outside of IH’s mandate to provide initial comprehensive crisis intervention. “Clearly,” Coletti said, “these were issues that nobody had a mandate to deal with. We needed to come up with a solution.”

Rarely had Nelson’s community stakeholders sat around a table, and out of this unique situation rose the innovative Nelson Street Culture Collaborative. The Collaborative began operating as a multi-sectoral round table where all the stakeholders had an equal voice.

The Collaborative is an innovative and upstream solution to Nelson’s challenges. By bringing together community service organizations and local businesses, along with police, local government and IH, the Collaborative was able to come to a common understanding of the problem, share their expertise and ideas, and create solutions to the problem before things became more critical. The Collaborative developed a set of strategies to address this issue including the Street Outreach Pilot Project being just one of those strategies. The belief was that their impact collectively would exceed that of any individual organization on its own.

MENTAL HEALTH AND SOCIAL INCLUSION

Back on the street, Giuliano gives the two men lunch vouchers, and says goodbye. Boomtown Sports has opened their doors, and he waves at the owner. Giuliano will spend the next couple hours looking for more people to help, before heading over to the Salvation Army’s breakfast.

If someone has a crisis or immediate need, the Salvation Army provides Giuliano a private room where people can vent. “This is usually an emotional crisis,” says Giuliano. “Someone may have found out they will need to spend time in jail or they had a hard night. So much of our work is listening to people's stories.”

Even something as simple as providing a sympathetic ear can help give someone a sense of purpose. Giuliano explains that often people feel like nobody believes or has faith in them, and that allowing someone to speak and reach their own conclusions can boost a person’s confidence. “It changes how people carry themselves,” says Giuliano, “and what goals they make in their lives.” In fact, research cited by PlanH has shown that social connection can lower rates of smoking and drinking and improve mental health.

BUILDING BRIDGES AND CREATING A CARING, INCLUSIVE COMMUNITY RESPONSE

Building a bridge between those citizens who survive on Nelson’s streets and the rest of the community is one of the Nelson Street Culture Collaborative’s goals. Recalling the first meeting of the Collaborative and how contentious it was, Park said, “We just kept talking, because the street culture population is not going anywhere, they are part of our community. And they are part of every Canadian city right now – poverty, homelessness, and mental health problems are at an all-time high.”

The desire to create an inclusive society that promotes positive mental health and moderate substance use, were just some of the goals that led Park to spearhead the Collaborative. Bringing together five different sectors of the community, including IH and local government, the first meeting had 36 stakeholders. “The idea,” said Park, “was to come together as a community to create a caring, coordinated response to the needs of some of this community’s most vulnerable citizens.”

After many meetings, a set of strategies were developed and a decision was made to act on the Street Outreach recommendation. With funding from several stakeholder groups, as well as money from the PlanH Healthy Communities Capacity Building Fund, the project was launched.

To this point, the Pilot Project shows great promise. The team has connected with 111 unique individuals, and provided them a range of services. This has included referrals to MHSU, as well as treatment, counseling, housing, and employment.

It took a solid year to put together the Collaborative, develop strategies, and act upon the first initiative. This process has taught Park one thing – “When you work as a collaborative you need to be prepared to take the time it takes.” Park stressed that while the process may take longer, allowing everyone involved a chance to speak and make decisions that reflect a consensus voice, creates investment. So when new problems arises, everyone is back at the table looking for new solutions.

AT THE END OF THE DAY IT’S ABOUT COLLABORATION

After breakfast, Guiliano blinks as the winter sun pours onto Vernon Street from the south. He will wander for awhile, looking to help anyone who may need it, before he heads over to Our Daily Bread, the Kootenay Christian Fellowship’s kitchen providing healthy, free, hot meals. On the way, he meets up with another team member, Bernadette White, the peer support worker. “She is a big part of the program,” Giuliano says, “she has lived experience and already knew the street culture population very well.” She helped to establish trust as the project began, and now does the same work as Giuliano and Jeremy Kelly, the other team member.

When they arrive at Our Daily Bread, Giuliano can spread out paperwork and help people with applications to treatment as they eat lunch. “What we do is work with people on their own plans to make positive changes in their lives.”

After lunch, Giuliano has an appointment with a client to help them secure government funding for a bus ticket to Castlegar for a medical appointment. Giuliano’s entire practice embodies a collaborative approach as he helps clients navigate the many services available. For example, he spends many hours at MHSU services coordinating care and speaking to their workers about how to remove systemic barriers and help people make positive transitions from being homeless to securing greater health and well-being.

“When you work as a collaborative you need to be prepared to take the time it takes.” - Rona Park

The other important community members who have the Street Outreach Team’s phone number are the many downtown business owners. “It’s a fine line,” says Giuliano, “between being there for the folk who live on the street, but at the same time, trying to help them be aware of how they impact businesses.” Now, when a business owner, or one of their employees has an issue, instead of phoning the police, they can phone the Street Outreach Team. Working through the collaborative approach and systems-lens has increased the understanding among community stakeholders about the target population and street related challenges.

The kinds of issues that business owners cite include individuals using drugs in their bathrooms, standing in their doorways smoking for hours, or aggressively panhandling outside their business. Because Nelson is such a small town (population roughly 10,000), chances are that Giuliano will know the person, and his intervention can usually keep the interaction with the business owner civil and reduce the need for the police “It’s an ‘everyone wins’ situation,” says Giuliano. “We ask if the person can move down the street, or if we can help, even just as a distraction.” At this point, most of the businesses that Giuliano has interacted with have enthusiastically supported the team’s interventions.

The Street Outreach Pilot Project will wind down in September 2017, and whether it receives additional funding or not, both Tina Coletti and Rona Park consider it a success. Regardless of what the future brings, “the community has gained so much from this collaboration,” said Park. “Our awareness of each other’s mandates, and especially our working relationships, have improved.”

Resources

Contact

Rona Park
‎Executive Director at Nelson Community Services
Rpark@servicesfyi.ca

Tina Coletti
Manager Mental Health and Substance Use
Nelson-Trail-Castlegar at Interior Health
Tina.Coletti@interiorhealth.ca