Client Stories

Many thanks to our clients for sharing their stories and the impact of Street Health’s services.

Nursing

 

Street Health’s services support clients who typically do not access service as well as those experiencing persistent and chronic healthcare needs. We see many clients who are over 65 years of age, lack a healthcare provider and are managing on a low income. Clients include those who are homeless, use substances and/or have mental health issues. It also includes individuals like WB, who has lived in a downtown co-op for 12 years.

In addition to extensive knowledge of harm reduction and wound care, Street Health’s Registered Nurses (RN) have received specialized footcare training which is a high demand service. We also have one RN with certified training in the NADA Protocol (National Acupuncture Detoxification Association) – 5 point ear acupuncture.

“I’ve been coming to Street Health for the acudetox service to help with tinnitus – ringing in my ears. It has been impacting my daytime and sleeping patterns for more than four months,” WB reflects. “I saw the sessions on a poster when I was attending the WINK program at the Sherbourne Health Centre. I know some other people who have struggled with tinnitus. I’ve received some medical care to ensure my issue isn’t meniere’s disease and rule out causes like ear wax, blood pressure and medication side-effects. I’m hoping to try some naturopathic options but right now these weekly acudetox sessions are helping.”

These sessions offer a safe, care-focused environment, allowing participants to relax and connect with others. “Every time WB has been in, she has spent the time writing,” observes Registered Nurse Wanda. “We have clients who are successfully using acudetox to lessen their smoking and manage cravings. The results vary from person to person, but documented benefits include: reduced addiction cravings and withdrawal, improved sleep quality, relaxation and mood, and reduced anxiety and depression. We know that building wellbeing is not an all or nothing process – for many people it takes a series of incremental steps.”

For low income seniors accessing alternative therapies is often unaffordable and many rely on the services offered by community centres and supports at various locations. “Many people think it’s easy to access free services, but they don’t realize the amount of time and effort it can take,” states WB. “It’s fine to say ‘It’s free,’ but when you don’t have much you have to schedule and focus your day. I take the TTC most days to reach community services. I rely on these supports to keep as healthy and well as possible.”

Identification

 

Many Street Health clients have complex situations. Imagine being homelessness, in conflict with the law, and seeking detox support – all at the same time.

“I’ve spent more than eight years homeless,” states Ken.  “About three years ago I was staying at shelter when I was arrested following a fight.

While in detention Ken sent off some handwritten letters, including one to Street Health’s ID Team to explain what was happening and make sure the service would hold his mail for an indefinite time. His letter highlighted just one of the many reasons this service is so important to clients who are insecurely house or on the streets.

“After 44 days in custody, one of my bail conditions was to provide a residential surety. I didn’t have a place to live or anyone to vouch for me. Eventually I was given a monitoring anklet, which comes with charging requirements and a bunch of conditions.”

On the day Ken dropped by to talk about his situation, he had just entered a detox program at St. Josephs Health Centre and needed to abide by a 14-hour daily curfew.

While at Street Health, Ken also checked in with the ID Safe staff about his CPP cheque. After a short time, Ken became anxious about getting back to St. Joes to ensure he wouldn’t lose his rehab spot. “There is a bench warrant out for me right now because I missed a court date. I’m in a situation right now with so many deadlines and conditions attached to everything I do. It makes life very stressful.”

“Many years ago a friend’s dad told me ’avoid beginnings.’ In hindsight it makes so much sense because if you aren’t careful, or drug use becomes a problem, it can impact your housing. Then if you don’t have family support, or if that support disappears, it can be very hard to get back on your feet.”

“I’m thankful for Sound Times, Haven, Lawyers Feed the Hungry and Street Health. Without those supports right now I’d have nothing.”

Community Service Workers (CSW)

 

Cecilia is a community member who accesses services through other community agencies and is housed in the Keele and Weston Road neighbourhood.

While it has been 10 years since Cecilia lived in Moss Park area, she still drops into Street Health whenever she is downtown. “This is where I feel connected,” she states. When she meets up with anyone needing some help, she doesn’t hesitate to suggest they visit Street Health. “For condoms, clean smoking kits, anything!”

Street Health front desk Community Service Workers (CSW) provide the starting point for many clients. “If people already have a worker and just need some occasional support, Street Health’s CSWs are a source of information about service changes, new opportunities and what is happening,” states Alina, CSW. “Lots of people also drop by for some basic supplies and seasonal necessities.”

She continues, “We also have clients who prefer to use the anonymous self-serve baskets in our vestibule. Now we are working on a vending machine option so soon community members have access to harm reduction 24/7.”

Today Alina connects Cecilia with a nurse to talk about resuming her antidepression medication and her grief about the recent death of a friend.

“I appreciate their (Street Health’s staff) patience,” says Cecilia. “It is nice to know a place where someone really listens.”

Street Health is always looking for ways to complement rather than replicate services. For example:

  • now that community meal programs have resumed, providing clients with local meal schedules, as well as food bank times and locations, is a daily request,
  • clients with pets, like Cecilia who has four cats, benefit from information about free pop-up pet food and vaccination locations to help keep their companions healthy,
  • having access to a telephone remains an important resource for clients who are trying to book a shelter space or follow up about healthcare results. The phone just off the entrance is used by clients dropping in throughout the day.

“While Street Health can’t do everything for everybody, CSW’s work with clients to find options,” highlights Alina. “Listening and connections are what can make things better for many of our clients.”

Mental Health Services

 

For Street Health clients mental health support can range from urgent, short-term to intensive, long-term needs. The service supports both with each Case Worker maintaining a client list of about 15 individuals as well as providing daily one-off supports. GL is a client who has struggled with developmental delays since childhood and left school after Grade 7. He moved from Saint John, New Brunswick to Toronto and started panhandling downtown, most often located on a grate in front of city hall. GL estimates that he lived in various shelters for more than 20 years – 20 years of living in shared accommodation, lacking privacy and having to abide by and outsmart rules that were restrictive and punitive.

Now, through the combined efforts of Development Services Ontario (DSO) and Street Health, GL is finally thriving in a place of his own. After two years on a waiting list, GL was offered a unit in a building purchased by the city and run by St. Jude Community Homes.

“Once that housing offer was received, it became a real team effort to help GL cope with his hopes and fears about making this big change,” states his Street Health Worker, Ruhullah, who has been supporting GL’s journey since 2019 (GL has been a Street Health client since 2012). “It involved the shelter workers, past case workers and myself. After all of those years of uncertainty and life on the streets GL’s bottom line was revealed – if the unit was furnished and, most importantly, had a TV and cable – he would move in!” Thanks to individuals who made in-kind donations of a bed and a TV, plus the support of the Furniture Bank GL is now in a private, accessible unit which is airy and cozy. Because this is an independent living building, GL needs to keep the unit clean and allow regular assessment by the building managers. He was assisted to sign up for automatic rent payments from his monthly Ontario Disability Support Payment (ODSP) and have a trustee support his cable and other living expenses. This kind of individualized attention and regular check-ins with a Doctor at Inner City Family Health Team and Ruhullah are supporting GL’s success.

“I still panhandle at the Eaton Centre,” states GL. “I like to get out and see people.” He uses a shared bike to get around and manages his own meals. When asked if he foresees a time when other activities will become more important to him GL states “I like living on my own. I’m focused on this right now. I want people to know that I’m a good person.”

GL’s journey will continue to be supported by Street Health’s Mental Health Team. “It’s great to see clients succeed and thrive,” states Ruhullah. “GL still has challenges. He is a smoker and substance user, which means his money is gone almost immediately after it is received. It is tough for him to think about the future and plan, but we continue to work step by step. Having housing is making a huge difference for GL’s security and ability to cope with day-to-day challenges.”

iPHARE

 

iPHARE (Integrated Prevention and Harm Reduction Initiative) is a collaboration between the City of Toronto and numerous community agencies, including Street Health, designed to help address the effects of the ongoing overdose crisis in the city’s emergency shelter system. In the last several years, overdose deaths have reached epidemic proportion all across Canada, driven largely by an increasingly adulterated and toxic unregulated drug supply, coupled with inadequate access to addictions care and social supports. While this crisis has impacted all levels of society, its effects have been most acutely felt by vulnerable populations, including homeless and underhoused people. iPHARE started in December 2020 as an attempt to begin to ameliorate some of the effects this public health crisis has had on residents of the City’s shelter system and has produced concrete, appreciable results: since 2021, overdose deaths in the shelter system have decreased by over 30%, representing dozens of lives saved and circumstances improved.

An integral part of iPHARE’s harm reduction strategy is employing people with lived experience of substance use and homelessness as peer workers. Peer workers have a strong understanding of the issues that impact the populations we serve and are able to leverage their knowledge and experience to both increase the reach of our services and help us better understand the needs of our client base, all while building up vital work experience and contacts to help transition peers into the job market; they are a crucial, irreplaceable component of effective harm reduction work.

I work as an iPHARE Harm Reduction Coordinator at 545 Lakeshore and one of our peer team members is LR. LR is a joy to work with; he is an energetic and enthusiastic presence in the workplace, always passionate and dependable and ready to help others however he can. But, like so many of the clients we serve, LR didn’t reach where he is today without struggling. “I had a lot of pain from my upbringing,” he relates. “My father would hit both me and my mother a lot, all the time. I was lucky to have an uncle who was more like a father to me than my actual dad. After my uncle died, I had nobody and I was suffering so much. Plus I was hanging out with the wrong crowd, so I started getting into drugs to help take away some of the pain I was feeling. It was a bad mix of circumstances: I never looked for trouble, but trouble always seemed to find me.”

That trouble soon began to have a major impact on LR’s life. He found himself homeless and in the shelter system, all while dealing with burgeoning problems around substance use and unresolved trauma. “I was in shelters for five and half years, in shelters all over the city. I’ve seen people OD and die, people with all kinds of pain, people who lost everything… I’ve seen it all with my own eyes. I understand what they’re going through and I want to use what I know

and what I’ve experienced to help them,” he offers without pause, “I want to help other people while making my life better too.”

It’s inarguable that LR has done just that. In the year plus I’ve worked with him, he’s never missed a shift, never complained or hesitated, never missed an opportunity to share his wisdom and expertise. And while he has made definite contributions to helping us design and deliver effective harm reduction services, he’s also seen major improvements in his own day-to-day life, crediting much of his recent success to his role with iPHARE: “Having a routine is a big help. I get up every morning and come into work and having that structure, that regularity, in my life is major. Some mornings, I’m cursing and annoyed and tired, but I get out the door because the structure keeps me going. Having that in my life has helped me finally get off drugs and stay off.” Asked what he would say to people experiencing what he went through for so many years, LR reiterates the importance of having something outside yourself to count on and relate to. “The life I was leading has two usual conclusions: death or jail. I didn’t want that, so iPHARE has been a huge help in getting past that. The schedule and routine of having a job, plus I feel like I’m actually helping people while I’m doing it… It means a lot. But even if you don’t have a job or something like iPHARE, you still need to get out and keep your mind occupied. That’s always the first step.”

As we were wrapping up our conversation, I ask LR what he thinks the world should know about our work in the shelter system. He pauses contemplatively for just a second, reflecting on everything he’s seen and been through, before offering a more eloquent summation than I could provide: “There are so many good people in the shelter system, both residents and workers… It’s a hard place to live and work, but I don’t judge anyone. You never know what someone is going through or has been through. But really, ultimately, we all need a reason to get up in the morning, to get out of bed. For me, helping other people, putting other people first, sharing what I’ve been through, is a great way to do that.”

Harm Reduction Drop-In

 

Sophia’s life was derailed at a young age by a stroke. She had to regain motor and memory functions and completed six months of rehabilitation at Bridgepoint. “Since then, I’ve relied on ODSP and fortunately I was able to obtain housing,” she notes. “I’ve been at my current TCHC location for more than 10 years.”

“During COVID, I lost my connection to my family in Brampton and Jamacia. I was spending some time at Allan Gardens and got to know so many people from the community gathered there. It was through Street Health’s outreach efforts that I learned more about harm reduction and the weekly Women’s Drop-In. When I saw the opportunity to become a volunteer and help out, I was hooked.”

At the Thursday night sessions, Sophia has provided a vital presence that helps other clients feel welcome and comfortable. Drop-In Coordinator Natalie highlights the ways Sophia is making a valuable contribution, “She connects with the community members, supports the staff and other volunteers, engages/welcomes attendees and builds our program connections with her presence and ability to communicate care.” Sophia especially enjoys bringing the art of beading to other participants. “I’ve done beading for many years and now I’ve been able to share this skill. Many people deal with depression and anxiety,” notes Sophia. “Crafting requires their focus and creates something before their eyes offering a sense of accomplishment. Beading has such a rich artistic history and is a very accessible form of expression.” For Sophia, who finds her memory is best for remembering faces and patterns, this skill is another way to maintain her connections with other people.

“When you live in a neighbourhood you get to know the other faces and many of us share similar struggles. My son is six years old and in school, so I have some time to bring good connections to other members of my community.”

Sophia pulls out a container of cigarettes and talks about how people who are struggling with addictions may appear different, but really need understanding. “I don’t smoke or do drugs, but I do drink.”

“When you have a child, you have even more reasons to be involved in your community,” she states. “I’m glad I’ve found some safe and secure options, like the Women’s Drop-In to have a place that offers me a lot and values what I can offer too. I want my son to see how important it is to be accepting of other people and be involved. That’s what is going to make a better community for everyone.”

HIRE Impact

 

“Now I want to go for whatever opportunities I can – I want to go as far as I can go with my life.”

Street Health’s clients experience homelessness, poverty, mental health challenges and addiction. Our harm reduction focus supports seeing the potential in each person. This focus, combined with years of training project delivery and evaluation has created Hire Impact – training and employment support for People with Lived/Living Experience (PWLE). “Understanding the challenges people face and valuing, rather than labeling with stigma, allows our clients to provide meaningful supports in the community,” states Mary Kay MacVicar, Hire Impact Coordinator. “Being a mentor and demonstrating other options for people who are street involved is a powerful motivator.” This is the path Kendra is taking, to help showcase the of to community agencies and acting as a mentor to those they serve.

For Kendra, the moments of change were put in motion due to injury and illness after years of substance use and sex work. “My parents divorced when I was 16 and I was placed in care. That’s when I ran away, ending up for many years on the streets in Toronto.”

During COVID, Kendra was diagnosed with a bone infection that led to three surgeries. “The doctors couldn’t say if I’d be able to walk, but thanks to spinal cord rehab at Lyndhurst I regained my mobility. While I was hospitalized, I lost my housing due to a fire. I lost everything, but in many ways the fire and the 18 months I spent in transitional housing, set me up for where I am now.” Kendra has a unit through St. Clare’s Housing and is connected with Street Health’s Harm Reduction Workers Zoe and Monica.

“Hire Impact provided a school setting and I was excited to learn how my experiences could benefit others,” remembers Kendra. “The courses on de-escalation and overdose prevention are something that I use all the time. I don’t have to worry because I can spot what needs to happen and I’m part of making our community a safer place.” In addition to completing an extensive curriculum of topics, the program provides internship opportunities and employment search support.

“When people see me doing harm reduction outreach, they know me and realize they can do it too!” Perhaps most importantly to Kendra was re-establishing her connection with her mom. “We missed each other for too many years,” notes Kendra. Now Kendra is reconnected with her mom and extended family. “All I ever wanted to do is make my mom proud – and – she is!”

“I’ve wondered sometime if working in overdose prevention or consumption sites might trigger a relapse,” states Kendra. “But I can honestly say that being involved and every connection I make to help someone else is better than any high I could buy.”

Overdose Prevention Site (OPS)

 

Gerry Banks has been a cherished member of the Dundas and Sherbourne community for over 30 years and is a client of several of Street Health’s programs. Known for his sense of humor and positive attitude, Gerry has touched many lives in the community. He is a dedicated community-builder, contributing to numerous boards and committees advocating for harm reduction, food bank accessibility, support for low-income and vulnerable seniors, and Toronto Community Housing residents, among many other causes. A talented writer, Gerry’s work is featured in ‘Messages from the Ground Floor,’ published by the Regent Park Community Health Centre. Reflecting on his experience, Gerry says, “Street Health helps in so many ways. Your compassion and dedication are greatly appreciated by many.”

“Street Health’s Overdose Prevention Site is unique among the city’s consumption sites,” highlights Gerry. “It’s small and the staff are focused on ensuring everyone who visits gains the immediate attention and referrals they need. It’s often referred to as “wrap around” service and helps people feel connected and knowing how to gain the support they need.”

Gerry’s involvement with Street Health has been mutually enriching. He has taught us much about reciprocity and mutual aid, and even from his hospital bed, he continues to stay in touch with staff, sharing jokes and kind words. Unfortunately, Gerry has been battling serious health issues for some time and recently shared some difficult news regarding his health with our staff.

On May 10, staff held a celebration in the backyard at 338 Dundas East to honor Gerry. The incredible turnout highlighted how much Gerry means to so many. His ability to bring smiles, whether through a joke or a shared treasure, was evident as friends gathered to share a meal and express their appreciation for him.

As Gerry wisely says, “I know that in the blink of an eye everything can change. The wisest thing to do is (well, one of the wisest things) to forgive often with all your heart and, for sure, to love with all your heart. If you didn’t do this now, remember, you may never get that chance again.”

St.Clare’s Housing Partnership

 

Street Health is a partner with St. Clare’s – a charitable organization that provides affordable, mix-income housing in downtown Toronto. Street Health staff bring a harm reduction focus and expertise to help clients attain and maintain housing. This client story is told by Housing Worker Jesse and client Mr. K.

Mr. K. became a Street Health client when he was referred for housing at St. Clare’s. Mr. K. had been staying in downtown shelters and experiencing chronic homelessness since arriving in Canada as a Protected Person (Refugee) in 2011. Since first meeting in 2021, I have been his housing worker and assist him with community supports.

At our first meeting, it was immediately clear that his case was unique and complex: he was a senior, did not speak English, and did not have a SIN (social insurance number) despite his refugee status. It was hard to know which resources he had accessed, or the status of any applications. Mr. K. had never had access to translation services before becoming a Street Health client.

Upon being housed, Mr. K. began to struggle financially. When he moved into the apartment, he was transferred to a new ODSP (Ontario Disability Support Program) office and assigned a new worker. His immigration documents were disputed, and he was cut off from ODSP. With no means of support to pay rent, his housing became tenuous. Additionally, because he did not have a SIN, he could not renew his housing subsidy, which is required annually by the municipal and provincial governments.

We connected with Neighbourhood Legal Services, where we met Nadia, an immigration lawyer. Nadia advocated alongside me, and eventually, Mr. K. received a SIN, applied for Permanent Residency, and stabilized his ODSP support. Now he is applying for Old Age Security, which will further stabilize his finances if/when he is approved.

Mr. K. is living proof that many existing systems create unnecessary barriers. This is further compounded when the client cannot relay the status of their applications or documentation and they become disempowered. Clients may make incorrect assumptions, miss important deadlines, or worse yet, not actually have begun the process at all. Those of us who work with clients need to ensure that they are empowered to make their own choices and are supported to follow through.

“When we first met at the shelter, I felt helpless,” Mr. K remembers, thinking about how far he has come and how much his life has improved. “Spending time with Jesse makes me feel normal,” he says, citing our regular coffee outings to Tim Horton’s. While Mr. K sometimes has trouble putting his thoughts into words (even with a translator!), his appreciation is always felt.

Safer Opioid Supply (SOS)

 

Street Health is an active member of the Downtown East Coalition Safer Opiate Supply (DEC SOS) program. We connect people with opiate use disorder (OUD) to safe, prescribed opiate alternatives to the increasingly toxic unregulated street supply. Nurse practitioners work collaboratively with a team of Community Health Workers to provide a wide range of intensive follow-up support to assist Safer Supply participants in meeting their housing, , health, and general wellness goals. Since the program’s inception, research has demonstrated that SOS participants have had reduced incidence of overdose, lower rates of hospitalization and increased rates of positive healthcare and housing outcomes compared to their peers. Street Health is currently contributing one Community Health Worker to the DEC program working out of the Regent Park Community Health Centre.

SOS Community Health Worker Quinn was able to sit down with one of our SOS participants to discuss how the program has impacted their life. A talented musician and engaged advocate for People Who use Drugs (PWUD), this participant has accessed more consistent medical care (including the supports they needed for dentures), and has secured a place in a hotel-shelter after being mostly street homeless for 4-5 years.

This is their discussion:

QC: How did you get involved with the SOS program?

A: I got involved with the SOS program – a friend of mine told me about it and I sought out the help. I was using too much fentanyl, and the supply was contaminated with other drugs and who-knows-what. I was getting really sick.

QC: How has your experience of the program been so far?

A: Very good. I’ve said it before, but without the program and the work you guys do, and spreading awareness, I wouldn’t be here today. There wouldn’t be people in the community that know about suboxone and naloxone and other blockers. I’ve overdosed in the community quite a few times, so I’ve been lucky that way. With the treatment regimen I’ve been prescribed, it’s saved me from Overdosing quite a few times.

QC: What has changed for you over the past three years since starting on the program?

A: I think I’m in a better place now. I feel like I’m on the verge of a breakthrough, I guess. That would be stabilized housing.

QC: Can you talk a bit about the unsafe supply? What does that look like in Toronto right now?

A: It looks like death. Everybody’s getting sick, big sores on their legs and bodies, abscesses, and pneumonia, and stuff we don’t even know what it is – stuff you’ve never heard of before. I know personally that I’ve gone through some medical issues that I didn’t even know were possible.

QC: Has the supply changed a lot since you started using?

A: It’s not even the same drug anymore. You’re doing more benzos than anything else, and these cocktails they’re making up – who knows what it is. A little crystal meth, sometimes some heroin, sometimes carfentanyl, among others.

QC: What advice would you give someone else in your position three years, dealing with the unsafe supply?

A: Make your appointments! Make your appointments and go to them.

QC: One thing I always appreciate about you, is that you’re always bringing in friends and people you meet to connect them to Regent Park and other SOS resources.

A: Well, it’s like – it comes naturally to me. I want everyone to get better. We’re all in this drug war – this crazy war against humanity.

QC: Do you feel like some of the stigma and attitude towards drugs is changing?

A: A little, but at the same time it reinforces certain people’s stigmas and orientation. Two steps forward, one step back – but you’re always moving forward at least one step.

QC: Is there anything you want the people reading this to know?

A: Every life is important; the potential to be anything is still there any available. The person just needs to be stable and have supports to access these things to become anything they need to become to be a functioning member of society. And with the SOS program, it makes it that much more possible. Because it’s a way of dealing with the problems associated with drug use without the vestiges of discriminatory language and attitudes towards drug use.