deachman: homeless people risk freezing to death and most of us don't know how to help
we can't force the homeless to go indoors. but, as one expert suggests, we can 'be kind, and treat them with respect.'
7 minute read
a homeless person sits in the snow on elgin street. shelters aren't always a better alternative, and in any case we can't force people to go into them.
tony caldwell
/
postmedia
imagine you’re going out one friday night to meet some friends, on elgin street, say, or in the byward market. on the way to the pub, you notice a homeless woman in a doorway, huddled against the bitter cold and talking to herself. she doesn’t ask for anything, so you don’t engage.
two or three hours later, as you head home, you see she’s still in the doorway, maybe asleep. poor thing, you think, i wouldn’t want to be her on such a cold night. that coat she’s wearing hardly looks warm enough. perhaps you drop a toonie on the stoop.
a couple of days later, you read in the paper that the woman died that night, in that same doorway, of exposure. she froze to death. the news reports indicate there were underlying mental-health issues at play.
so she had a name. a family. there but for the grace and all that.
you may have been the last person to see her alive. how might you feel? could you have helped prevent her death? should you have tried? and if so, how?
as thought experiments go, this one is hardly far-fetched. two people in ottawa died last month in similar circumstances: a man on elgin street on jan. 6 and a woman in the byward market four days later. with shelters at capacity, it’s not unreasonable to think they won’t be the last such deaths.
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we know little of their final moments, but the locations where they were found suggest there were many opportunities for passersby to notice them and do something. yet they both died in the cold.
what can we do to save lives?
the two deaths have lingered in my psyche. as i revisit their stories, i find myself considering what i would do if i were one of those passersby, and what my moral compass tells me i should do. as well, what do i actually have the legal right to do?
these are uncomfortable questions because, let’s face it, i have often been that passerby. you probably have, too. the only difference is that no one we passed by died — at least not that we heard about. and so this multi-pronged question repeatedly arises: what can i, should i, and am i allowed to do to help?
in trying to sort it out, i spoke to a number of expert, experienced people, including uottawa law professor and canada research chair in mental health and access to justice emmanuelle bernheim; centretown community health centre ceo michelle hurtubise; alliance to end homelessness ottawa executive director kaite burkholder harris; carleton university neuroscience assistant professor and associate dean of science kim hellemans; three people with ottawa inner city health: operations director anne marie hopkins, psychiatrist simon hatcher, and psychiatric nurse and mental health team lead kim van herk; and a good friend who knows all too well the vagaries of navigating a life often clouded by mental-health issues. they are not all specifically cited here, but their thoughts have helped informed mine.
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on the recent deaths, van herk says, “we should not be ok with that. it’s unacceptable.”
a homeless person tries to keep warm on sparks street.
tony caldwell
/
postmedia
affordable housing, of course, is the gold standard of not freezing to death on the street, but that, unfortunately, remains a distant hope for many. according to the city’s point-in-time count, conducted last fall, there are about 3,000 homeless people in ottawa. that includes immigrants, refugees and refugee claimants, who make up 42 per cent of the total, while changes in data-collection techniques make comparisons with the 2018 and 2021 figures — the homeless count is conducted every three years — a bit of a mug’s game.
for example, the drop in chronically homeless people (those who have been homeless for at least 180 days over the previous year or 18 months in the previous three years) from 57 per cent of the homeless total in 2021 to 49 per cent in 2024, is a positive development, but it’s a decrease of just 43 people. better than trending in the opposite direction, but that means there remain about 1,475 chronically homeless people in ottawa.
another notable statistic from the pit count is that one-third of ottawa’s homeless population in 2024 require some sort of mental-health support. which raises the first question: can i, in the short term as a matter of conscience, force some shivering soul into a warm shelter building somewhere when it’s perilously cold outside and i believe she can’t make that decision for herself?
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what the mental health act says
the answer is sort of, but hardly. the province’s mental health act allows for involuntary admission to a facility for assessment. you or i could apply for a form 2 through a justice of the peace if we feel someone requires mental health care. we would first need to show evidence of mental illness, a danger to self or others and/or a failure to care for their basic needs. if granted, the form 2 would be passed along to police, who, according to hatcher, would have seven days in which to take the person to the hospital, where a physician would do an assessment. form 2s are more commonly used by families seeking treatment for an unwilling member, and not passersby on a friday night.
and as hurtubise notes, the mental health act tends to interpret harm to self or others as a deliberate or intentional act. “so if a person was able to say, ‘i totally get that i could freeze to death outside, but i’ve got my sleeping bag and a spot that’s sheltered,’ that would not actually meet the threshold to make them move indoors.”
“and,” she adds, “do i have the right to take that choice away from them in a society that, honestly, has chosen to abandon them to that choice?”
the overriding sentiment i heard was that there’s no easy answer, but that it’s important to let people make decisions for themselves.
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“behind all this is the idea that mental health can be dangerous,” says bernheim, “and you have examples, for sure, where things happen, but this is not the general situation with people with mental-health issues. us deciding what is good for them is really dangerous. it’s true that in some circumstances it’s needed, but in a lot of others it’s not. we don’t want to project what we think is best for them.”
burkholder harris agrees that we can’t simply take away people’s agency over their lives, suggesting that to do so is “a dangerous road, unless you have a whole lot of protections for the dignity of the person.
“i think it would be a case of probably not being implemented surgically, but across the board, and that’s going lead to bad outcomes for people.”
many homeless people, meanwhile, actively choose living on the street instead of in a shelter, citing concerns for their safety in these shelters. according to the pit count, 31 per cent of homeless people who refused to stay in a shelter did so for safety reasons. and for a woman, for example, who has been sexually or physically abused, choosing instead to sleep on the street is not an unreasonable act.
“that’s not a bad decision,” says van herk. “we’ve seen the amount of rape and violence at shelters, and she isn’t necessarily safer there.”
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again, and at the risk of sounding like a broken record, affordable housing is key. but hatcher points to other failures, such as ontario’s “under-managed” health-care system. “for instance, in ottawa there’s no plan for mental health care or mental health services, for what that would look like in five or 10 years’ time,” he says. “nothing. there’s no big picture. mental health services in ottawa are like something from 30 years ago. there are no community mental health centres that serve geographical areas like there are in most developed countries around the world.”
a passerby checks on a homeless man sleeping on a bench in ottawa.
tony caldwell
/
postmedia
while it pains me to think of a homeless person choosing the street and dying as a result, less do i want to see their choices removed. i have written a few times about a woman living in a tent and canoe, and while i occasionally fear the worst for her, i am repeatedly buoyed by her resilience. hurtubise makes the point that the survival skills of people living on the street are far more adaptive than people give them credit for, and from my limited experience, she’s right.
in the meantime, what’s an uncomfortable passerby to do? “check their breathing, be kind, and treat them with respect,” suggests hatcher.
if you’re not comfortable doing that, if the person is agitated, say, then call the police or emergency medical services. “people,” says van herk, “are dying from the cold because nobody checked on them.”
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hurtubise stresses the importance of getting people into a warm space, even briefly. “without taking away people’s choice, we can still do some things to get them out of the cold for a short period of time.” offer to buy them a coffee or a warm meal, she suggests, and sit with them. “that may be that moment that allows them to survive the rest of the evening or day.”
that seems like a decent place to start — and maybe as much as we can ethically or legally do. even so, it’s obviously not something we can all do all the time, but why not every now and then? two people freezing to death on our streets is two too many.
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