Portland Hotel Society
Lead Organization: Portland Hotel Society
Location: Vancouver, British Columbia, Serving: Vancouver
Why People with serious mental illnesses and addictions, who tend to gravitate to the inner areas of larger cities, are at very high risk of homelessness, physical harm and incarceration.
The downtown eastside is a neighbourhood in Vancouver, Canada’s third largest city. It has a particularly high incidence of poverty and related problems among its residents, including mental illness, drug abuse, drug-related crime and prostitution. Housing for many of the downtown eastside’s residents has been problematic, with a high proportion renting unsafe rooms in dilapidated buildings and many left homeless.
A particularly disadvantaged group are people with concurrent disorders – those with a serious mental illness with one or more addictions. Many are intravenous drug users who are also HIV-positive or at-risk. These individuals are extremely difficult to house on any stable basis due to behavioural challenges they present to landlords and fellow residents.
The Portland Hotel, one of four housing facilities operated by Vancouver’s Portland Hotel Society, is dedicated to providing sustainable housing for this “hard-to-house” population.
What The Portland Hotel, notwithstanding its name, provides permanent accommodation for 86 adults with mental illnesses, addictions and other problems. It combines housing with professional supports to assist residents according to their individual needs and desires.
The program accepts all residents as they understand themselves and their needs, and seeks to accompany them in their chosen paths. All interventions with residents are made on a case-by-case basis. A no-evictions policy underscores the program’s deep commitment to acceptance and finding creative solutions to problems.
Who The Portland Hotel Society is a non-profit organization that was created in 1993 to advocate, develop and implement creative and responsive services for persons living with concurrent disorders.
The Portland Hotel itself was initiated in 1991 by Vancouver’s Downtown Eastside Residents Association (DERA). The Association converted a local hotel and named it after the US city of Portland, where Canadian organizers had been inspired by housing programs for homeless people. The facility was transferred to the Portland Hotel Society on its completion. The program moved to a new building (re-named the Portland Hotel) in the downtown eastside in 1999.
The program is funded by the British Columbia Housing and Mortgage Corporation (a provincial Crown corporation) and the Vancouver Coastal Health Authority.
How The Portland Hotel provides permanent, semi-private accommodation with supports to persons with concurrent disorders. Each resident’s rent is charged at an amount corresponding to the shelter allowance portion of pension or welfare payments.
The Portland Hotel has 86 single-occupancy units, each with its own toilet and shower. While 17 of these units have full kitchens, most of the units have minimal facilities for food. Each floor has a common kitchen, laundry facility and a lounge. On the entry level, a café run by another non-profit agency provides one free meal a day to residents, and three free meals a day for residents who are HIV positive. There is also a television lounge at the front entrance, a large multi-purpose room, a number of small rooms used by service providers and access to the building’s single elevator.
Eight mental health workers provide round-the-clock service to residents, with two workers always on site in 12-hour shifts. Staff manage and maintain the facility and relate directly to the residents. A doctor and a nurse are on-site four half-days each week and serve the residents of all four of the Society’s housing facilities. The program also arranges for a variety of other services, including: home support services, nutritional counselling, general counselling, massage and acupuncture, podiatry, hair styling, art and poetry groups facilitated by local artists and poets, and regular communal events.
Apart from the guiding criteria outlining who the program serves, the Portland Hotel has no formal intake or admissions process. Similarly, it has few rules and regulations. Emphasis is placed on accepting residents where they are at, and being flexible, responsive and creative in working with them to remain housed and as healthy as possible.
Results The Portland Hotel has succeeded in providing long term housing for people with mental illness, addictions and other problems, and in reducing their susceptibility to harm. Approximately 40 percent of residents stay at the Portland Hotel for about 10 years, while the balance of residents stay 4 to 6 years. This contrasts dramatically with the prior history of residents, who typically registered 6 to 8 addresses – or none at all – in the year before moving to the Portland Hotel. Some residents eventually move out to live on their own or with family.
The Portland Hotel has also succeeded in creating stable access to vital services for its residents. The mix of stable housing and skilled personal support creates a stable and relatively healthy environment for individuals who quickly get into difficulty when left on their own. From the perspective of the Portland Hotel’s public-sector funders, the cost of the program is considerably less – and its outcomes much better – than allowing people to live on the streets with frequent contact with hospitals, police, the justice system and jails. A major reduction in time that residents spend in hospitals and prisons is a direct outcome of the program.
Staff members characteristically employ a harm-reduction response to residents’ misuse of substances, in accordance with the program’s philosophy and the characteristics and choices of its target group. In this context, sobriety is not necessarily an indicator of results. However, if a resident seeks to reduce or end a substance dependency, he or she will be actively supported in that choice.
A valuable social outcome of the program is that residents have a home and a community where they feel accepted and respected, in sharp contrast to previous life experiences.
What's Been Learned Beyond the obvious requirement of substantial and stable funding from funders who appreciate the economic and social value of this type of program, a critical success factor is staffing. Who is hired and how they are supported in their challenging jobs are essential considerations. Staff must be genuinely flexible, non-judgmental and compassionate in dealing with residents, who often direct dysfunctional attitudes and behaviours towards the staff. Many people who are initially interested in staff positions, and appear to be qualified for them, find with some experience that they aren’t prepared to hold these jobs. For this reason, a successful first interview with a prospective staff member is followed by some training shifts, which are followed by a second interview.
The program provides in-service training geared to the needs and development priorities of its staff. Staff are trained in assisting people with mental illnesses and addictions generally and in non-violent crisis intervention specifically. The central focus of all staff training relates to transference, wherein a resident transfers emotions associated with experiences of early life from the original object onto the staff member, and counter-transference – where the staff member responds in ways that help the resident maintain a healthy perspective on personal boundaries. Staff members are also trained in self-defence; however, in over 11 years, there have been few instances of physical violence.
Another success factor is the development of partnerships with related service agencies and community groups, in order to mobilize resources and increase awareness and support for the work.
What Comes Next The Portland Hotel will remain focused on its specific mandate to provide sustained and supportive housing to the most disadvantaged residents of Vancouver’s downtown eastside. It will continue to ensure that its services fit the people rather than making the people fit the services.
