Advocating for the city's homeless: U of T medical students meet Toronto councillors

A group of medical students met with city councillors to present an initiative that they hope will improve services for the homeless. 

More than 25 students – who are in first- and second-year at the Faculty of Medicine – met with nine city councillors to talk about a data management system to better coordinate services for the homeless.

Interim findings of the city’s most recent street needs assessment report found that more than 5,200 people in Toronto are homeless.

For Patricia Hoyeck, Inna Berditchevskaia and Kara Grace Hounsell, second-year medical students leading the initiative, they see the need for better services every day. 

“We see people with no fixed address everyday on our way to school,” said Hoyeck. “When we shadow physicians, we witness the effects of the social determinants of health and inadequate housing. We have a role in advocating for things that can improve peoples’ health.”

The Ontario Medical Students Association and the Canadian Federation of Medical Students each organize an annual lobby day, but the group of medical students wanted to build something to provide long-term opportunities for engagement locally.

Although most of the meetings were held on a single day, the students began to consult with advocates, researchers and other community partners in the spring. 

The students also met with Jo Connelly, executive director at Inner City Family Health Team, prior to meeting with city councillors 

Part of what makes the issue of homelessness so complex is the question of who funds the variety of supports needed, Hounsell said, adding that health and affordable housing are largely provincial issues, but shelters are funded municipally.

“These things are fragmented into different funding structures, but people’s experiences aren’t isolated that way,” Hoyeck said. “It’s difficult to work within these funding paradigms when they don’t capture the essence of the problem, allowing people to fall through the cracks.”

The students have found that homeless people once they receive treatment in hospitals are often discharged back into homelessness.

“There are people who aren’t sick enough to be living in the hospital, but they’re also not healthy enough to live on the street or in a shelter,” said Berditchevskaia. “So when someone’s discharged from the hospital a shelter – whose responsibility is it to provide support to that person?”

The students proposed a system called the homeless management information system (HMIS), which is used in Calgary and many American cities. It’s a web-based system that helps people who work with the homeless population to better coordinate the services. For example, if a client’s information were accessible to multiple service providers that could help with referrals and reveal which services they’ve accessed, Hounsell said. And on a larger scale, there’s more opportunity for program evaluation, making it easier to see what’s working well and where resources need to be moved or added.

Ward 20 Councillor Joe Cressy, who is a member of the city’s Community Development and Recreation Committee – which addresses concerns over shelters – was one of the councillors who met with the students.

“Far too often, the only voices we hear at city hall are the same ones – it tends to be property owners who live near developments or proposed shelters,“ Cressy said. “Rarely do we have younger voices come to the table. It’s the duty of everyone in this city to ensure we’re caring for the most vulnerable. These medical students have unique insight as physicians in training, which has brought a viewpoint to the homelessness crisis in a series of proposals that, if adopted by council, would help.” 
 
The students hope councillors will create a staff report on the feasibility of implementing the initiative and plan to continue their efforts.

“Humility in advocacy is also important,” Hounsell said. “We’re medical students who don’t work in this field, so this is a good opportunity for us to reflect on what we’re able to contribute – and when we need to ask others for their opinions and help.” 

They’re building information packages to share with councillors who ask for them and continuing to consult with community stakeholders about what their ideal system would look like.

“We want this to be an ongoing conversation – advocacy doesn’t just happen on one day,” said Berditchevskaia. “We’re learning to use our voices to push for things that will better the health of our population. We have a responsibility to our future patients to help them individually, but also on a larger scale.”