Making the Most of System Expert Conversations
A week ago I was interviewing people experiencing homelessness in Virginia Beach. On the beach. In the woods. Outside tents. In a shed. At a drop-in center. Outside a 7-11. At 2am at an IHOP. Beside a dumpster. In a meal line.
Not long before this time in Virginia Beach I was doing the same thing in Barrie and Orillia. In a gazebo. By a marina. Outside a shelter. In an alleyway. By a coffee shop. Along the shoreline. In the alcove of a business.
In the last year I have been fortunate enough to have a half dozen experiences where I was the lead researcher with people with lived experience at being homeless. I am moved each and every time. Of all the research I get to do, interviewing people with lived experience is by far the most rewarding to me. I get the best information, unfiltered by others. People that are homeless or recently experienced homelessness don’t feel that they have to say nice things about any particular service provider – though they may very well have loads of positive things to say. I take that power dynamic out of the equation, which would be ever so present if the sessions were being conducted inside a service environment or were orchestrated by staff within a service organization.
More often than not, I am able to reveal information in an aggregate sense that the community did not have before. I am not interested in examining any particular anecdote of a person that I interview. Instead, I am interested in what happens when I undertake analysis across the interviews. This is when trends emerge and I can start to draw conclusions about what is going on in a community. I try to get a good number of interviews conducted each time. In Virginia I did 81. In Simcoe I did 67. In London I did 87. I’ll stop there.
The context for why I am seeking the voice of persons with lived experience changes, but the general questions that I ask are the same.
I start with simple things – age and gender. I can do the first cut of analysis on these two pieces of information first. It isn’t uncommon for the experience of service access and outcomes to be different for younger persons versus older persons, for the experience of men to be different from the experience of women – and the experience of men and women to be quite different from the experience of persons that identify as transgendered.
Next I look at whether they identify as being single, being in a childless couple, or whether they are a family unit taking care of kids. If they have kids I find out how many and the ages of the kids. Generally, the experience of childless couples is very different than the other groups, as service systems in most cities go out of their way to treat them as single adults rather than a couple. And in too many communities, same-sex childless couples struggle with the stigma of trying to maintain their relationship inside a shelter environment where acts of affection or intimacy are not allowed.
I then move onto the person’s experience of homelessness. This gets a little trickier so the way in which I explore the questions is a bit more involved. In essence what I want to know is: what is the cumulative duration of homelessness throughout their entire lifetime; how long they have been homeless in their most recent experience of homelessness; how long they have been homeless in the city where I am actually speaking to them. Related to the homeless question, I want to find out the last time they had housing and the city where that housing was located. I’m sure the day will come when this turns out differently, but in all my years of doing this type of research I find out, lo and behold, that most people have had secure housing at some point in the city where I am interviewing them, debunking the myth that homeless people are travelling from one city to another in search of the greatest, most generous services of all time.
At that point I remind folks that I am not a cop nor am I service provider and that if they provide me open and honest information I can help more homeless folks overall, but they are welcome to skip my next set of questions if they want. I remind them that their response is anonymous. I also tell folks it is better to skip the questions that to give me a load of BS. First I ask them if they are having any issues with their mental health, usually framing the question first as “Have you ever had a conversation with a psychiatrist or psychologist? When was that? What was that for?”. I follow that with physical health. I usually frame this question first with, “Have you seen a doctor or nurse for anything in the last year? When was that? What was it for? Is it still going on? Anything else you feel you should see a doctor about now?” Then I ask them how much alcohol or other drugs they consume on a daily or weekly basis. I usually frame this with, “Be straight up with me – how much have you had to drink this week and what did you drink? What other drugs did you use and how many times?”
A statement of affirmation goes a long way after these three questions. I find it helps to look them straight in the eye when I thank them for their honesty on those questions. In almost all instances people I interview answer all three questions.
From there I move onto how much they interact with other services. In the last year (or perhaps I’ll say something like “Since last winter” to help them put the time frame in context), how many times, approximately, have the police had an intentional conversation with you…more than a ‘Hey, how ya doin’?’ sort of conversation?” I then ask how many times they have been to the emergency room of the hospital in the last year for their own health issues and how many of those trips were in an ambulance. I follow that up with inquiring whether they have spent any time admitted as a patient in the hospital in the last year. And finally in this section I ask them how many days they have spent behind bars in the last year.
“In your opinion, what is the number one reason you aren’t housed right now?” is the next question that I ask. Sometimes people will tell me they don’t know. I ask them to close their eyes and dig a little deeper in those instances. I remind them that they are the expert on why they aren’t housed and I want to learn from the expert.
The questions in the next section of my interview change depending on context. At this point I may be asking their opinion on permanent supportive housing or affordable housing. I may be asking about the type of housing they would want. Sometimes I find myself asking what they would do to improve the homelessness and housing system. In other instances I have found myself asking folks how they spend their days from the moment they wake up until they go to sleep.
The last question I ask is always the same, “What haven’t I asked you about that you feel we need to talk about?” I never know where the response to this question will go. At times, the most rich information from the entire interview comes from this very question.
I know some social researchers feel it necessary to give homeless folks an honorarium for participation either in cash, cigarettes, food, grocery card, coffee, or whatever. I don’t. I think the currency of our exchange should be a shared commitment to improve homeless programs and services. The way I see it, the folks I am interviewing are already the most invested people in needing to see improvements. They give me their time and I give them mine. I am passionate about making improvements. They invest in fuelling my passion. The system as a whole benefits.
Every single time you consider improving your program or your community’s response to homelessness, it is incomplete, in my opinion, if you do not get the input from people with lived experience – currently or past homeless people. Don’t do it as tokenism. And don’t do it with staff that have a direct bearing on whether they get a shelter bed tonight or get access to housing. Neutralize the power dynamic. And when you get the information, listen to it. This isn’t just a “nice to do” part of the process…it is potentially the most important part of information gathering and analysis that you can do.
