Integrated Care Hub, Part Two – Staff giving back: ‘We try our best to help, right?’

Left to right are Joseph, Trevor and John. Joseph is a client who helps around the ICH. Both Trevor and John are former clients who have begun to work there helping others. Photo by Michelle Dorey Forestell/Kingstonist.

Editor’s note: In Part One of this two-part article, we met two dedicated retirees who volunteer their time at Kingston’s Integrated Care Hub (ICH). Here in Part Two, we spend the afternoon at the ICH with the people who provide services and the people who access them.

Kingston’s Integrated Care Hub (ICH) opened at its 661 Montreal Street location in November 2020 in response to a convergence of crises: the global COVID-19 pandemic, the drug poisoning epidemic, and the housing crisis. 

In the weeks following the state of emergency declaration, as the pandemic and drug poisoning crisis intersected, the number of opioid-related deaths increased quickly. In Ontario, there was a 38.2 per cent increase in opioid-related deaths in the first 15 weeks of the pandemic (695 deaths, an average of 46 deaths weekly) compared to the 15 weeks immediately prior (503 deaths, an average of 34 deaths weekly), according to Public Health Ontario (2020).

The idea behind the ICH was to create a hub of various health and social services for precariously housed or unhoused individuals in Kingston. These services include meals, showers, an overnight drop-in centre, and Consumption Treatment Services (CTS) — or a “safe injection site” — operated by Kingston Community Health Centres (KCHC) through Street Health.

In just the first 17 days of operation, staff at the ICH reported serving over 100 separate individuals, giving out over 2,500 meals, and having the sleeping area or “rest zone” at capacity every night.

At that time, Kingstonist quoted Justine McIsaac, Coordinator of Consumption Treatment Services (CTS) with Street Health Centre, who said she believes the public holds a misconception that people who use drugs — her clients — don’t value their lives.

“They truly, truly do. These people are resilient. They have value, purpose, and meaning in this community, and they deserve to be celebrated for making healthy choices in regard to their well-being,” she said.

“[Drug use] is a coping technique that is developed to deal with an immense amount of pain, trauma, and suffering that these individuals have acquired in their life. They deserve more than what they’ve been given.”

Four years later, the Hub, as it is affectionately referred to by the people there, continues to be a highly political issue within the Kingston community. Staff have received death threats against the patrons of the ICH, and there are regular taunts from people driving by, using hurtful words like “Junkie, Loser, Dirt Bag, Crackhead, Garbage, Animal,” and unsympathetic advice like “Just don’t do drugs” and “Why don’t you get a job?” Meanwhile, press coverage often makes the homeless population visible in a negative way, further “reinforcing their ‘outsider’ status.”

After an interview with Pamela Gray and Brigit Smith, two volunteers who are attempting to change the situation, Gray introduces Trevor Anderson, a CTS employee who will facilitate a tour of the Hub and answer questions.

Gray says bluntly but with obvious pride, “Trevor was an addict, and we are very grateful to him for what he does for our community. He’s just one of the most well-respected people here. There’s nobody I like introducing more than you, Trev. You just do so much for the people here.”

Gray indicates before the tour that many people who aren’t used to the Hub or street-involved people find the idea of a visit the Hub off-putting, “Sometimes what people see is very hard for them…The mental illness piece [of the ICH’s function] is that there are high numbers of very, very unwell people here. And so it’s hard for [visitors] when they come here because they think sick people are always getting better, right? But we have a number of people that will stay here, probably for the rest of their lives.”

As Gray leaves to take care of another pressing issue, Anderson leads the way. He is not a volunteer; he emphasizes, “I work here. I used to live here.” And he sees the tour as a welcome opportunity to show off the place and the work the ICH does. 

Anderson explains that he’s a lifelong Kingston area resident, that he lived on the street for about 10 years, and that he was in active addiction for 20 years. This seems surprising since he does not look any older than 30.

“Yep. I started young,” he says.

“I went to jail for two years and got out, and I’ve been out for 11 months — and I am staying away from it.”

The ICH is operated by Addictions and Mental Health Services — Kingston, Frontenac, Lennox and Addington (AMHS-KFLA) Trellis HIV and Community Care (formerly HARS), with harm reduction and Consumption and Treatment Services (CTS) offered by KCHC. Down a ramp is the CTS site. Anderson explains that no pictures are allowed in this part of the building because it is a safe, private space for clients to use the drugs they are addicted to, while being monitored for their safety by CTS staff.

There is a sign-in desk at the entrance. Atop the desk are well-organized medical supplies and a large selection of information pamphlets nestled next to a vase of tulips in varied colours. The walls are covered in beautiful drawings. One large painting stands out: a female figure crouched on a city street. Above her, an angelic female form soars upward, chest first, arms outstretched toward the sky, triumphant.

Justin, an ICH staff member, helps someone through the walk-up window where he can serve snacks and drinks. Photo by Michelle Dorey Forestell/Kingstonist.
A man talks to Justin through the service window into the kitchen. Photo by Michelle Dorey Forestell/Kingstonist.

Anderson explains the process: “We bring people in. They come in and sign a form. We ask them what they’ve used in the last couple of hours and what they are using when they come into the space. And we ask if they have any disabilities that we need to watch out for. Then they come back here, and they pick one of these booths.” He gestures toward the next room, where a handful of people sit at tables and recline on floor mats. Some are actively injecting themselves. Some are wearing name tags like Anderson’s, and are obviously monitoring the others.

“And then they use, and then we watch over them after they use,” he says frankly.

It is all very open. Still, Anderson explains that “there are dividers we can put around if they want more space, and then after they use, if they pass out or whatever, we can bring them in here, and they can chill and just relax until they are… mobile again. We have five booths here. And this is pretty much just where they come and use safely, so we can walk through them when they use.”

If they need to, they can sleep in the CTS until closing time at 9 p.m., Anderson explains, “and then we bring them this way.” He leads the way through a set of doors and down a hallway, passing by the cozy little area where staff can go to take their breaks.

Next, there is a large room with a kitchen on one side. A sign shows the times that breakfast, lunch, and dinner are served. There is also a 2 a.m. “snack time/ grab and go.” 

“This is where we serve the food,” Anderson says.

“People can just go up here. They sleep in here. We give them mattresses. They can come up here during the day, chill, eat their food, relax, watch TV if they want.”

It is a beautiful day out, and most of the residents of the Hub are enjoying the sunshine elsewhere. Around 50 are outside in the general vicinity of the building, and a few are visible in the encampment adjacent to the Hub. Here inside, a few people sleep in the large room: one is on a couch and one on a mattress, and another young man sleeps slumped on a desk like a tired high schooler.

“We have a capacity of 25, 30 at a time; it can get pretty hectic,” Anderson continues.

“We don’t allow it to go over 25 [at night] because we only have so many staff in here, and if it something does get out of control then we have to be able to take care of it.”

He leads the way through another door and upstairs, saying, “Then, during the night time, we have 25 ‘pods,’ we call them — little rooms with beds in them.”

He explains that to get a pod, residents must line up outside at 5 p.m. to get on the bed list. “Then we sign them in, and they get a bed.” There are 24 beds; four are set up for couples.

There are 24 sleeping pods at the hub like this one to provide a tiny bit of privacy at night. Photo by Michelle Michelle Dorey Forestell/Kingstonist.

If the CTS is closing at night with people still incapacitated, says Anderson, “We’ll bring them up, we’ll get them a bed automatically, and we’ll do five-minute checks. So every five minutes, they set a timer. They go around and check each pod every five minutes and make sure everybody’s okay.”

“And yeah,” he smiles and gestures around, “this is the Integrated Care Hub.”

The conversation turns to the purpose of the visit: education. Challenging the stigma associated with mental illness, including substance use disorders, takes understanding, education, and a closer look at our own attitudes toward health.

“People from the outside, they don’t really understand that,” Anderson emphasizes.

The Centre for Addiction and Mental Health (CAMH) — Canada’s largest mental health teaching hospital and one of the world’s leading research centres in its field — points out, “Fear and misunderstanding often lead to prejudice against people with mental illness and addictions, even among service providers. It’s one of the main reasons why many people don’t consider it a real health issue. This prejudice and discrimination leads to feelings of hopelessness and shame in those struggling to cope with their situation, creating a serious barrier to diagnosis and treatment.”

Anderson introduces John and Joseph, who are currently managing the rest zone. John, another former client who now works at the Hub, agrees that education is needed about the ICH: “I had no clue about any of this until I showed up here. I used to be a client.”

Anderson is asked if that is a pattern: whether a lot of people working at the ICH come from the background of being a client.

“No, there’s not too many of them. We do have clients who are still living here and still in active addiction who we let work here to make themselves some money and stuff like that. It’s pretty good. We try our best to help, right?” he says.

“I think it’s pretty amazing what we do here. We see clients roughly 2,000 times a week just in CTS alone. And we save so much time and money for [the hospitals] in the [emergency department] and ambulance runs. Like it is $70 for us to deal with an overdose here. It’s $1,500 at the hospital.”

“And then we struggle to get funding, we struggle to get this, we struggle to get that, and it gets ridiculous. They don’t really understand what we do here, right?” he says.

Pamela Gray shared the same frustration about funding for more programming earlier in the day, saying how much she hopes that the private sector will see, through the work she and Brigit Smith are doing to involve them, that there are some very simple solutions to the problems the ICH clients and the people of the encampment face. But it takes money and more people getting actively involved to help instead of looking the other way.

Anderson leads the way outside, where he gestures to a newly installed traffic light in the ICH parking lot.

A quiet spot to nap under a sign that reads “Support not Stigma.” The amount of artwork here, mostly done by clients, is impressive. Photo by Michelle Dorey Forestell/Kingstonist.

He is frustrated that the City spent what he estimates is tens of thousands of dollars to purchase and install the light. It is not, of course, an actual traffic light. He says its function is to show ‘red’ to indicate no daytime camping in Belle Park and ‘green’ to indicate it is safe to make a shelter in the park — as if the residents of Belle Park can’t tell night from day.

“When it’s red, they can’t be in their encampment; they gotta pack up, everything out their encampment, and then wait until sunset. And then, when it’s green, they can go back on the property,” Anderson says.

Asked to clarify the costs of the light, the City’s communication department replied, “The work was completed by City/[Utilities Kingston] staff using a spare signal head that was part of the existing inventory. The signal head can be redeployed to another location in the future if needed. The estimated cost for the work is $1,500 and was covered within our existing operations support budget.”

“The purpose of the traffic signal activation at Belle Park was implemented to support individuals who shelter in the park,” the City expounded. “The light is used as a visual aid to advise when daytime sheltering is not allowed and when sheltering is allowed in accordance with the City Bylaw. This measure was taken after a majority of the affected individuals in the park were surveyed and indicated they wished to have the signal installed to help them gauge the time.” 

Asked where the campers are supposed to take their things in the daytime, Anderson points toward a large shipping container, saying, “There’s a big sea can up there. But who wants to? Who wants to give their stuff to somebody and lock it up? Maybe they need it during the day, you know what I mean? It’s ridiculous.”

He goes on to say, “But we beat that obviously, thank God. It is a constant fight,” referring to the City’s enforcement of its “Daytime Sheltering Prohibition.”

He says that City officials have confiscated many of the shelters they deemed “unsafe,” and gives some specific examples. One example concerns a man who donated six or seven military tents that were worth several thousand dollars at least, Anderson says. “He made military movies or TV shows, and these [tents] couldn’t be used in the films because they’re a little bit damaged. So the guy came down here and said, ‘Hey, do you guys want them?’ It was amazing.” Yet these were confiscated.

It is hard to imagine that a goodwill private donation would just be taken and thrown away, and Anderson agrees.

“Yeah, it’s brutal,” he says.

Though the encampment is not a part of the ICH, it has built up here in the adjacent Belle Park because of what is available: food, showers, and the lifesaving presence of CTS workers.

Some questions are uncomfortable to ask from a place of privilege, but Anderson is adamant that he is an open book. “Go ahead, ask anything you want,” he says, emphasizing that he wants the public to understand the place.

The “visual aid” indicates it isn’t legal to shelter in the park adjacent to the Hub. Photo by Michelle Dorey Forestell/Kingstonist.

Is it dangerous here? “Not necessarily, no. Like obviously, if the people who live here every single day see a new face walking through their encampment, they’re going to get suspicious — like, ‘Who are you? What are you doing here?’ Obviously it’s… their home, right? But they’re not going to get, like, physical or anything.” 

Some have argued that Belle Park is supposed to be for everybody and that the presence of an encampment makes it inaccessible to other users. Anderson finds this a bit funny, explaining that what he sees is a building, the ICH: “That was abandoned for I don’t even know how many years and years and years, and the golf course is closed. How many people were using it before we were even here? It was empty. So, who used it? Nobody.”

“And,” he goes on, “where would be a better place to keep [the encampment inhabitants] all contained and let them use this space? Unless you want to break them all up to be touring the city, and then it’s going to be even worse for the city. It makes no sense. Why not keep everybody [together] who is in active addiction and has mental health issues and everything else? Why not keep them here?”

It’s is at the ICH or the encampment where they at least have a community and access to the support they need, Anderson expresses.

Anderson knows from experience how important this place and others like it are. Growing up in Kingston, he attended Rideau Heights Public School. Then, he says, “I went only one year to QECVI; I’ve been in an active addiction since I was 13 years old.” Many of the addicts who depend on the ICH have come from similar backgrounds, he says.

Some others are simply poor and need assistance to organize housing. “There are some elderly people here [who] could not keep up with  their bills, and they had no other place to go but here” because the shelter system in the city is at capacity, he says.

Some don’t use drugs at all, Anderson notes.

“They may drink and stuff like that, but we have a few people that are here that don’t; they don’t use drugs, and they’re here because there is food, there’s clothing, there’s places to get help,” he says.

“People from the outside need to understand. They need to come down and not be so judgmental towards something they don’t even understand… everybody here has their own story and their own struggle, and a lot of them are pretty, pretty wild.”

Anderson gestures around at the encampment and points out the amount of skill that has gone into assembling some of the homes there. “There’s solar panels, there’s electricity, one guy built a little cabin back in the woods.” He’s even aware of a homemade houseboat someone has constructed to live on. The amount of ingenuity is incredible, he says.

“Lots of these people have skills,” the ICH worker shares.

“Who knows what we could do if we had more support and housing opportunities.”

The stigma associated with drug addiction is a huge barrier to getting positive things accomplished. Still, Anderson is hopeful that with the support of people like Gray and Smith, who cared enough to try to help, things can change for the better.

Gray and Smith are actively looking for help for the people of the ICH. Any donations are great, especially money, but they insist they’ll accept donations of any kind.

“We are looking at the private sector… at people who might want to give back to the community. Someone who has had a business here for years and a legacy, we want to ask those people for help. I don’t think we will solve this without private sector partnerships,” says Gray.

Smith chimes in, “It would be so easy… it boggles my mind how easy it could be.”

Trevor looks around the spot where he used to live in a tent in Belle Park just a few years ago. Photo by Michelle Dorey Forestell/Kingstonist.

“I lived here,” Anderson reveals candidly as he finishes up his stint as tour guide. “I started [living rough here] before the ICH was even here. I was one of their first clients at Street Health when we opened up there, and then we moved over to Artillery Park, and then we moved here. But I’ve been struggling with addiction for my whole life. I’m 34 and I started using when I was like 12 — so for over 20 years. And it’s not fun. But I went to jail, and I just realized I had had enough. I had the right support, and I got out.”

He is quick to clarify that the support did not come from the penal system, “but [being incarcerated] obviously saved my life… And I met somebody through Alcoholics Anonymous. She gave me her number, and when I got out, we reconnected. Since then, things have gotten so much better. My family’s back in my life. I got my [driver’s] licence for the first time. I’ve got so many things back in 11 months that I missed out on for 20 years.”

“I used to have a tent just over there,” he says, pointing. “But now that I know I’m strong enough in my own head, in my mind, that I can come down here and support the people that I used to live with and be like, it’s helping me even more. And then, them seeing me like this gives them hope to want to do better.”

“We don’t really have too many success stories,” Anderson says, “but there’s a few.”

And a few is more than none. 

With help and understanding from the community, hopefully that number can grow.

3 thoughts on “Integrated Care Hub, Part Two – Staff giving back: ‘We try our best to help, right?’

  • An eye-opening article, Many thanks, Kingstonist, for helping us better understand what is going on at the Hub and the challenges of the folk who work, live, and hang around there. I hope our councillors are reading this and realize the value of the work that is done there and the community (and hope) it has created.

  • Thank you for your input. I see some of these people at the volunteer free tax clinic. All of those who my team and I have assisted are grateful. I have a belief, ‘but for the grace of God’ I could be in their shoes.
    Mary Ellen Hannah

  • Thank you for these two articles and for keeping these folks in the news. Seeing people who use drugs as human beings coping with trauma, physical or emotional is an important fact in challenging stigma. Great interviews!

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