Distinct solutions for a distinct population: A community-based approach to affordable housing for young people experiencing homelessness in Toronto

2021

Authors: 

  1. Katie MacEntee, University of Toronto, Dalla Lana School of Public Health
  2. Paula Braitstein, University of Toronto, Dalla Lana School of Public Health
  3. Alex Abramovich, Centre for Addiction and Mental Health, Institute for Mental Health Policy Research (CAMH), Toronto, ON

Introduction

Youth are on the street in large part because they can’t afford housing in or around Toronto.

It is estimated that there are between 850-2000 youth experiencing homelessness on any given night in Toronto (City of Toronto, 2018; Gaetz & O'Grady, 2002). When COVID-19 hit the city early in 2020, the already over extended emergency shelter system was further stressed (Perri, Dosani, & Hwang, 2020). There is a lack of focused services to support youth under 25 who are experiencing homelessness to find secure, long term housing (Gaetz & Dej, 2017). We outline the need for the City of Toronto to adopt a Housing First for Youth (HF4Y) approach that is targeted at key populations of youth experiencing homelessness and provides intersectional supports for transitioning out of homelessness into long term, safe, and affordable housing.

 

Overview of Youth Homelessness in Toronto

The City of Toronto’s recent Street Needs Assessment (2018) found that youth represent 10% of the total homeless population in the city. Half (52%) of these respondents were new to the streets, with a smaller percentage (10%) being homeless for 6 to 12 months. The longer youth stay on the streets the more likely they are to encounter violence, experience worsening mental health, develop addiction challenges, and become more entrenched in street life (Gaetz, O'Grady, Kidd, & Schwan, 2016).

There are multiple pathways into homelessness for youth; however, primary drivers are family conflict, poverty, and child abuse (Cull, Platzer, & Balloch, 2006; Embleton, Lee, Gunn, Ayuku, & Braitstein, 2016; Public Health Agency of Canada, 2006). Identity-based family conflict, resulting from a young person coming out as lesbian, gay, bisexual, transgender, queer, questioning, and Two-Spirited (LGBTQ2S), is another major contributing factor to youth homelessness (Abramovich & Shelton, 2017a). Additional factors include involvement with child protection services, housing instability, poverty, migration, abuse, and mental health issues (City of Toronto, 2018; Gaetz et al., 2016). Youth who lack family support or who are exiting public systems, such as child welfare and the juvenile justice system, may experience particular difficulties finding and maintaining stable housing.

Homelessness is associated with multiple negative health impacts. The majority (52%) of youth experiencing homelessness in Toronto report one or more type of health condition, one quarter (24%) report having been hospitalized in the last year and over a third (35%) report visiting an Emergency Department (City of Toronto, 2018). There are also reported high rates of self-harm and suicidality (Frederick, Kirst, & Erickson, 2012). Other major concerns include problematic alcohol and substance use, mental health challenges, risk of HIV infection through unprotected sexual contact or injection drug use, respiratory health concerns associated with living rough or in poor housing conditions, poor nutrition, and premature death (Gaetz et al., 2016; Kulik, Gaetz, Crowe, & Ford-Jones, 2011). These concerns are amplified by barriers to healthcare (e.g. distrust of service providers, and discrimination by service providers) that keep youth experiencing homelessness from accessing available healthcare services when needed (Barker, Kerr, Nguyen, Wood, & DeBeck, 2015).

Lack of housing further impacts young people’s future opportunities. For example, youth who experience homelessness are likely to experience chronic housing insecurity and unemployment (Gaetz et al., 2016). They are targeted by law enforcement and often end up ensnared in the criminal justice system (O'Grady, Gaetz, & Buccieri, 2013). Homelessness reduces the likelihood of youth completing their basic education (Dhillon, 2011). The vast majority of youth experiencing homelessness rely on Ontario Works (OW) or Ontario Disability Support Program (ODSP) as their main source of income (WHO, 2014). These challenges and barriers can combine to leave youth trapped in a cycle of poverty that continues into adulthood (WHO, 2014).

 

Transitioning Out of Homelessness

When transitioning out of homelessness youth in Canada often follow non-linear trajectories (Gaetz & Dej, 2017). They typically move in and out of stable housing in connection with disrupted access to employment and/or education and attainment of other personal goals (Gaetz et al., 2016; Quirouette, Frederick, Hughes, Karabanow, & Kidd, 2016). However, with housing youth do better. For example, research has shown that when youth who struggle with addictions can access housing their overall health improves and they also experience an increase in treatment access and a decrease in the likelihood of death (Cheng, Wood, Feng, Mathias, & Montaner, 2013).

 

Housing Needs of Key Populations of Youth

Ending youth homelessness requires prioritizing disproportionately represented populations of youth experiencing homelessness because a one size fits all approach does not work. Stemming the flow of youth entering the cycle of housing insecurity is critical, as are family reconciliation supports that enable youth to return home when it is safe to do so (Gaetz et al., 2016). However, prevention is too late for those who are already street-involved and experiencing homelessness and for some youth family reconciliation is not appropriate. The most promising way forward is to develop a plan that responds to the distinct needs of key populations (Abramovich, 2016; Gaetz & Dej, 2017). We focus here on youth who identify as LGBTQ2S, racialized, migrant, Indigenous, and girls and young women. These populations are highlighted, also, in the City of Toronto’s (2019) housing policy and planning, although not necessarily with a focus on youth. It is important to note that youth may identify across these key populations (e.g. Indigenous, transgender, and gay) further compounding their experiences of marginalization and ultimately impacting their ability to access and maintain secure housing.

 

LGBTQ2S Youth

Compared to heterosexual and cisgender youth, LGBTQ2S youth tend to become homeless at a younger age and experience homelessness for longer episodes (Abramovich & Shelton, 2017a; Gaetz et al., 2016). A quarter (24%) of youth who participated in the Toronto Street Needs Assessment (2018) identified as LGBTQ2S. However, this is likely an under representation. Youth who identify as LGBTQ2S frequently avoid accessing support services and shelters, due to discrimination, violence, and heteronormative and cisnormative programming and policies (e.g. intake forms and housing programs that categorize youth based on the gender binary) (Abramovich, 2017). Housing support for this key population needs to be LGBTQ2S inclusive and affirming. Supports should be prepared to respond to the increased exposure to violence, exploitation and social exclusion experienced by this population (Côté & Blais, 2019). Trans youth may have unique transition-related healthcare and legal needs (e.g. access to hormones and support changing legal identification) (Abramovich & Shelton, 2017b). Access to safe housing for this population can be marred by homophobic and transphobic landlords. LGBTQ2S youth typically earn less money and experience higher rates of unemployment and sexual and gender discrimination compared to their heterosexual and cisgender counterparts (Waite, Ecker, & Ross, 2019). This makes securing long term housing more difficult and increases the likelihood of poverty.

 

Indigenous Youth

The City of Toronto (2019) reports that Indigenous Peoples represent an estimated 16% of the overall homeless population, compared to composing only 1-2.5% of the population in Toronto. High rates of homelessness amongst First Nations, Metis and Inuit people can be traced back to Canada’s colonial history and ongoing systemic racism (National Inquiry into Missing Murdered Indigenous Women Girls, 2019). This key population is more likely to have lived in the care of the state (Kidd, Thistle, Beaulieu, O'Grady, & Gaetz, 2019). Thistle (2017) articulates that an Indigenous understanding of homelessness extends beyond the lack of a structural place to live, and includes an isolation from kin, culture and land. Indigenous young women experience intersecting oppressions associated with gender, poverty and race. Evidence illustrating increased risk of suicidality, post-traumatic stress disorder, substance use, physical and sexual violence (Bingham et al., 2019) suggests the importance of access to mental health services. Housing services for Indigenous youth need to consider the greater incidence of incarceration amongst this population (Barker, Alfred, et al., 2015) and understand the impact of this on housing access and employment opportunities. Youth who spent their childhood living in Indigenous communities, growing up on a reserve, and who are newer to the city (Gaetz et al., 2016) may benefit from support with system navigation. The housing response for Indigenous youth experiencing homelessness must be connected to individual Indigenous cultures (e.g. language programs, linkages with elders) and extended family in ways that support a (re)engagement with traditional knowledge systems and self-determination (Kidd et al., 2019; Oliver & LeBlanc, 2015).

 

Racialized Youth

Racialized youth are disproportionately represented amongst the homeless youth population in Toronto (City of Toronto, 2018). Pathways into homelessness for racialized youth are shaped by Canada’s system of racist oppression and White supremacy, with historic links to state sanctioned slavery, community displacement, and more recent school structure policy (such as the curricular emphasis on multiculturalism rather than a more substantive critical anti-racism) limits young Black bodies’ rights and opportunities (Maynard, 2017). When considering housing supports for this population, the Toronto Police Department’s racial profiling of Black and Brown youth must be acknowledged as driving an over representation of racialized youth in the criminal justice system and detrimental impacts on future housing and employment opportunities (O'Grady, Gaetz, & Buccieri, 2011). Various forms of discrimination and racism by service providers, teachers and other school officials also impact this key populations’ transition out of homelessness (Springer, Lum, & Roswell, 2013). Challenges for Black LGBTQ2S youth are heightened due to exclusion from Black and LGBTQ2S communities (Benn, 2017). Housing support that targets this key population should recognise the diversity of racialized youth experiencing homelessness in Toronto and provide services that are fundamentally culturally appropriate and anti-racist.

 

Girls and Young women

Girls and young women represented 31% of the respondents of the Toronto Street Needs Assessment (2018). Although, similar to LGBTQ2S youth, the gendered experience of hidden homeless likely contributes to the under reporting of girls and young women who are experiencing housing insecurity (Van Berkum & Oudshoorn, 2019). Girls and young women’s housing concerns are impacted by systemic inequities in employment and remuneration making market-rate housing more difficult to access for this population (City of Toronto, 2019). Recent research suggests that women may require longer support when exiting homelessness (Jadidzadeh & Falvo, 2019). The increased likelihood of this key population to be supporting family dependents brings with it intersecting concerns related to access to childcare, food, and housing for parents and children. If fleeing intimate partner violence (IPV) and domestic abuse, health and legal services may be required. There are also ongoing safety and security concerns for survivors of domestic abuse who have managed to secure independent housing (Tutty, Ogden, Giurgiu, & Weaver-Dunlop, 2013).

 

Migrant Youth

Migrant status is an umbrella term that includes immigrants, permanent residents, temporary workers, and documented and undocumented refugees. The Toronto Street Needs Assessment (2018) identified migration as a key contributor to homelessness in the city. In a national study, newcomer youth were likely to report multiple experiences of homelessness (Gaetz et al., 2016). Youth who are new to Canada or new to the city encounter a number of obstacles that are indicative of tailored housing response needs. For example, Walsh, Hanley, Ives, and Hordyk (2016) identified support needs associated with: gaining status and employment, treatment for residual trauma from the migration experience, language and translation, navigating and building familiarity with Canadian service systems, guidance on how to address systemic discrimination based on their migrant status, and housing loss connected to job security (for temporary foreign workers).

 

Affordable Housing in Toronto

Affordable housing is commonly defined as housing that costs less than 30% of a household’s income before tax (Canada Mortgage and Housing Corporation, 2018). However, when rental rates rose by 50% from 2011-2019, access to affordable housing in Toronto became – and remains - scarce (City of Toronto, 2020b). In 2018, a bachelor apartment was estimated to cost nearly three quarters (73%) of a young person’s average monthly income (City of Toronto, 2020b; Statistics Canada, 2020). Although housing is a universal human right, it is not a reality for many young people in Toronto.

Canada’s National Housing Strategy (2017) has committed to cutting homelessness in half and recognizes the following key populations as those ‘most in need’: women and children fleeing family violence, seniors, Indigenous Peoples, people with disabilities, people dealing with mental health and addiction issues, veterans and young adults. The Housing TO 2020-2030 Action Plan (2019) lays the groundwork for the development of 18,000 new supportive homes and women and girls are expected to gain access to an additional 10,000 new affordable rental and supportive homes. The Housing Commissioner of Toronto is expected to consult key populations in a review of housing programs and policies to ensure they follow an anti-discrimination framework (City of Toronto, 2019). To date, however, the City’s response to the housing needs of key populations of youth experiencing homelessness has so far been insufficient or, in some cases, woefully absent. It is imperative that diverse representation of youth who are disproportionately impacted by homelessness and have experienced housing insecurity be ensured an equal and accessible role in consultations throughout these developments.

 

Housing Initiatives and Supports: Promising practices and recommendations

In the latter half of this paper we will review the arguments for adopting a Housing First for Youth (HF4Y) approach. We include examples of existing HF4Y programs and initiatives and practical recommendations on how the city and service providers can support the development of a robust long term housing response for key populations of youth experiencing homelessness in Toronto.

 

Housing First for distinct youth populations

The housing first model has been a core component of the Toronto housing plan for over 10 years (City of Toronto, 2019). The model advocates immediate access to permanent housing without the requirement to show housing readiness (e.g. sobriety, employment, education enrolment). This is underpinned by the belief that people are more likely to thrive when they are stably housed. A rights-based approach foregrounds a person’s right to choose the housing and supports they require and when they want them. In an effort to address rapid-rehousing needs, the model advocates for the use of dedicated staff to locate and match housing with youth needs, funding for housing deposits and move in costs, as well as case workers to support youth in their housing transition (National Alliance to End Homelessness, 2020). Successes of the Housing First approach with adults have been significant (Baxter, Tweed, Katikireddi, & Thomson, 2019), but there are fewer studies looking at the impact of the model to address youth homelessness.

 

Housing First to Address Youth Homelessness

A key study to evaluate the effectiveness of the Housing First Model for youth experiencing homelessness in Canada was the the At Home/Chez Soi study (2009-2011). The intervention was implemented with a population of youth (ages 18-24) experiencing homelessness and mental illness in five Canadian cities (Moncton, Montreal, Toronto, Winnipeg and Vancouver) (Kozloff et al., 2016). The results demonstrate that the provision of permanent supportive housing increased housing stability (Aubry et al., 2020; Thulien, Gastaldo, Hwang, & McCay, 2018). Participants who had completed high school and had access to employment and mental health care were more likely than other participants to maintain housing over the course of the study. Having stable housing was also associated with a reduction in injection drug use (Roy et al., 2016). These results echo previous work that notes that access to housing, rather than individual behaviour, is a key factor to young people’s transitions into and out of homelessness (Karamouzian et al., 2019).

 

The At Home/Chez Soi study successes are tempered with notable challenges. Access to housing without access to population-specific support was observed to actually increase or introduce new stressors and insecurities in young people’s lives (Kidd et al., 2016). Participants who received housing alone experienced ongoing challenges related to poverty, loss of community and a sense of being overwhelmed by the responsibilities of independent living (Thulien et al., 2018). Housing situated far from affordable food sources and not knowing how to prepare meals resulted in some youth experiencing hunger and malnutrition (Brothers, Lin, Schonberg, Drew, & Auerswald, 2020). The results of this study led to the Housing First model becoming the ‘gold standard’ in homelessness response when integrated alongside robust social supports for young people to help them transition meaningfully off the streets and integrate into society.

                                                                                                                                       

Existing Long Term Housing Case Studies: Promising developments and ideas

The following examples are of affordable housing initiatives in Canada. The 2020 modular housing initiative in Toronto illustrates how the unique moment brought on by the COVID-19 pandemic has instigated new pathways towards efficient housing development. The examples of tailored services in RainCity Housing in British Columbia and the Infinity Project in Calgary illustrate the possibilities and successes of services that respond to the distinct needs of key populations. In presenting these case studies, we echo Gaetz, Ward, and Kimura (2019) who argue for the ongoing need for longitudinal implementation studies that will continue to assess and inform the adaptation of a city-wide response to the youth housing crises. In particular, we note the need for further research that considers the form and duration of housing supports for key populations of youth transitioning out of homelessness and into long term housing.

 

Modular housing

Modular housing is a 2020 initiative that responds to the abject lack of affordable housing in the city. In partnership with Create TO, the City of Toronto is building 100 single-occupancy prefabricated units with an expected completion date of October 2020. Each unit will have kitchen and washroom facilities and the buildings will have communal kitchens, administrative areas as well as space for other programing (City of Toronto, 2020a). With the onslaught of COVID-19, the city was able to fast-track the site identification and approval process (City of Toronto, 2020c). The two new buildings under construction are the first of a larger initiative to integrate modular housing in the city (City of Toronto, 2019). The city’s efficient approval of the affordable housing development inspires hope for future developments. However, we also note that fast tracking the community consultation process was not ideal. A small but vocal group of neighbours have expressed fear and opposition to the development (Smee, 2020). Their fears are based primarily in the social stigmatization and misconceptions of homelessness. Furthermore, this pilot program has been designated for people over the age of 18, and future research is required to determine whether such an initiative would translate effectively for younger people and how such an initiative would be welcomed by communities.

 

RainCity Housing: Housing First Program for LGBTQ2S Youth

RainCity Housing is a non-profit housing initiative located in Vancouver, BC that offers LGBTQ2S youth a choice between communal housing and live-alone rental agreements (Munro, Reynolds, & Townsend, 2017). The majority of youth who entered into the first year of the program were Indigenous and trans. Alongside housing support, the program integrates services associated with health, employment and education, as well as life-skills development. Culturally relevant supports for Indigenous youth are available. LGBTQ2S peer and adult mentorship is also provided through this program. Staff identify as LGBTQ2S and have lived experience of homelessness. The program actively works to reject cisnormativity, transphobia and homophobia alongside integrating decolonizing strategies in order to tailor supports and services to individual residents (Munro et al., 2017). This includes efforts to connect youth to medical care that is knowledgeable and respectful of trans, queer, and gender-expansive identities. Emphasizing a relational design, youth experienced a reduced sense of isolation and increased connection between tenants and society at large (Munro et al., 2017).

 

The Infinity Project: The Boys and Girls Club of Calgary

The Infinity Project, which is integrated into the Boys and Girls Club of Calgary’s population-specific housing programs, follows a HF4Y approach. It is open to all youth between the ages of 16 and 24 who are at risk of, or experiencing, homelessness (Boys & Girls Clubs of Calgary, 2020). After one year of the program, the vast majority (92%) of the youth remained stably housed. After two years, the proportion of participants who were stably housed fell to 66% (The Homeless Hub, 2012). After 6 months in the program, the majority of youth reported a stable income; however, it was also noted that this income was insufficient to cover the cost of living in Calgary (The Homeless Hub, 2012). One notable lesson from this program is the importance of recognizing young people’s capacity to choose and make decisions about their life, where and how they live. A major challenge with the program was the insufficient supply of affordable housing in the city. Youth required intensive case management and long-term support from the program’s housing workers, especially if they left home before the age of 18. Funding for project staff was critical to keeping case loads manageable and providing youth with the supports they needed, when they needed them.

 

Conclusions and Recommendations on the Development of a Youth Housing Strategy

There is a lack of competent, safe, affirming housing services that respond to the complex needs of youth at risk of or experiencing homelessness. Affordable housing is a critical foundation for young people in poverty, and/or living without family support. Prioritizing housing that follows the HF4Y model can greatly improve the ability of youth to effectively integrate into society and lead meaningful, and productive lives.  

The City of Toronto needs to develop a housing action plan that commits to supporting a long term affordable housing program for youth experiencing homelessness. The following recommendations outline key considerations when moving forward with this initiative.

  1. Ensure that youth with lived experiences of homelessness and transitioning out of homelessness are provided with accessible and meaningful participation in all policy development and action planning related to housing responses that will impact youth.
  2. Ensure that the youth-centred housing plan is tailored to respond to the complex needs of key populations of youth experiencing homelessness, including LGBTQ2S youth, Indigenous youth, racialized youth, girls and young women, and migrant youth.
  3. Link housing supports for youth directly to existing networks of youth services geared to address youth homelessness, including youth drop-in centers, shelters and transitional housing programs, so as to support a smooth transition out of homelessness and decrease the likelihood of returning to homelessness.
  4. Follow a HF4Y approach geared towards the rapid re-housing of youth who are experiencing homelessness or at risk of homelessness.
  5. Ensure the youth housing strategy includes integrated supports to increase access to education, employment, physical and mental health, transportation, nutrition/access to food, cultural/community-based services, criminal justice services, and migrant services.
  6. Increase the availability of affordable housing in Toronto that is accessible to youth, meaning it is accessible and safe for youth to access independently and without the need for adult consent.
  7. Ensure adequate funding for employees, including funds for employees whose job is dedicated to identifying affordable housing opportunities and for transition support workers. Particular attention should be given to keep support workers’ case loads reasonable so that services can be provided on an ongoing basis and in response to youth’s transitional needs when exiting the streets and (re)integrating with mainstream society. 
  8. Ensure all housing and emergency support service workers are trained to respond appropriately and productively to the unique and intersecting needs of key populations of youth who are experiencing homelessness.
  9. Housing staff and support should be diverse and reflective of the communities of youth they are serving.
  10. Ensure housing access, policies and standards conform to current best practices surrounding housing services that focus on meeting the needs of specific youth populations through inclusive, anti-oppressive, anti-racist and gender affirming documentation, guidelines, training and management.
  11. Integrate long term research and assessment of all housing initiatives to ensure programs are adequately responding to youth who are most in need.

 

Work Cited

Abramovich, A. (2016). Preventing, Reducing and Ending LGBTQ2S Youth Homelessness: The Need for Targeted Strategies. 2016, 4(4), 11. doi:10.17645/si.v4i4.669

Abramovich, A. (2017). Understanding How Policy and Culture Create Oppressive Conditions for LGBTQ2S Youth in the Shelter System. Journal of Homosexuality, 64(11), 1484-1501. doi:10.1080/00918369.2016.1244449

Abramovich, A., & Shelton, J. (2017a). Introduction: Where are We Now? In A. Abramovich & J. Shelton (Eds.), Where Am I Going to Go? Intersecional approaches to Ending LGBTQ2S Youth Homelessness in Canada and the US. Toronto, ON: Canadian Observatory on Homelessness Press.

Abramovich, A., & Shelton, J. (Eds.). (2017b). Where am I going to Go? Intersectional Approaches to Ending LGBTQ2S Youth Homelessness in Canada and the U.S. Toronto, ON: Canadian Observatory on Homelessness.

Aubry, T., Bloch, G., Brcic, V., Saad, A., Magwood, O., Abdala, T., . . . Pottie, K. (2020). Effectiveness of Permanent Supportive Housing and Income Assistance Interventions for Homelessness Individuals in High-Income Countries: A Systematic Review. Lancent Public Health, 5, e342-e362.

Barker, B., Alfred, G. T., Fleming, K., Nguyen, P., Wood, E., Kerr, T., & DeBeck, K. (2015). Aboriginal street-involved youth experience elevated risk of incarceration. Public Health, 129(12), 1662-1668. doi:10.1016/j.puhe.2015.08.003

Barker, B., Kerr, T., Nguyen, P., Wood, E., & DeBeck, K. (2015). Barriers to health and social services for street-involved youth in a Canadian setting. J Public Health Policy, 36(3), 350-363. doi:10.1057/jphp.2015.8

Baxter, A. J., Tweed, E. J., Katikireddi, S. V., & Thomson, H. (2019). Effects of Housing First approaches on health and well-being of adults who are homeless or at risk of homelessness: systematic review and meta-analysis of randomised controlled trials. J Epidemiol Community Health, 73(5), 379-387. doi:10.1136/jech-2018-210981

Benn, A. (2017). The Black Queer Youth Initiative: Challenging racism, stigma and exclusion. In A. Abramovich & J. Shelton (Eds.), Where amd I Going to Go? Intersectional approaches to ending LGBTQ2S youth homelessness in Canada and the U.S. (pp. 217-228). Toronto, ON: Canadian Observatory on Homelessness.

Bingham, B., Moniruzzaman, A., Patterson, M., Sareen, J., Distasio, J., O’Neil, J., & Somers, J. M. (2019). Gender differences among Indigenous Canadians experiencing homelessness and mental illness. BMC Psychology, 7(1), 57. doi:10.1186/s40359-019-0331-

Boys & Girls Clubs of Calgary. (2020). Youth Housing.   Retrieved from https://www.boysandgirlsclubsofcalgary.ca/programs/youth-housing-and-shelters/youth-housing/

Brothers, S., Lin, J., Schonberg, J., Drew, C., & Auerswald, C. (2020). Food insecurity among formerly homeless youth in supportive housing: A social-ecological analysis of a structural intervention. Social Science & Medicine, 245, 112724. doi:https://doi.org/10.1016/j.socscimed.2019.112724

Canada Mortgage and Housing Corporation. (2018). About Affordable Housing in Canada: Programs and Investments that help Canadians Access High-Quality Affordable Housing.   Retrieved from https://www.cmhc-schl.gc.ca/en/Developing-and-Renovating/Develop-New-Affordable-Housing/Programs-and-information/About-Affordable-Housing-in-Canada

Cheng, T., Wood, E., Feng, C., Mathias, S., & Montaner, J. (2013). Transitions Into and Out of Homelessness Among Street-Involved Youth in a Canadian Setting. Health & Place, 23, 122-127.

City of Toronto. (2018). Street Needs Assessment: Results Report. Retrieved from https://www.toronto.ca/wp-content/uploads/2018/11/99be-2018-SNA-Results-Report.pdf

City of Toronto. (2019). HousingTO 2020-2030 Action Plan. Retrieved from Toronto, ON: https://www.toronto.ca/wp-content/uploads/2020/04/94f0-housing-to-2020-2...

City of Toronto. (2020a). City of Toronto Modular Housing Initiative Progressing Quickly; Initial site locations identified.   Retrieved from https://www.toronto.ca/news/city-of-toronto-modular-housing-initiative-p...

City of Toronto. (2020b). Current City of toronto Average Market Rents & Utility Allowances.   Retrieved from https://www.toronto.ca/community-people/community-partners/social-housin...

City of Toronto. (2020c). Implmenting the Toronto Modular Housing Initiative as an Urgent Response to the COVID-19 Pandemic.   Retrieved from http://app.toronto.ca/tmmis/viewAgendaItemHistory.do?item=2020.CC20.6htt...

Côté, P.-B., & Blais, M. (2019). Between Resignation, Resistance and Recognition: A Qualitative Analysis of LGBTQ+ Youth Profiles of Homelessness Agencies Utilization. Children and Youth Services Review, 100, 437-443.

Cull, M., Platzer, H., & Balloch, S. (2006). Out On My Own: Understanding the Experiences and Needs of Homeless Lesbian, Gay, Bisexual and Transgender Youth. Brighton, UK: Health and Social Policy Research.

Dhillon, J. (2011). Social Exclusion, Gender, and Access to Education in Canada Narrative Accounts from Girls on the Street. Feminist Formations, 23(3), 110-134.

Embleton, L., Lee, H., Gunn, J., Ayuku, D., & Braitstein, P. (2016). Causes of Child and Youth Homelessness in Developed and Developing Countries: A Systematic Review and Meta-analysis. JAMA Pediatr, 170(5), 435-444. doi:10.1001/jamapediatrics.2016.0156

Frederick, T. J., Kirst, M., & Erickson, P. G. (2012). Suicide attempts and suicidal ideation among street-involved youth in Toronto. Advances in Mental Health, 11(1), 8-17. doi:10.5172/jamh.2012.11.1.8

Gaetz, S., & Dej, E. (2017). A New Direction: A fremwork for homelessness prevention. Retrieved from Toronto, ON: https://homelesshub.ca/sites/default/files/attachments/COHPreventionFram...

Gaetz, S., & O'Grady, B. (2002). Making Money: Exploring the Economy of Young Homeless Workers. Work, Employment and Society, 16(3), 433-456. doi:10.1177/095001702762217425

Gaetz, S., O'Grady, B., Kidd, S., & Schwan, K. (2016). Without a Home: The National Youth Homelessness Survey. Retrieved from Toronto, ON: https://www.homelesshub.ca/YouthWithoutHome

Gaetz, S., Ward, A., & Kimura, L. (2019). Youth homelessness and housing stability: What outcomes should we be looking for? Healthcare Management Forum, 32(2), 73-77. doi:10.1177/0840470418817333

Government of Canada. (2017). Canada's National Housing Strategy: A Place to Call Home. Retrieved from https://assets.cmhc-schl.gc.ca/sf/project/placetocallhome/pdfs/canada-na...

Jadidzadeh, A., & Falvo, N. (2019). Patterns of exits from housing in a homelessness system of care: the case of Calgary, Alberta. Housing Studies, 34(1), 66-91.

Karamouzian, M., Cheng, T., Nosova, E., Sedgemore, K., Shoveller, J., Kerr, T., & Debeck, K. (2019). Perceived Devaluation among a Cohort of Street-Involved Youth in Vancouver, Canada. Substance Use & Misuse, 54(2), 324-330. doi:10.1080/10826084.2018.1523193

Kidd, S., Frederick, T., Karabanow, J., Hughes, J., Naylor, T., & Barbic, S. (2016). A Mixed Methods Study of Recently Homeless Youth Efforts to Sustain Housing and Stability. Child and Adolescent Social Work Journal, 33(3), 207-218. doi:10.1007/s10560-015-0424-2

Kidd, S., Thistle, J., Beaulieu, T., O'Grady, B., & Gaetz, S. (2019). A national study of Indigenous youth homelessness in Canada. Public Health, 176, 163-171. doi:https://doi.org/10.1016/j.puhe.2018.06.012

Kozloff, N., Adair, C. E., Lazgare, L. I. P., Poremski, D., Cheung, A. H., Sandu, R., & Stergiopoulos, V. (2016). " Housing first" for homeless youth with mental illness. Pediatrics, 138(4), e20161514.

Kulik, D. M., Gaetz, S., Crowe, C., & Ford-Jones, E. L. (2011). Homeless youth's overwhelming health burden: A review of the literature. Paediatr Child Health, 16(6), e43-47. doi:10.1093/pch/16.6.e43

Maynard, R. (2017). Policing Black lives: State violence in Canada from slavery to the present. Winnipeg, MB: Fernwood Publishing.

Munro, A., Reynolds, V., & Townsend, M. (2017). Youth Wisdom, Harm Reduction & Housing First: Raincity Housing's Queer & Trans Youth Housind Project. In A. Abramovich & J. Shelton (Eds.), Where Am I Going To Go?Intersetional Approaches to Ending LGBTQ2S Youth Homelessness in Canada & the U.S. (pp. 135-154). Toronto, ON: Canadian Observatory on Homelessness Press.

National Alliance to End Homelessness. (2020). Rapid Re-Housing Works.   Retrieved from https://endhomelessness.org/rapid-re-housing-works/

National Inquiry into Missing Murdered Indigenous Women Girls. (2019). Reclaiming Power and Place: The Final Report of the National Inquiry Into Missing and Murdered Indigenous Women and Girls (0660292750). Retrieved from https://www.mmiwg-ffada.ca/wp-content/uploads/2019/06/Final_Report_Vol_1...

O'Grady, B., Gaetz, S., & Buccieri, K. (2011). Can I see your ID? The policing of youth homelessness in Toronto: Canadian Homelessness Research Network.

O'Grady, B., Gaetz, S., & Buccieri, K. (2013). Policing Street Youth in Toronto. In S. Gaetz, B. O'Grady, K. Buccieri, J. Karabanow, & A. Marsolais (Eds.), Youth Homelessness in Canada: Implications for Policy and Practice (pp. 335-354). Toronto, ON: Canadian Homelessness Research Network Press.

Oliver, V., & LeBlanc, R. (2015). Family Matters: A Strength-based Family Resiliency Perspective Toward Improving the Health of Young Women Experiencing Homelessness. International Journal of Child, Youth & Family Studies, 6(1), 52-67. doi:http://dx.doi.org/10.18357/ijcyfs.61201513478

Perri, M., Dosani, N., & Hwang, S. (2020). COVID-19 and people experiencing homelessness: challenges and mitigation strategies: CMAJ. Canadian Medical Association. Journal, 192(26), E716-E719. doi:http://dx.doi.org/10.1503/cmaj.200834

Public Health Agency of Canada. (2006). Street youth in Canada: Findings from the enhanced surveillance of Canadian street youth, 1999-2003. Ottawa, ON: Government of Canada.

Quirouette, M., Frederick, T., Hughes, J., Karabanow, J., & Kidd, S. (2016). 'Conflict with the Law': Regulation & Homeless Youth Trajectories toward Stability. Canadian Journal of Law and Society, 31(3), 383-404. doi:http://dx.doi.org/10.1017/cls.2016.26

Roy, É., Robert, M., Fournier, L., Laverdière, É., Berbiche, D., & Boivin, J. F. (2016). Predictors of residential stability among homeless young adults: a cohort study. BMC Public Health, 16, 131. doi:10.1186/s12889-016-2802-x

Smee, M. (2020). Fast-Tracked Plan to Build Apartments for People Experiencing Homelessness Gets Push-Back from Neighbours.   Retrieved from https://www.cbc.ca/news/canada/toronto/fast-tracked-plan-to-build-apartm...

Springer, J., Lum, J., & Roswell, T. (2013). Policy Challenges to Homelessness Among Caribbean Youth in Toronto. In S. Gaetz, B. O'Grady, K. Buccieri, J. Karabanow, & A. Marsolais (Eds.), Youth Homelessness in Canada: Implications for Policy and Practice (pp. 445-468). Toronto, ON: Canadian Homelessness Research Network Press.

Statistics Canada. (2020). Table 11-10-0239-01 Income of individuals by age group, sex and income source, Canada, provinces and selected census metropolitan areas.   Retrieved from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1110023901&pickMem...

The Homeless Hub. (2012). Boys and Girls Club of Calgary: The Inifnity Project. Retrieved from Toronto, ON: https://www.ighhub.org/sites/default/files/BGCC_0.pdf

Thistle, J. (2017). Definition of Indigenous Homelessness in Canada. Retrieved from Toronto, PN: https://homelesshub.ca/sites/default/files/COHIndigenousHomelessnessDefi...

Thulien, N. S., Gastaldo, D., Hwang, S. W., & McCay, E. (2018). The elusive goal of social integration: A critical examination of the socio-economic and psychosocial consequences experienced by homeless young people who obtain housing. Can J Public Health, 109(1), 89-98. doi:10.17269/s41997-018-0029-6

Tutty, L. M., Ogden, C., Giurgiu, B., & Weaver-Dunlop, G. (2013). I Built My House of Hope: Abused Women and Pathways Into Homelessness. Violence against women, 19(12), 1498-1517. doi:10.1177/1077801213517514

Van Berkum, A., & Oudshoorn, A. (2019). ‘Where to now?’Understanding the landscape of health and social services for homeless women in London, Ontario, Canada. Journal of Social Inclusion, 10(1), 41-58.

Waite, S., Ecker, J., & Ross, L. E. (2019). A systematic review and thematic synthesis of Canada's LGBTQ2S+ employment, labour market and earnings literature. PLoS One, 14(10), e0223372. doi:10.1371/journal.pone.0223372

Walsh, C. A., Hanley, J., Ives, N., & Hordyk, S. R. (2016). Exploring the Experiences of Newcomer Women with Insecure Housing in Montréal Canada. Journal of International Migration and Integration, 17(3), 887-904. doi:10.1007/s12134-015-0444-y

WHO. (2014). Global Status Report on Violence Prevention 2014. Retrieved from Geneva: https://www.who.int/violence_injury_prevention/violence/status_report/20...