The people cycling through Toronto’s emergency shelter system were not invisible to the people working alongside them. They were invisible to the systems designed to respond to them — because no one had documented, at scale, who they were and what they actually needed.
As Executive Director of the Innercity Family Health Team, a comprehensive survey of long-term residents at Seaton House and the Women’s Residence documented the nature and prevalence of complex co-morbidities — physical health, mental health, substance use, social care needs — among people for whom emergency shelter had become a permanent condition. The findings were not surprising to frontline workers. They were new to policymakers.
That gap — between what communities experience and what institutions count as evidence — is structural. Closing it required translating lived system reality into a form that expert panels and government decision-makers could act on. The evidence was provided to the bodies shaping long-term homelessness strategy, informing a shift away from crisis response toward integrated, supportive housing solutions.
Policy built without that evidence tends to optimise for the institution. This work was an attempt to make sure it optimised for the people the policy was actually about.