Introduction

When I began writing this book, my focus was on telling the story of a homeless woman named Margaret, who I met at a shelter one cold winter night. I sat across from her, transfixed by the broken-down woman before me and listened as she shared her story. Meeting Margaret opened my eyes to the reasons why so many homeless people on our streets have a mental illness and became the starting point for my twenty-year journey into the homelessness crisis in Canada.

Margaret is one of thousands of homeless people who have been victimized by a government plan that resulted in one of the grimmest and most shameful chapters in the history of Canada’s psychiatric care. What happened to Margaret is the untold story of why so many homeless people today struggle with mental illness and why so few social services exist for them.

This book follows one woman’s brutal descent into homelessness and shows how she went from hospital patient to homeless person as a result of deinstitutionalization that swept across the country starting in the 1960s and led to thousands of psychiatric patients being discharged into boarding homes and communities. It was supposed to help former patients become more independent and productive, and take them out of oppressive hospital environments.

Deinstitutionalization moved forward without opposition, and over the next many decades led to the closure of more than 80 percent of psychiatric hospital beds in Canada. The problem was in the government’s failure to set up community services and provide supportive housing for the former psychiatric patients. These same people who had been receiving 24-7 care inside the hospital were moved into the community and suddenly had to fend for themselves.

The supports that were promised never materialized, nor did the services that were supposed to help former patients secure housing and find jobs. The health care workers weren’t hired to make sure former patients were taking their medications, and the community treatment centres that were to open in areas close to where patients were being moved were never built. Instead of the former patients living in supportive housing and having access to a wide range of supports, they ended up sleeping in alleyways in cardboard boxes and on top of hot air grates, and begging for spare change for their next meal. Because of this rough living, they’re dying at much higher rates and at much younger ages than the general population.

This book shows how deinstitutionalization was the catalyst for the crisis that exists on our streets today. While it may have successfull