In its 70th year, Belong Ottawa at Centre 454 has a long history of offering compassionate care to the most vulnerable people in the city, but now on the frontline of the opioid crisis, that care can be a matter of life and death on a daily basis.
Operating from the basement of St. Albans church in downtown Ottawa, program manager Dean Dewar says the small staff of the Anglican Community Ministry is seeing increased rates of overdose and reverses an average of one overdose every day. Centre 454 is not a safe consumption site, and no one is allowed to use drugs on the premises, but they help deal with the effects of the drugs people use elsewhere.
Staff at 454 communicate with other downtown agencies to try to keep up with the everchanging toxic substances the drugs are laced with and to warn people who use drugs what they might encounter.
People who come to Centre 454 often struggle with homelessness, poverty, mental illness and addictions. They can access washrooms, showers and computers. They can wash their clothes and get help navigating the health care and social support systems, find connection and community.
Dewar joined Belong Ottawa in March 2023 in the midst of the opioid crisis. One of his first priorities was to get more training for the staff and refine their protocol for dealing with overdoses. Centre 454 staff now carry Naloxone kits with them at all times, which can reverse the effects of overdose with opioids such as fentanyl. Sometimes the drugs are laced with other substances, such as rat poison.
Centre 454 also increased the minimum number of staff from five to six, so that if an overdose happens, they can have a team of three to help while still having staff to manage the rest of the centre and participants.
The staff monitor people they have revived with Naloxone to make sure they are okay as well as people showing signs that they might be close to overdose. “If they were on the streets, someone would call 911 and they’d be brought to the hospital, just because they’re so unwell and the police officer doesn’t have the time to sit with them and make sure that they’re okay.” On a busy day, staff may monitor as many as 11 people.
The causes of the crisis aren’t all clear, but there has been a confluence of factors. The pandemic increased isolation for those who were already on the margins. The lack of affordable and supportive housing is a big part of the problem. The people who use Centre 454 are mainly accessing emergency shelters. “We also have a good chunk of people who are outside of the shelters, so living rough in tents, on grates at night, or who just walk around at night and sleep here during the day,” Dewar said. A small number are in rooming houses or couch surfing, and an even smaller number are housed. For those who receive money through the Ontario Disability Support Program, most of their payments go to covering rent, leaving very little for anything else.
Belong Ottawa’s executive director Rachel Robinson noted that the move in previous decades to close psychiatric hospitals in favour of housing people with serious mental illnesses in the community resulted in many people living on the streets. “At the time, everyone believed community care was the answer,” she said, acknowledging that there were very serious problems with the hospitals. Unfortunately, it is very expensive to give people the support they need in the community and in many cases, it doesn’t happen, she said. “Many people … don’t have the capacity to live independently, and there’s a shortage of supportive housing … so we’ve got a crisis downtown of … 200 people every night sleeping outside now.”
Meeting needs
These are complex problems with no easy fixes, so Centre 454, open seven days a week, copes and cares for the people they serve in the best ways they can.
During the pandemic, 454 started providing a regular meal program, which it never had before, and now serves lunch to about 120 people a day. It is currently prepared at Belong Ottawa at The Well and is delivered to 454.
Centre 454 began receiving increased food from the food bank during the pandemic, but when funding to the food bank was cut post-COVID, the amount of food distributed to day programs also had to be reduced.
Dewar is looking forward to the installation of new laundry machines. The old ones had been used all day, every day for about 10 years. The bathrooms and showers are also in high demand and show it. Small fixes like adding hooks for clothes and soap and shampoo dispensers add dignity to the experience, but Dewar hopes in the longer term to upgrade the bathrooms.
Another challenge is that the staff are not trained as health care workers, but their work can involve health care, mostly in the form of first aid. Collaboration and consultation with other agencies, such as the Sandy Hill and Somerset West Community Health Centres and Ottawa Inner City Health has helped 454 shape overdose protocols and deal with other health care challenges.
A nurse from the Sandy Hill Community Health Centre now visits Centre 454 weekly and does wound care, but even more importantly helps reconnect clients to health services, says Dewar.
Community relations
Not surprisingly, residents in the area have concerns. Among the neighbours, “there are fierce advocates for us, who love what we do and are there to support us,” said Dewar, but there are others who say there is an over-concentration of social services in the area and want service providers like Centre 454 to be moved elsewhere. Somewhere in the middle are people who have specific concerns that Centre 454 tries to address. If someone paints graffiti, the Centre cleans it off. A garden box in the courtyard of Centre 454 attracted rats, so they are removing it.
With help from the Sandy Hill Community Liaison Committee and the Sandy Hill Community Health Centre, Centre 454 got a grant for a team of one staff member and participants to clean up litter in the neighbourhood every day between 2 pm and 4 pm. “It’s just been phenomenal for community relations. Sometimes people offer them some muffins and a drink. Sometimes they just say thank you,” said Dewar. It may not change everyone’s view, but it helps to represent Centre 454 and its participants in a more positive light.
Belong Ottawa works closely with the Sandy Hill Community Health Centre and other community groups to liaise with neighbours, agencies and elected officials alike. They try to communicate that closing Centre 454 would not make the opioid crisis downtown go away and without the supports it provides to people, the situation would be more difficult. They hope to build support for the idea working together, it is possible to make a significant impact on the lives of those in need and contribute to the health and vitality of the community.
Making a difference
Dewar spoke about the rewarding moments of seeing the difference they can make in people’s lives. He recounted getting to know a man who confided that during the pandemic, he lost his business and then started gambling. When he knew he was going to be evicted, he took the last money out of his account, bought camping supplies and moved into some bush in the area. “He came to our services for the meals and the laundry and showers.” When asked if he was interested in work, he said, “Yes, but I just can’t find it. It looks bad when you are homeless.” Staff connected him with an employment help centre that helped him get a job at a restaurant. “He would come to the centre during the day and freshen up. We gave him a locker to store his belongings in, and then he would go to his job more presentable. … After his job, he’d go home to his tent, and we’d start the whole thing the next day. That worked so well that he got housing and a new job. He comes and volunteers every Wednesday just to say thank you.”
They have also helped people reconnect with their families and sometimes return home. “We’ve gotten some really great feedback from their families,” Dewar said.
When he asks staff what they think Centre 454’s greatest strength is they always say it is the rapport they build with participants. And when he asks them what keeps them coming to work every day, “Every single person has said the people. They tell different anecdotes of the participants. Sometimes it’s making someone laugh, sometimes it’s just being there with a person who’s not having a good day and being able to be their cheerleader a little bit.”
Qu’est-ce que le bonheur?