Quebec doesn't know how many homeless people die every year. Why some say that needs to change
B.C., city of Toronto, publish annual reports on deaths in homeless population
Frédérique Royer looked out her Montreal window on Sept. 8 and spotted a man lying motionless on the ground next to a park bench.
His skin looked purple.
"I saw right away that something was really wrong," said Royer, a resident of the city's Plateau neighbourhood. "I went outside quickly to get next to him and I called 911 right away."
An Urgences-santé ambulance arrived and Peter Harrison's death was confirmed almost instantly. The 61-year-old man appeared to have been homeless.
In the days following Harrison's death, Royer and others left flowers next to the bench at Yvonne-Maisonneuve Park.
"It's a really tragic situation," she said. "It's people that we bump into every day, yet they still remain invisible."
In many ways, the invisibility of homelessness in Quebec is apparent not just in life but in death as well.
Harrison is among several people who have died in Montreal in recent weeks who were believed to be experiencing homelessness.
Although some of those deaths were reported in the media, there's no real way of knowing how many homeless people — in either the province at large or the city of Montreal — die in any given year and why they're dying.
When homeless people die in Quebec, very little, if anything, gets done with that information.
Experts say that's a problem.
They say collecting that data and making it public would help shape policy and potentially save lives. They also say it's a question of dignity and respect.
"These are people," said Heather Johnston who, after four years as executive director, took on an advisory role last month at the Projet Autochtone du Québec (PAQ) shelter in downtown Montreal that serves an Indigenous clientele.
"These are people, human beings with families and people who love them and their lives were important and they had meaning."
The invisibility of homelessness
In 2018, Quebec conducted its first provincewide survey to determine the approximate size of its homeless population. The most recent data, released last month, does not include information about deaths within that group.
Just like tracking the number of homeless people, gathering accurate data on the deaths is a major challenge.
But to not even try to collect that information amounts to a huge missed opportunity, according to Caroline Leblanc, a PhD candidate in community health at Université de Sherbrooke's faculty of medicine. Her research focuses on the living conditions of homeless people who don't have access to shelters or other community resources.
"It would allow for better planning — the development of policies and also to adapt services by targeting specific problems related to homelessness — and avoid preventable deaths," said Leblanc, describing the value of data about deaths.
"It would help build our entire collective resiliency as a society."
Since 2012, British Columbia has published annual reports of deaths within the homeless population. The city of Toronto implemented its own system in 2017.
B.C. and Toronto's reports include details like the age, gender and cause of death.
In B.C., the data is based on information collected by the provincial coroners service. Coroners' investigations help identify people who may have been experiencing homelessness or have no fixed address. That means only deaths that meet the criteria of being investigated by a coroner are included in those reports.
In Toronto, the data comes from three primary sources:
- The city's shelter, support and housing administration (SSHA) division.
- An online form that individuals and organizations that assist homeless people can use to submit the names of people who have died.
- The Toronto Homeless Memorial, which is a grassroots initiative that pays tribute to unhoused people who have died.
Even if it is imperfect, the information from those reports is invaluable, according to Gordon Tanner, the general manager of Toronto's SSHA division, which manages the city's homelessness service system.
He said the data could sway Toronto Public Health to beef up mental health services if it notices a trend of people dying by suicide. It can also set up safe consumption sites within a shelter to prevent overdoses.
"The data really guides us and tells us how tragic this situation is and really reinforces the fact that people who experience homelessness are at far greater risk of death than the general population," said Tanner.
In 2022, Toronto recorded 187 deaths among people experiencing homelessness, which is lower than the 223 deaths recorded the previous year but higher than the annual totals from 2017 to 2020.
The latest available data for B.C. is from 2021. That year, the number of recorded deaths within the homeless population jumped to 247 from 141 the previous year, a 75 per cent jump.
In both B.C. and Toronto, drug overdoses were by far the leading cause of the reported deaths.
This type of data is not available for the city of Montreal or anywhere else in Quebec.
"We track it within our own organization," Johnston said, when asked about deaths among clients at the PAQ shelter.
"We know exactly how many people have died and when they died and how they died, but that information is really not shared outside of our organization because there's no mechanism or no body where we can share that."
Last month, several of the shelter's clients overdosed simultaneously. One of them, a 42-year-old woman, died.
Johnston said toxic drugs are clearly circulating more in the city, including among people who are homeless, but without clear data, it's almost like community organizations are "flying blind."
"I would suspect if they were collecting those deaths, they would see a significant increase in the rise of deaths from overdoses amongst the homeless population. But I don't think they know that [for sure]. It's all anecdotal," said Johnston.
'It's time': researcher
Dr. Stephen Hwang, a physician at the Unity Health Toronto hospital network who's done extensive research on mortality among people who are homeless, said gathering that data is not easy given the different ways and locations in which homeless people die, but it's necessary.
"You can't fix the problem if you don't know how big the problem is and you don't measure it," he said.
"Monitoring that is important to understand if we're making things better or not."
Both the BC Coroners Service and Toronto Public Health acknowledge that the annual death toll is likely higher than reported, given the imperfections of the process.
A spokesperson for Toronto Public Health said it is working on a reporting system for hospitals, which would help account for the many people who die while in care.
In an interview with CBC News, Josefina Blanco, the Montreal executive committee member in charge of social inclusion, said the city wants to get as much data as possible on the realities of people dealing with homelessness on the island.
But as far as gathering data specifically about deaths, Blanco said that's up to the Quebec Health Ministry.
A spokesperson for that ministry said the province does not have any data on deaths in the homeless population and did not specify if it plans to put in place a system similar to the ones in Toronto or B.C.
After reaching out to the office of Lionel Carmant, the minister responsible for social services, CBC News was referred to other ministries like Public Security — which oversees the coroner's office — and Labour which includes the Directeur de l'état civil. That's the agency that registers marriages, births and deaths in the province.
The Directeur de l'état civil doesn't have statistics related to the "categorization of persons," said Jonathan Gaudreault, a Labour Ministry spokesperson. Gaudreault suggested contacting the provincial statistics agency, l'Institut de la statistique du Québec. A staff member there said the institute also doesn't have that information.
The cause of death for Peter Harrison, the 61-year-old man who died last month in the Plateau, is still unknown. The Quebec coroner's office is investigating.
With no data collection system in place for homeless deaths in Quebec, the coroner's findings, when published, are unlikely to contribute anything when it comes to understanding the plight of homelessness.
"We collect data regarding socioeconomic indicators, we collect data on the deaths of cyclists and pedestrians," said Leblanc, the PhD candidate at Université de Sherbrooke.
"It'd be nice to reflect and understand the reasons why in 2023, we don't have solid numbers on the number of homeless people who die," said Leblanc.
"One thing I do know is that it's time."
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With files from Paula Dayan-Perez