Abstract
Exclusionary policing has been a strong, enduring trend for responding to the presence of marginalised groups in public spaces of Western cities – at times so dominant that it overshadows the existence of alternative rationalities such as public health and social justice. Are such alternatives simply powerless? Are they mere auxiliaries of exclusive strategies? In Montreal, public order, public health and social justice have been embodied by a variety of stakeholders and strategies, thereby offering the chance to explore the intercourse between the three rationalities in a situated way. While public health and social justice have long supported each other, relationships with public order have often presented conflict. The case of Montreal, however, also reflects some shifts towards balanced collaboration under certain circumstances that will be scrutinised.
Introduction
In Western countries, signs have long been used to inform passers-by of which behaviours are and are not acceptable according to the law; traffic law is an overarching example. Infringing behaviours are regarded as dangerous and harmful to the physical safety of fellow users of public spaces. Over the last two decades, another type of sign has developed within Western city landscapes, prohibiting acts that are deemed potentially bothersome or annoying to fellow users of public spaces, including residents, shopkeepers and so on. To a large extent powered by recent regulations on public nuisance or anti-social behaviour (Squires, 2008; Millie, 2009), these signs are commonplace in the United Kingdom and in North America, and to a lesser degree, in continental Europe (Van Stokkom, 2011).
Public nuisance has gradually become a term of common judgement made about certain behaviours that leads to the punishment of perpetrators in the name of public order. As projected by a fairly large body of literature, marginalised sections of society – young people on the street, older homeless people and undocumented migrants – have been greatly affected by this trend, and the criminalisation of behaviour has become a tactic for responding to the presence of marginalised groups in public spaces (Beckett and Western, 2001; Nemeth, 2006; Squires, 2008). While I acknowledge the relevance of highlighting a punitive and/or evicting trend in the way marginalised users of public spaces are handled, I am willing to address situations where public order is not the only rationality at stake. Others have argued that there are a variety of situations across the Western countries, some featuring alternative responses (Kübler and Wälti, 2001; Huey, 2007; Johnsen and Fitzpatrick, 2010). What happens when different responses are carried out simultaneously? A co-occurrence of punitive and alternative responses might not be peaceful and harmonious. Gaining insight into the hybrid situations clarifies the anatomy and the conditions of a potential balance between the various rationalities.
Downtown Montreal is a good illustration of the co-occurrence of various rationalities. There, just as in many other North American gentrified or gentrifying areas, the presence of homeless people is commonly discussed in terms of a nuisance. In turn, this perspective guides the responses of the local police and other stakeholders, such as the Municipality of Montreal and local corporate businesses (Bellot et al., 2005; Sylvestre, 2010a). However, the paths of homeless people engage and converge not only with law enforcement agencies but also with advocacy groups and (social and health) care providers whose assignments fall under public health and/or social justice, rather than public order. The trio of public order, public health and social justice somewhat recalls Wacquant’s three ‘strategies to treat the conditions and conducts that [contemporary societies] deem undesirable, offensive, or threatening’: socialisation, medicalisation and penalisation (2009: xxi). Framing this trio is productive for it provides avenues for taking nuisance governance analysis beyond the opposition between ‘exclusive’ and ‘inclusive’ (or, ‘social’) strategies. As a matter of fact, the notion of inclusion is of little help when depicting certain interventions such as those aimed at recovery. Yet, are health-related interventions towards the homeless a mere ‘conduit to criminalisation at the bottom of the class structure as it introduces a logic of individual treatment’ as suggested by Wacquant (2009: xxi)? The case of Montreal may suggest the opposite, as public health and social justice have been intertwined for a long time and, over the last decades, the relationships with those in charge of public order have been far from peaceful. Nevertheless, as argued further on in this article, several configurations may apply, depending on the circumstances that will be scrutinised.
I will use a collection of sociological observations and conversations in Montreal’s scene over the last 8 years to further frame my trio and discuss the extent to which it matches Wacquant’s. I will therefore bridge a conceptual outlining of the rationalities and a sketching of their translation into daily practices and interactions involving professionals, volunteers, homeless people and ‘ordinary’ citizens in Downtown Montreal. I will then show that Montreal’s trio should also be viewed as a triad – in which three units/items are not only simultaneously present but also connected. There are indeed connections between the three rationalities through the ways they are embodied in practices/actor behaviour, but the triad is, in turn, conflicted and collaborative. However, rather than inexorably heading towards (increased) penalisation, I would like to suggest a conditional balance, which is interesting to discuss alongside Bauman’s proposition regarding ‘the administration of strangers’ in the post/late modern era (1995: 180):
Rules of admission are effective only in as far as they are complemented by the sanctions of expulsion, banishment, cashiering, blackballing, sending down – but the latter series may inspire conformity only as long as the hope of admission is kept alive.
Situating three rationalities: Public order, public health and social justice
Public order
The presence of deprived people in cities has long been experienced as a threat to public safety (Chambliss, 1964; Foucault, 1975). However, over the past few decades, the ‘crime’ category has been significantly extended. Next to ‘danger’, ‘disorder’ has come to the fore, as a result of the popularity of the ‘broken window theory’. The premise that minor forms of deviance such as vandalism are likely to lead to serious forms of offence has resulted in the very idea that nuisance should be dealt with as a predictor of serious criminal activity. Although the broken window theory was highly debated among scholars (Harcourt, 2001), it has been very influential in current policy aimed at eradicating crime in Western countries (Millie, 2009). Besides the firmer implementation of existing laws, new legal provisions were enacted in some countries, resulting in the criminalisation of previously tolerated markings (such as graffiti or broken glass) and acts (such as loitering, pan-handling and street drinking). The English Crime and Disorder Act, which passed in 1998 − providing a legal definition of anti-social behaviour and introducing the Anti-Social Behaviour Order (ASBO) – is probably the most noted (Crawford, 2008; Millie, 2009). Throughout the 1990s, a number of continental European cities passed municipal ordinances in order to prohibit street begging (Wacquant, 1999). In Canada, the Province of Ontario passed the Safe Streets Act in 1999, followed by British Columbia, in 2004. This way, ‘solicitation in an aggressive manner’ became a penal offence, thereby criminalising the practices of pan-handling and squeegeeing (O’Grady et al., 2011: 28; Mopas, 2005).
The city of Montreal (within the province of Quebec) approaches nuisance policing somewhat differently. Rather than relying on new penal legislation that targets anti-social behaviour, since 1997, nuisance policing has been chiefly grounded in existing municipal and provincial legal provisions that are associated with some moves in policing strategy and organisation. These concern loitering, public drinking, squeegeeing, rough-sleeping, solicitation, and presence in public parks beyond opening times (Bellot et al., 2005). The local police authority prioritised a number of anti-social acts through setting a list of 34 calling codes regarding noise, disturbing behaviour, drug trafficking, driver misconduct, social disorder, vandalism, environmental nuisance and automobile obstruction, thereby endeavouring to improve strategies for handling incoming phone calls and facilitating accountability (Sylvestre, 2010a: 809). Meanwhile, the patrolling police presence in selected ‘hot spots’ increased, even more so in downtown areas.
In Montreal, nuisance policing was justified by the necessity to contribute to the quality of life of citizens (Parazelli, 2002; Charest, 2003; Sylvestre, 2010b). However, such changes in policing have largely coincided with local plans to revitalise inner city areas, earning them popularity among tax-paying residents and tourists (Van Criekingen and Decroly, 2003). This corresponds with the shrinking possibilities for affordable housing in downtown areas (Smith, 1996; Gaudreau, 2005). Just as in other North American cities, Downtown Montreal went through a steady trend in developing indoor urban space, for example inside supermalls that connected to office centres and metro stations through subterranean concourses. In these spaces, which still are most popular during the long cold season, the presence of undesirable users of public space is easily ruled out as depicted by Davis (1990) and Graham and Marvin (2001). However, this did not eradicate the people of Montreal’s taste for fresh air as soon as spring comes into view. In spite of the enduring popularity of indoor public space, Downtown Montreal is now experiencing a rediscovery of a number of traditional streets, in which both urban design and a busy performing arts festival agenda are meant to make these streets attractive to a wide range of pedestrians. Although creating different spaces, these two trends are converging towards making the presence of the homeless problematic. While the first trend tends to expel them from easily ‘defensible’ spaces, the second trend is likely to bring about conflictual interactions involving the homeless, possibly ending in expelling them through nuisance policing.
Over the last few years, nuisance policing has recorded some considerable outcomes in Montreal, most notably an upward trend in judicial suits against the homeless (Bellot et al., 2005; Bellot and Sylvestre, 2012). 1 Badly regarded behaviours are to be banned. Yet, since the latter often relate to survival strategies – e.g. pan-handling and squeegeeing 2 – banning the behaviours may entail banning the perpetrators. The latter are either expelled and no longer welcome in the places in which they chose to earn a living and/or socialise or neutralised and sent behind bars. By treating the presence of homeless people in public spaces as an issue of public order, nuisance policing contributes to the invisibilisation of social problems, in line with Wacquant’s (2009) understanding of penalisation. Yet, this is not all about how homelessness is handled in Montreal.
Public health
Many homeless people also encounter people who have another commitment, which pertains to health care. It is inevitable for the very precarious living conditions of street life to become conducive to physical health problems, which relate to lack of sleep, poor diet and hygiene, and in many cases, experiences of violence (Roy and Hurtubise, 2010). Regardless of whether these behaviours are viewed as reasons to become homeless or as coping strategies for the stresses associated with street life, they are likely to have detrimental effects on the physical health of homeless people. Additionally, Montreal’s particular weather conditions (very cold and long winters and very hot summers) need to be considered. Mental illness is another issue to consider, and it is debated whether there is an above average percentage of homeless people who face mental health problems (Poirier, 2007). In any case, it is possible that street life has a detrimental impact on mental health. It is typical for homeless people to delay visits to practitioners, leading to more serious health problems. It is common for homeless patients in very poor condition to be admitted to Downtown Montreal’s hospitals. Regular community health care facilities (CLSC) are also accustomed to homeless clients. In line with a general commitment of Quebec’s public health network to respond to special needs of certain sections of the population with regard to access to care provision (MSSS, 2004), local public health authorities have been developing tailor-made services for homeless people such as équipe itinérance 3 and clinique des jeunes de la rue. 4
Alongside low-threshold services, since the 1990s, some agencies have set up a number of on-site outreach programmes that intend to commission workers (be they ‘professional’ social workers or peer-workers) to approach target groups in the public space where the homeless live and to provide aid by increasing accessibility to health care. This approach is in line with the long tradition of ‘kerbstone counselling’, also known as street corner work (Keays, 2009). This works hand in hand with pre-existing targeted prevention measures aimed at marginalised groups such as street youth and with regards to a number of diseases (Roy et al., 2007). Also, since 1989, local public health agencies have set up targeted harm reduction strategies like needle-exchange programmes. 5
Overall, health care professionals attempt to enhance the condition of the marginalised groups and reduce risks commonly linked to certain health issues, for example substance use; risks are considered for substance users as well as fellow users of the public space. Does this illustrate a trend towards the medicalisation of homelessness, as foreseen by Wacquant, with ‘medicalisation’ defined as: ‘relying on an understanding of homelessness as a health issue (addiction or deficiency)’ and thus ‘search[ing] for a medical remedy to a problem that is defined from the outset as an individual pathology liable to be treated by health professionals’ (2009: xxi)? Montreal’s health professionals’ focus remains primarily on the condition of the homeless people, which aligns with their professional mandate/assignment and a formal responsibility and accountability for the improvement of health. Recovery is viewed as a primary target. Yet, is the aim of ‘recovery’ only about handling individual pathology? In the case of homelessness, this view might induce a denial of structural causes like poverty, social inequality and social security arrangements. Such a trend, highlighted in the USA (Conrad, 1992; Mathieu, 1993), is also perceptible in Quebec (Lecomte, 1989; Poirier, 2007). However, treating the health-related consequences of precariousness does not entail a negation of structural determinants of health. Recovery is the ultimate goal of health professionals – notably those committed to mental health – but the term may be understood in various ways: it implies the reduction or control of symptoms (medical model); it also refers to the support that patients receive to regain control of their lives, as a process rather than a result (psychological model); and it is support for patients in gaining their independence and their citizenship (social model) (Plante, 2012: 73; Gelinas, 2007). While a large part of Montreal’s health care practice pertains to the improvement of the physical and/or mental condition of patients in the short term – notably in hospital facilities – some of it considers the long-term impact, regarding patients as human beings and not just in terms of their bodies.
This sort of consideration is often seen in the low-threshold facilities provided by the public sector. This follows from a commitment to the social determinants of health within public health authorities, further to the WHO Ottawa Charter for Health Promotion (1986), which is also in some local projects run by non-governmental organisations such as Médecins du Monde. This can be seen in some outreach health services carried out in Downtown Montreal. While some programmes primarily aim to pull marginalised groups back to regular support agencies, others critically question their reluctance to engage with support programmes and explore avenues for delivering alternative services and support (Duval and Fontaine, 2000). Thus, there is an ongoing medicalisation of social problems, but the related responses are guided by divergent understandings of recovery, some of which are compatible with an idea of social justice.
Social justice
There are other resources that homeless people are also likely to come across that do not fit into the public order or health categories. Instead, these are aimed at general improvements to the living conditions of the most disadvantaged sections of society. This might be through providing: food/catering services, shower and laundry facilities, rest areas, temporary shelter or semi-permanent housing, legal advice, counselling, guidance towards regular paid work or additional professional training or more broadly, through a wide range of organisations that attempt to give homeless people a chance to escape marginality and exclusion by opening up avenues towards inclusion in mainstream society, or in Bauman’s terms (1995: 180): admission. Just like those in many other large cities across North America, Montreal’s charities have a long history: Accueil Bonneau started as early as 1877, providing support to people in need. In 1972, concerns for the needs of alcoholic users of shelters led to the development of additional care provision. Meanwhile, the resurgence of absolute poverty in metropolitan areas in the 1980s brought about further developments in existing organisations and gave rise to a number of new initiatives on the side of private, non-profit organisations such as Le Bon Dieu dans la Rue (1988). Numerous charities and advocacy groups are willing to address the presence of marginalised groups in the urban public space and follow an inclusive model with attempts to reverse marginalisation processes when they are not choice-based. Such an inclusive path has been designed with a predominantly top-down dynamic. However, a number of Montreal’s resources rely on self-help or peer work, inviting homeless people to take part and play an active role in leadership (Baillergeau, 2006).
For the sake of simplicity, this third rationality is labelled social justice, understood as a commitment to the improvement of the well-being of the most disadvantaged sections of society (Wolff, 2008). Just as in the academic literature about social justice, in the field the sources of disadvantage are under discussion and may vary from one care provider to another, as do the ways for their eradication, which range from (targeted) resource enhancement to status enhancement. Among Montreal’s social justice agencies, homelessness is commonly acknowledged as a complex issue, originating in the housing crisis and the resurgence of absolute poverty since the 1980s, a lack of affordable housing, high housing costs (with the risk of homelessness designated by greater than 50% of income being spent on housing). Moreover, all of these factors are complicated by rising intolerance, fears of crime and distrust among citizens, the criminalisation of some uses of public spaces and negative discrimination within public service agencies in general and health services in particular. Among Montreal’s social justice agencies, there is an overall commitment to status enhancement through impacting the structural causes of homelessness, as reflected in the aims of RAPSIM, 6 a platform of 95 agencies dedicated to the care of the homeless. RAPSIM’s aim intends to be comprehensive: analysing and responding to needs, raising awareness, and more broadly, remaining committed to the fight against social and economic exclusion. 7
In that sense, the social justice rationality is heading towards Wacquant’s understanding of the ‘socialisation’ of the poor: ‘acting at the level of the collective structures and mechanisms that produce and reproduce them’ (2009: xxi). Beyond goals, what about achievements? It has commonly been argued that structural causes of homelessness such as unemployment are hard to solve, especially in an era of shrinking public expenditures on social policy. Moreover, in the case of Montreal, the relentless struggles in favour of affordable housing have met persistent resistance from both governmental bodies and corporate real estate agencies (Gaudreau, 2005; Cantin et al., 2008). However, to claim that Montreal’s social justice agencies only respond to individual needs would be a fallacy. Our qualitative research on the contribution of social justice agencies that deal with homeless people in Montreal revealed that most of the operating logics appear to be primarily individual based, while they often offer a range of responses that extend beyond personal needs (Baillergeau et al., 2009). 8 For instance, by encouraging social participation, they reinforce self-esteem, but this also potentially contributes to a commitment to advocacy/enlargement of the rights of marginalised groups. Peer work and self-help are also carried out at advocacy groups or social service agencies. Similarly, favouring peaceful cohabitation in public spaces could be seen to encourage homeless people to adapt to ‘acceptable behaviour’ but also to engage with fellow users of public spaces, perhaps prompting dialogue with marginalised groups and changing their opinions about one another and ultimately reducing humiliating interactions and relieving them of a noted obstacle to status enhancement. Notably, this happens through used needle collection campaigns and the yearly Festival des Arts de la Rue. Such an understanding of social justice is probably not as ambitious as Wacquant’s socialisation in terms of general social change. Notwithstanding, social change at the micro and the meso level is obvious in both the strategies and achievements of the agencies with goals that extend beyond immediate responses, individual needs and mitigating personal shortcomings and the proximate causes of homelessness, such as disruptive family backgrounds.
Contrary to the public order line, the social justice line – just as the public health line – is not focusing on nuisance, but on homelessness, regarding nuisance as an unfortunate consequence of large numbers of people being forced to resort to living in public spaces. Working on the causes of homelessness should, in turn, reduce nuisance, whether it is conceptualised in an objective or subjective order. Both rationalities also share an optimistic view that is fuelled by hope for a way out of marginality through opening doors that lead to the (re)gaining of dignity and respect. In contrast, the exclusionary line can be viewed as pessimistic with regards to the prospects of homeless people (Beckett and Western, 2001).
At this point, I have sketched three rationalities that are coherent but have a degree of inward variation. The rationalities are embodied by sets of stakeholders conducting various strategies towards specific purposes. Some stakeholders happen to be ambivalent, notably the Municipality of Montreal (Charest, 2003). Whilst actively supporting upward population change in Downtown Montreal in the 1980s, the Municipality got involved in the care of the homeless, through the creation of Dernier Recours Montreal. This platform aimed at enhancing the accessibility of temporary housing facilities and related services. This project reflects a clear acknowledgement of the structural causes of homelessness such as insufficient income, job loss, low job prospects and urban changes that are detrimental to housing and services for low income groups – beyond behavioural factors and mental health issues (Lecomte, 1989: 23) – and an explicit ambition to impact the structural factors through support for the development of dedicated resources and the expansion of scientific knowledge about homelessness (Fournier and Mercier, 1989). In the early 1990s, the Municipality was carrying out housing projects that targeted former homeless people (Gaudreau, 2005). However, in the second half of the 1990s, the line followed by the Municipality was often confusing, never explicitly disapproving of repressive policing towards homeless youth, whilst encouraging and supporting tailored homeless care, not the least through local health agencies (Charest, 2003). Overall, the responses engaged by the Municipality in governing the presence of homeless people appear to follow multiple rationalities. Yet, all fit into the trio of public order, public health and social justice. As I will show, the Municipality is not the only stakeholder to apparently follow multiple rationalities or change over a short period of time.
The conflictual triad
The three rationalities introduced above are not contradictory per se. Getting homeless youth off the street does not always hinder social justice. It can be achieved by offering them fair chances for education or work and by providing them with decent housing in a respectful manner. In fact, zero tolerance ingredients have been purposefully included in joined-up approaches to public safety such as community safety programmes (Hughes et al., 2002). However, a number of interactions contribute to mutual hindrance. In Montreal, the three rationalities – and the agencies embodying them – do interact a lot, notably public health and social justice. While the relationships between these two have been mainly supportive, interactions involving public order have often been conflictual over the past decades.
Conceptually outlining public health and social justice policy has proven much easier than determining which of Montreal’s agencies embody particular rationalities, as opposed to the others. As a matter of fact, public health and social services have long been associated at the provincial level (merged under the auspices of the Ministry of Health and Social Service, the largest provincial body in Quebec, with the most important budget) as well as the local level, leading health workers and social workers to often act jointly. At the grass-roots level, in the long run, collaboration entails being aware of each other’s professional duties and skills. Through these instances, homelessness has long been addressed as both a social and a health issue that requires attention to be paid to the underlying social and economic processes. Local public health organisations have also collaborated with private, non-profit organisations, providing health-related outreach services in their drop-in facilities. Interventions targeting recovery aim for admission.
Collaboration is regarded as supportive. However, there is endless discussion at various levels (academic, practice, management) about whether or not interventions that target marginalised groups impact the social determinants of health beyond recovery in the narrow sense, according to their ambitions. Particularly, Colombo (2003) criticised the line followed by public health agencies for not respecting the opinions and expectations of homeless youth regarding social inclusion.
It is possible that public health has not achieved its intended, far-reaching impact on the determinants of homelessness. Nevertheless, conflicts with social justice are rather minor, especially when compared to the exclusionary practices following from nuisance policing. Nuisance policing has been an obstacle for numerous attempts to respond to the situation of homeless people along a health and/or social justice rationality. Conflicts between policing and social justice have long been notorious, as reflected by conflicting welfare and criminal justice discourses on the nature of homelessness (Wardhaugh, 2000:33; Bellot et al., 2005:16). Suspicion towards marginalised groups eventually leads to more difficulties for inclusive projects. Since the 1990s, residents’ organisations’ claims in favour of policing that focuses on evicting homeless people (Charest, 2003; Sylvestre, 2010b) have affected health-related projects, as well as shelter provisions and soup kitchens (although never as influential as in some US cities – Mitchell and Heynen, 2009) and the expansion of public housing/affordable housing (Gaudreau, 2005). In fact, NIMBY protests hindered the location or relocation of health-related projects such as needle-exchange programmes (CACTUS, 2005). Furthermore, nuisance policing negatively impacted the accessibility of these programmes among target groups (INSPQ, 2013).
In addition, the criminalisation of deviant behaviour runs parallel with informal stigmatisation processes. The enforcement of zero tolerance policing empowers mainstream society’s beliefs about drug addiction, poverty and prostitution and may trigger a self-fulfilling prophecy (Sylvestre, 2010b). North American society tends to blame homeless people for the difficult situation they are in as opposed to people facing developmental disabilities, for example (Phelan et al., 1997). The criminalisation of light deviant behaviour such as ‘nuisance’ makes it not only socially deviant but also legally forbidden, leading marginalised groups to face humiliating interactions with authorities (such as the police) but also with ordinary strangers on the street. This holds particularly true for homeless youth involved in highly visible survival strategies such as begging/pan-handling (Kidd, 2007) or squeegeeing (Charest, 2003). In turn, such humiliating interactions may result in a strengthened internalisation of the underlying beliefs held by marginalised groups such as homeless youth (Kidd, 2007). Our own research among the target groups of outreach programmes in Montreal also shows that the self-esteem of marginalised groups is negatively affected by the fact that they are perceived as a ‘nuisance’, which contributes to the discomfort and stress of marginalised people, regardless of whether they are involved in serious forms of criminal activity. In turn, low self-esteem can further their marginalisation and withdrawal from mainstream society in general and public space in particular.
Besides, some marginalised groups become reluctant to enrol in either governmental or non-governmental programmes aimed at enhancing their health conditions and/or well-being in spite of their eligibility, unless specific attempts are made to approach them in their living environment. Turning disorder and nuisance into crime not only fostered suspicion among mainstream society towards marginalised groups, but it also fostered suspicion among marginalised groups towards mainstream society and, more specifically, aid agencies that might be perceived to be connected to repressive powers. In part, this has resulted in some marginalised groups’ reluctance to engage in governmental or non-governmental programmes that could be beneficial, possibly resulting in further deterioration of their own conditions and possibly leading to the contamination of other people. Among highly vulnerable homeless people such as runaway minors, withdrawal from public space in favour of squat locations has been observed. Additionally, because of the criminalisation of visible survival strategies such as pan-handling and squeegeeing, some homeless youth have tended towards less visible but also more harmful survival strategies including drug dealing and sex work (in a rather similar fashion as depicted by Kidd, 2007). Not only has policing made these vulnerable groups harder to reach, but such evicting policing has turned out to be conducive to more serious issues, in terms of both health conditions and social marginality, thereby jeopardising the work of supporting agencies.
The collaborating triad
Nonetheless, deliberate collaboration is far from rare. In the United States, police units and health agencies have collaborated within Crisis Intervention Teams (CIT) since 1987. In Montreal, police officers have been admitted into some drop-in centres 9 to search for suspects but also when they were called by social professionals/volunteers to help with difficult cases (Lecomte, 1989). Alongside these ad hoc arrangements, starting in the 1990s, police authorities have been involved in inter-institutional agreements regarding the situation of homeless people facing mental health issues and involved in recurrent police contacts (Laberge et al., 1995). When exclusionary measures have proven insufficient, non-penal solutions were sought for these cases. In line with such bottleneck-led collaboration, a recent case of inter-agency collaboration serves as an illustration of the possibility of a more balanced response to the presence of homeless people involved in cases of public nuisance.
In 2009, the Montreal municipal police authority invited an external partnership with the local Agency for Health and Social Service (CSSS Jeanne-Mance) in order to set up a ‘hybrid mobile team aimed at referral and intervention in the matter of homelessness’ (locally known as the EMRII team). 10 As such, the EMRII team is quite an outstanding response to the persistent presence of homeless people who are causing frequent police intervention, but it is not the only one. Joint collaborative interventions – such as hybrid teams – have developed elsewhere across the Western world. 11 As the first hybrid team to join forces between police and health services in Quebec, the EMRII team consists of five police officers from the municipal police and four front-line professionals from the local authority for health and social service. The official assignment of the EMRII team is to reach out to people facing homelessness (or likely to) who frequently encounter the police and are seen as having/bearing vulnerability factors. The aims are to guide them towards appropriate services to improve their living conditions and to foster (re)inclusion into mainstream society. Service users are persons experiencing chronic homelessness, co-morbidity (combining several vulnerability factors) and/or a revolving door problem (short-term but repeated take-up of service/care), coupled with repeated contact with the police, chiefly associated with precarious living conditions and a combination of problems they have faced. The guidance is linked to case follow-up until the point of recovery/rehabilitation or at least the establishment of a solid connection with a relevant care provider. 12 Regular, patrolling police officers refer cases to the EMRII team based on the criteria of frequent interventions or frequent reports of nuisance. Once on the case, the hybrid team has substantial input with regards to both case assessment (on the basis of both police records and health care system records) and an appropriate approach.
Over the last three years, the EMRII team has provided intensive case follow-up for 95 people, out of which 30 files are now closed (including 24 securely referred to relevant resources). Another 150 people got direct or indirect support for referral, secured transfer to relevant services or undertook mediation with the regular patrolling police. Through daily collaboration, time and space have been secured for thorough assessment and discussion of difficult cases and for attempts to handle them in a way that takes into consideration both the protection of the public and the well-being of the homeless, suggesting a rather stable balance between public order, public health and social justice.
What circumstances allow such a balance? There are a few, with the first to be found at the institutional level. The starting point of the collaboration is a bottleneck on the side of the police: the persistent presence of homeless people involved in nuisance issues led the local police authority to seek assistance from partners such as the public health agencies. This enabled the latter to collaborate without submitting to the exclusionary nuisance management. A good illustration of this is the operational protocols that are set with regard to clients’ personal data. Elsewhere some social workers have had to share data with the police regardless of the likely impact this would have on trust relations with their clients (Stickley et al., 2005), while here, personal information is contained within front-line team case discussions. The relative balance does not only rely on the expertise and power of overhead institutional stakeholders. At the grass-roots level, inter-agency negotiation also plays an important role. It is up to the front-line professionals to make decisions about the approach towards each client. This implies a high degree of professional expertise on all sides of the team as well as a high degree of awareness of the institutional challenges on both sides.
What are the outcomes of the thorough assessment of cases with respect to the three rationalities discussed earlier? Where is the collaboration heading? On the basis of analysing the combined assessment of cases, a collection of scenarios could be highlighted, depending on whether or not the clients are regarded as dangerous on the one hand and whether or not they are regarded as vulnerable, on the other hand.
In most cases, clients were assessed as ‘vulnerable’ as a result of mental health issues, addiction, physical health issues or loss of autonomy. The follow-up strategy was therefore aimed at guiding the client towards recovery and rehabilitation. The point was to handle the nuisance cases by avoiding judicial proceedings as much as possible. When a legal issue is at stake, recommendations are made in favour of alternatives to incarceration, particularly in cases that are deemed ‘highly vulnerable’. For such cases, the collaborating professionals advocate for protective measures by raising awareness about the situation of the client. However, in some cases of vulnerability combined with a high degree of dangerousness, either for the person him/herself of for fellow users of public spaces, the collaboration tends towards neutralisation for safety reasons, through either incarceration or institutionalisation at a health care provider. In such cases of actively favoured neutralisation, there is still the ambition to provide case follow-up to ensure the client gets the care needed (psychiatric assessment; therapeutic treatment offered and so on). Neutralisation is thus meant to be transient. The prospect of recovery in the long term is considered, and the hope of admission is not excluded. That is not the only scenario in which neutralisation is advocated. In some cases, vulnerability is assessed as low (no serious mental health issues nor physical or cognitive health issues), but disturbance of public order is regarded as high. The collaboration would encourage judicial proceedings, sometimes more than the patrolling police would normally do, when alternatives have been tried and have failed.
This intention is to avoid judicial proceedings in most cases, thereby directing collaboration away from an exclusionary regime. However, this is not always the case when vulnerability is regarded as low, judicial proceedings may even be encouraged and backed by professional statements from the EMRII team. The point is that judicial proceedings should be beneficial to the long-term recovery of the patient, in line with the idea of coercive care, such as described by Johnsen and Fitzpatrick (2010). 13 Allowing health/social professionals to have, eventually, a proper talk with a drug-addicted client who is forced into abstinence because of detention for a few weeks is arguably an appealing start for professionals willing to set up and discuss a plan of action. However, one may wonder about the follow-up offered in the long run, especially in light of a temporarily funded inter-agency collaboration. In the case of a sudden budget cut, the client is left in detention with no more professional support, and thus with low prospects for long-term recovery or (re)inclusion. This bends the underlying collaboration towards Wacquant’s understanding of medicalisation, supporting penalisation, as neutralisation is not incorporated with active support powered by an inclusionary purpose in the long run.
In settings where cases are thoroughly discussed, inter-agency collaboration may mitigate mutual misunderstandings that are detrimental to long-term recovery and admission, resulting in some alternative patterns of nuisance governance. However, such collaboration does not always avoid eviction/neutralisation, with the latter being actively favoured in some cases. All in all, the assessment of dangerousness is critical, as is the framing of nuisance, particularly when what is heard as nuisance occurs within survival strategies and/or the fulfilment of the basic needs of people who are in highly vulnerable situations. When ‘nuisance’ is taken from the perspective of patrolling police officers (police intervention or calls of a complaining party, hence one-sided), it is critical that the definition of nuisance is debated through inter-professional front-line discussions, based on assessment criteria rooted in various professional cultures. If not, public health and social justice agencies could become mere auxiliaries of exclusionary strategies, not only in the long term, but also in the short term.
The meaning of recovery is also critical. Coercive care for the sake of recovery in the narrow sense may turn out to be vulnerable to punitiveness. Non-punitive inter-agency collaboration goes together with the taking of recovery further than the mere reduction or control of symptoms, and towards supporting homeless people to regain control of their lives or, even, to (re)gain their citizenship, as bearers of both duties and rights, worthy of being admitted.
Conclusion: A conditional balance
The exclusive use of nuisance governance has proven dominant in many places across the Western world over the past decades. However, in some cities such as Montreal, different responses are carried out simultaneously, involving a range of agencies such as the police, public health authorities and social justice organisations. Interaction at the margins of agencies can be conducive to potential progress towards tackling cases of nuisance by mitigating causes of homelessness beyond personal and behavioural factors. Such openings rely on a number of elements that are to be scrutinised at all times. In Montreal, the role of public health authorities as a key player must be noted, as over the last few decades, they have been strong enough to ‘face’ exclusionary strategies and negotiate conditions – unlike in many other places in North America, not the least many US cities, where the means of public health agencies are dramatically limited. However, the openings are not immune to recurrent threats, such as a narrowing understanding of recovery or the overlooked fact that nuisance is partly a social construct, notably disgust-fed nuisance, and a conflicted situation in which searching for a way out should not leave out the view of any of the parties involved.
Regarding the ways to handle strangers in the post/late modern era, Bauman outlined a conditional balance in which the control of social space relies on the co-occurrence of both inclusivist and exclusivist strategies. Likewise, the case of Montreal displays, rather than a one-sided, stable configuration, a dynamic power relationship, existing between a variety of interests that are in turn competing with and hindering each other or negotiating and supporting each other. At times, exclusionary methods are regarded as tools for an alternative, inclusionary purpose, and at others they are viewed the other way around. No balance is to be taken for granted when it comes to nuisance governance.
The hope of admission is a critical ingredient in the balance. Hope of admission ranks very low among many homeless people across the Western world, particularly in a context of exclusivist policing supported by local corporate business and fellow users of public spaces. Social justice agencies – at times backed by public health agencies – struggle in order to revive hope, be they – themselves – fuelled with such hope of admission, for either the short term or the long term.
Footnotes
Acknowledgements
I am deeply grateful to a few colleagues involved in the various research projects carried out in Montreal: Céline Bellot, Christopher McAll, Roch Hurtubise, Myriam Thirot, Marta Llobet, Marie-Claude Rose and Dorieke Wewerinke. Conclusions and possible mistakes are mine alone. I thank Jan Willem Duyvendak and three anonymous reviewers for their valuable comments and suggestions on earlier drafts.
Funding
This article is based on a collection of research works for which grants were received from a number of governmental agencies: Fonds de recherche du Québec – Société et culture (QC, Canada); Plan Urbanisme Construction Architecture (France); Centre de Santé et de Services Sociaux Jeanne-Mance (Montreal, QC, Canada); and the Police Authority of Montreal (QC, Canada).