Housing first makes better use of public dollars—especially for those who are high service users
In 2008 the federal government invested $110 million for a five year demonstration project aimed at providing evidence about what services and systems best help people experiencing serious mental illness and homelessness. The Mental Health Commission of Canada’s At Home/Chez Soi project was established as a field trial of complex interventions in Vancouver, Winnipeg, Toronto, Montreal, and Moncton. The rigorous, multi-site, experimental research design of the At Home/Chez Soi project was expected to help identify what works, at what cost, for whom, and in which environments. It compared “Housing First” approaches with existing approaches in each of the five cities. For the first time in a trial, it included a standardized definition of Housing First and used assessments to document the quality of the implementation of the program over its first two years.
Each of the five cities involved in At Home/Chez Soi targeted specific individuals who were experiencing homelessness: in Moncton, people in a rapidly growing city with a shortage of mental health services, with a focus on the rural population; in Montreal, outcomes for people related to vocational interventions; in Toronto, people from different ethno-racial backgrounds; in Winnipeg, urban Aboriginal people; and in Vancouver, people who also have substance use issues.
An interim research report [opens to PDF] was released in late 2012, which describes some of the research findings based on selected one-year outcomes of the participants in the project. It revealed that: (1) Housing First improves the lives of those who are homeless and have a mental illness; (2) Housing First makes better use of public dollars-especially for those who are high service users; (3) Housing First can be implemented across Canada; and (4) a cross ministry approach that combines health, housing, social services with non profit and private sector partners is required to solve chronic homelessness.
The three-year-long national study will end on March 31, 2013—and questions now arise about what will happen to the individuals who benefited from the Housing First approach, with its support services. Lori Culbert reports in the Vancouver Sun:
It is no doubt a bittersweet ending for the project, which aimed to prove the most difficult-to-house people in society can stabilize if they are offered a home first, and then support services such as doctors, drug treatment and counselling.
Academic researchers at Simon Fraser University and outreach workers had hoped Vancouver’s $30-million arm of the project would receive permanent funding, and that it would be expanded to help other homeless people with mental illnesses.
The Vancouver Sun, which also published two exclusive series on the At Home/Chez Soi project, reports the federal government will provide transition funding to cover one additional year of rent for participants living in 200 apartments scattered across Vancouver, and 100 rooms in the former Bosman hotel downtown. However, the federal government will no longer pay for associated support services; those will now be offered through existing programs run by Vancouver Coastal Health and the provincial government.
We speak with Catharine Hume, the At Home/Chez Soi project site coordinator in Vancouver.
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RELATED | National Film Board: Here At Home: In Search of the Real Cost of Homelessness | Mental Health Commission of Canada: Fact sheets, reports, videos about the project | Vancouver Sun: Formerly homeless study participants can remain in their Vancouver homes |
Image: A still from the Here At Home film, “Will to Live”, National Film Board.
At Home/Chez Soi Toronto participant Isaac says project has changed his life