Housing first - experiment going well after a year

After a year in operation, Canada’s At Home-Chez Soi study of a housing first strategy for homeless, mentally ill individuals is going well.

Run by the Canadian Mental Health Commission and funded through a $110 million investment by the federal government, this program is providing housing for just over 1,300 homeless, mentally ill Canadians to evaluate the housing first strategy. It was launched in October 2009 in five Canadian cities including Vancouver, Winnipeg, Toronto, Montreal and Moncton.

In Vancouver, the focus is on individuals who are homeless, mentally ill and also have a history of substance abuse. So far, more than 250 people have been housed in that city and a total of 300 will be housed by sometime this spring. An additional 200 will form a control group – not provided housing but accessing services and supports already in existence in Vancouver. So far, organizers are optimistic about the changes they’ve seen in people’s lives already.

The philosophy behind the housing first approach is that only after people have a safe place to sleep and eat are they able to focus on improving other chronic challenges such as mental illness or addiction issues. As the name implies, participants are given housing first and then they can access other support services if they choose.

One of the primary goals in this study is to provide enough information to support a true and comprehensive strategy to end homelessness.

Researchers are hoping to prove it is better policy – from a financial and also moral standpoint -- to provide this sort of housing than to allow the mentally ill and addicted to continue relying on shelters, hospitals and the justice system for the management of their medical problems.

Across Canada, 2,285 homeless people will participate. 1,325 will be given a place to live and services to assist them while the others will participate in the control group receiving the regular services currently available in their cities. It is the largest study of its kind currently taking place in the world.

The only requirements for participants are to pay the housing portion of their social assistance and give regular interviews to study staff. Otherwise, the program is about choice and people can choose which services they want to access.

Although there are two more years of funding for this study during which researchers can continue to track people’s progress and health status, they have already learned much in the first year. Observation is proving what was already suspected – that those with the most severe health problems are often the least likely to seek medical help; that those who have spent the longest time on the streets and who have complex mental illness from an early age seem to be more involved with the justice and health and social systems.

I am excited to see this large scale experiment taking place and hope the researchers are able to make their point so that as a society we can make changes to the way we deal with homelessness and mental illness.

A similar project in New York saw participants experience a drastic drop in their need for medical services as well as interactions with the police. In that program, it cost $57 a day to house individuals – a fraction of the cost of keeping a person in jail or in a hospital.

I believe Canada’s experiment with housing first will yield similar results. When people have the dignity of a safe place to live and access to appropriate services it will not only be beneficial for their health, but will also cost society a lot less than our current system of bandaid solutions.


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