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Indigenous and non‐Indigenous parents separated from their children and experiencing homelessness and mental illness in Canada
Author(s): Rachel Caplan, Geoffrey Nelson, Jino Distasio, Corinne Isaak, Betty Edel, Myra Piat, Ph.D., Eric Macnaughton, Maritt Kirst, Michelle Patterson, Tim Aubry, Susan Mulligan, Paula Goering
Publication Date: 2020
The purpose of this study is to examine the parent–child experiences of Indigenous and non‐Indigenous mothers and fathers experiencing homelessness, mental illness, and separation from their children. A qualitative thematic analysis of baseline and 18‐month follow‐up narrative interviews was used to compare 12 mothers (n = 8 Indigenous and n = 4 nonindigenous) with 24 fathers (n = 13 Indigenous and n = 11 non‐Indigenous). First, it was found that...
Gender differences among Indigenous Canadians experiencing homelessness and mental illness
Author(s): Brittany Bingham, Akm Moniruzzaman, Michelle Patterson, Jitinder Sareen, Jino Distasio, John O’Neil and Julian M. Somers
Publication Date: 2019
Indigenous people are over represented among homeless populations worldwide and the prevalence of Indigenous homelessness appears to be increasing in Canadian cities. Violence against Indigenous women in Canada has been widely publicized but has not informed the planning of housing interventions. Despite historical policies leading to disenfranchisement of Indigenous rights in gender-specific ways, little is known about contemporary differences i...
Indigenous and Non-Indigenous People Experiencing Homelessness and Mental Illness in Two Canadian Cities: A Retrospective Analysis and Implications for Culturally Informed Action
Author(s): Brittany Bingham, Akm Moniruzzaman, Michelle Patterson, Jino Distasio, Jitender Sareen, John O’Neil, Julian M Somers
Publication Date: 2019
Indigenous people in Canada are not only over-represented among the homeless population but their pathways to homelessness may differ from those of non-Indigenous people. This study investigated the history and current status of Indigenous and non-Indigenous people experiencing homelessness and mental illness. We hypothesised that compared with non-Indigenous people, those who are Indigenous would demonstrate histories of displacement earlier in...
Effects of comorbid substance use disorders on outcomes in a Housing First intervention for homeless people with mental illness
Author(s): Karen Urbanoski, Scott Veldhuizen, Michael Krausz, Christian Schütz, Julian M. Somers, Maritt Kirst, Marie-Josée Fleury, Vicky Stergiopoulos, Michelle Patterson, Verena Strehlau, Paula Goering
Publication Date: 2017
Background and Aims Evidence supports the effectiveness of Housing First (HF) programs for people who are experiencing homelessness and mental illness; however, questions remain about its use in people with comorbid substance use disorders (SUD). The aim of this project was to test whether SUD modifies the effectiveness of an HF intervention. Design Secondary analysis of data from a randomized controlled trial of HF versus treatment-as-usual (TAU...
A randomized trial examining housing first in congregate and scattered site formats
Author(s): Julian M. Somers, Akm Moniruzzaman, Michelle Patterson, Lauren Currie, Stefanie N. Rezansoff, Anita Palepu, Karen Fryer
Publication Date: 2017
Objective No previous experimental trials have investigated Housing First (HF) in both scattered site (SHF) and congregate (CHF) formats. We hypothesized that CHF and SHF would be associated with a greater percentage of time stably housed as well as superior health and psychosocial outcomes over 24 months compared to treatment as usual (TAU). Methods Inclusion criteria were homelessness, mental illness, and high need for support. Participants wer...
Outcome Trajectories among Homeless Individuals with Mental Disorders in a Multisite Randomised Controlled Trial of Housing First
Author(s): Carol E. Adair, David L. Streiner, Ryan Barnhart, Brianna Kopp, Scott Veldhuizen, Michelle Patterson, Tim Aubry, Jennifer Lavoie, Jitender Sareen, Stefanie Renee LeBlanc, Paula Goering
Publication Date: 2017
Purpose Housing First (HF) has been shown to improve housing stability, on average, for formerly homeless adults with mental illness. However, little is known about patterns of change and characteristics that predict different outcome trajectories over time. This article reports on latent trajectories of housing stability among 2140 participants (84% followed 24 months) of a multisite randomised controlled trial of HF. Methods Data were analyzed...
Recruitment and retention of homeless individuals with mental illness in a housing first intervention study
Author(s): Verena Strehlau, Iris Torchalla, Michelle Patterson, Akm Moniruzzaman, Allison Laing, Sindi Addorisiob, Jim Frankish, Michael Krausz
Publication Date: 2017
Background Homeless individuals with mental illness are challenging to recruit and retain in longitudinal research studies. The present study uses information from the Vancouver site of a Canadian multi-city longitudinal randomized controlled trial on housing first interventions for homeless individuals. We were able to recruit 500 participants and retain large number of homeless individuals with mental illness; 92% of the participants completed...
A cross-sectional examination of the mental health of homeless mothers: does the relationship between mothering and mental health vary by duration of homelessness?
Author(s): Denise M Zabkiewicz, Michelle Patterson, Alexandra Wright
Publication Date: 2014
Objectives: This study draws on baseline data from the At Home/Chez Soi demonstration project to examine the association between parenting status and mental health among homeless women and whether the association varies by duration of homelessness. Setting: Structured interviews were conducted with participants in five cities across Canada including Moncton, Montreal, Toronto, Vancouver and Winnipeg. Participants: Eligibility criteria included th...
Collaboration and involvement of persons with lived experience in planning Canada’s At Home/Chez Soi project
Author(s): Geoffrey Nelson, Eric Macnaughton, Susan Eckerle Curwood, Nathalie Egalité, Jijian Voronka, Marie-Josée Fleury, Maritt Kirst, Linsay Flowers, Michelle Patterson, Michael Dudley, Myra Piat, Ph.D., Paula Goering
Publication Date: 2016
Planning the implementation of evidence-based mental health services entails commitment to both rigour and community relevance, which entails navigating the challenges of collaboration between professionals and community members in a planning environment which is neither ‘top-down’ nor ‘bottom-up’. This research focused on collaboration among different stakeholders (e.g. researchers, service-providers, persons with lived experience [PWLE]) at fiv...
What Happens After the Demonstration Phase?: The Sustainability of Canada's At Home/Chez Soi Housing First Programs for Homeless Persons with Mental Illness
Author(s): Geoffrey Nelson, Rachel Caplan, Timothy MacLeod, Eric Macnaughton, Rebecca Cherner, Tim Aubry, Christian Methot, Eric Latimer, Myra Piat, Ph.D., Erin Plenert, Scott McCullough, Sarah Zell, Michelle Patterson, Vicky Stergiopoulos, Paula Goering
Publication Date: 2017
Abstract This research examined the sustainability of Canada's At Home/Chez Soi Housing First (HF) programs for homeless persons with mental illness 2 years after the end of the demonstration phase of a large (more than 2000 participants enrolled), five-site, randomized controlled trial. Qualitative interviews were conducted with 142 participants (key informants, HF staff, and persons with lived experience) to understand sustainability outcomes a...
How does Housing First catalyze recovery?: Qualitative findings from a Canadian multi-site randomized controlled trial
Author(s): Eric Macnaughton, Greg Townley, Geoffrey Nelson, Rachel Caplan, Timothy MacLeod, Lauren Polvere, Corinne Isaak, Maritt Kirst, Christopher McAll, Danielle Nolin, Michelle Patterson, Myra Piat, Ph.D., Paula Goering
Publication Date: 2016
ABSTRACT Qualitative narrative interviews were conducted with 195 participants with histories of homelessness and mental illness at baseline and at an 18-month follow-up. Participants were randomly assigned at baseline to Housing First (HF; n = 119) or treatment as usual (TAU; n = 76) in five Canadian cities. Changes in consumers’ narratives over time were examined for 13 life domains (e.g., housing stability, typical day, social relationships)....
Emergency department use and hospitalizations among homeless adults with substance dependence and mental disorders
Author(s): Adrienne Cheung, Julian M. Somers, Akm Moniruzzaman, Michelle Patterson, Charles J. Frankish, Krausz
Publication Date: 2015
Background Homelessness, substance use, and mental disorders each have been associated with higher rates of emergency department (ED) use and hospitalization. We sought to understand the correlation between ED use, hospital admission, and substance dependence among homeless individuals with concurrent mental illness who participated in a ‘Housing First’ (HF) intervention trial. Methods The Vancouver At Home study consisted of two randomized contr...
Implementing Housing First Across Sites and Over Time: Later Fidelity and Implementation Evaluation of a Pan-Canadian Multi-site Housing First Program for Homeless People with Mental Illness
Author(s): Eric Macnaughton, Ana Stefancic, Geoffrey Nelson, Rachel Caplan, Greg Townley, Tim Aubry, Scott McCullough, Michelle Patterson, Vicky Stergiopoulos, Catherine Vallée, Sam Tsemberis, Marie-Josée Fleury, Myra Piat, Ph.D., Paula Goering
Publication Date: 2015
This article examines later fidelity and implementation of a five-site pan-Canadian Housing First research demonstration project. The average fidelity score across five Housing First domains and 10 programs was high in the first year of operation (3.47/4) and higher in the third year of operation (3.62/4). Qualitative interviews (36 key informant interviews and 17 focus groups) revealed that staff expertise, partnerships with other services, and...
Life Changes Among Homeless Persons With Mental Illness: A Longitudinal Study of Housing First and Usual Treatment
Author(s): Geoffrey Nelson, Michelle Patterson, Maritt. Kirst, Eric Macnaughton, Corinne A. Isaak, Danielle Nolin, Christopher McAll, Vicky Stergiopoulos, Greg Townley, Timothy MacLeod
Publication Date: 2015
Objective: This study compared the life changes of homeless people with mental illness participating in Housing First or treatment as usual and examined factors related to various changes. Methods: Semistructured narrative interviews were conducted with 219 participants in five Canadian cities at baseline; 197 were interviewed again at 18 months after random assignment to Housing First (N=119) or treatment as usual (N=78). Interviews were co...
One-Year Outcomes of a Randomized Controlled Trial of Housing First With ACT in Five Canadian Cities
Author(s): Tim Aubry, Sam Tsemberis, Carol E. Adair, Scott Veldhuizen, David Streiner, Eric Latimer, Jitender Sareen, Michelle Patterson, Kathleen McGarvey, Brianna Kopp, Catharine Hume
Publication Date: 2015
Objective: Housing First is a groundbreaking approach to ending chronic homelessness among people with mental illness. This article presents one-year findings from a multisite randomized controlled trial (RCT) comparing Housing First with treatment as usual. Methods: The study was a nonblind, parallel-group RCT conducted in five Canadian cities. A sample of 950 high-need participants with severe mental illness, who were either absolutely hom...
Early Implementation Evaluation of a Multi-site Housing First Intervention for Homeless People with Mental Illness: A Mixed Methods Approach
Author(s): Geoffrey Nelson, Ana Stefancic, Jennifer Rae, Greg Townley, Sam Tsemberis, Eric Macnaughton, Tim Aubry, Jino Distasio, Roch Hurtubise, Michelle Patterson, Vicky Stergiopoulos, Myra Piat, Ph.D., Paula Goering
Publication Date: 2013
This research sought to determine whether the implementation of Housing First in a large-scale, multi-site Canadian project for homeless participants with mental illness shows high fidelity to the Pathways Housing First model, and what factors help or hinder implementation. Fidelity ratings for 10 Housing First programs in five cities were made by an external quality assurance team along five key dimensions of Housing First based on 84 key inform...
The At Home/Chez Soi Project: A Review of the Proposal Development and Planning Phase in Vancouver, BC
Author(s): Michelle Patterson, Diane Schmidt, Denise Zabkiewicz
Organization: Mental Health Commission of Canada; Simon Fraser University
Publication Date: 2010
This report examines how a consortium of diverse stakeholders, including community service providers and researchers, convened in Vancouver to respond to the MHCC's Request for Applications for a research demonstration project on mental health and homelessness. It describes the challenges the local team faced and the sources of strength they drew on as they developed their response and proposal.  This report also includes a Key Messages document...
Baseline Consumer Narratives of Lived Experience of the Mental Health Commission of Canada’s At Home/Chez Soi Project: Vancouver Report
Author(s): Michelle Patterson, Melinda Markey, Faith Eiboff
Organization: Mental Health Commission of Canada; Simon Fraser University
Publication Date: 2011
This report examines the key themes that emerged from "personal story" interviews conducted with 52 participants within one month of their enrollment in the Vancouver At Home Study.  The report also includes a Key Messages document and an Executive Summary at the beginning.
The At Home/Chez Soi Project: Implementation at the Vancouver, BC Site
Author(s): Diane Schmidt, Michelle Patterson
Organization: Mental Health Commission of Canada; Simon Fraser University
Publication Date: 2011
This report examines how members of the Vancouver site mobilized research, housing, and service provider teams to recruit, house and support participants in the At Home/Chez Soi project. It describes the strengths of the local team and the challenges they faced as they implemented all aspects of the project from October 2009 to January 2011.  This report also includes a Key Messages document and an Executive Summary at the beginning.
The At Home/Chez Soi Project: Year Two Project Implementation at the Vancouver, BC Site
Author(s): Michelle Patterson
Organization: Mental Health Commission of Canada; Simon Fraser University
Publication Date: 2012
This report documents the implementation of housing and support interventions in the second year of project implementation at the Vancouver At Home/Chez Soi site, including the second round of intervention fidelity assessments. It describes the strengths of the housing and intervention teams and the ongoing and emerging challenges they faced as they carried out their programs from January 2011 to January 2012. This report follows The At Home/Chez...