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Publication Date: 2020
This guide presents clinical evidence to help develop interventions to improve health and social outcomes for folks vulnerably housed or experiencing homelessness.
Key Points:
Clinical assessment and care of homeless and vulnerably housed populations should include tailoring approaches to a person’s gender, age, Indigenous heritage, ethnicity and history of trauma; and advocacy for comprehensive primary health care.
As initial steps in the ca...
Publication Date: 2020
Frequent emergency department (ED) users experiencing homelessness are associated with high costs for healthcare systems yet interventions for this group have been minimally investigated. This study used 24-month data from a multisite randomized controlled trial of Housing First (HF) to examine how effective the intervention is in helping frequent ED users with a mental illness to achieve housing stability, improve behavioural health and function...
Publication Date: 2018
This article presents the findings of a fidelity assessment conductedwith a Housing First programme in Canada that supported clients with problematic substance use. A mixed-methods (quantitative and qualitative) evaluation design was used. A fidelity assessment survey, fidelity rating conciliation session, and interviews were conducted with programme staff and management to identify facilitators and barriers to the programme’s fidelity to the Hou...
Publication Date: 2019
We examined communities’ expressed needs for capacity building in the implementation of Housing First (HF) for persons experiencing homelessness. The findings are based on thematic analyses of qualitative data obtained from participants (n = 77) in 11 focus groups conducted in seven Canadian cities. We identified capacity building needs in the areas of training (e.g., HF principles, clinical services, landlord engagement) and technical assistance...
Publication Date: 2017
Abstract
Homelessness has consequences for families, including risk of deterioration in the health of their members, disruption of family dynamics, and separation of parents and children. This study used qualitative interviews to explore pathways into and perceived consequences of homelessness among 18 families living in an emergency family shelter system in Canada. Findings showed that families’ experiences prior to their homelessness were ch...
Organization: EENet Ontario Housing First Regional Network Community of Interest
Publication Date: 2017
The policy brief, A Portable Housing Benefit as an Indispensable Component of Ending Homelessness in Canada, describes why PHB is a critical part of services delivered by Housing First programs to assist people who have experienced chronic or episodic homelessness to become stably housed. The policy brief also presents the research that has demonstrated its effectiveness, along with a set of recommendations.
Current challenges in implementing a...
Publication Date: 2017
<p>Compared to the wealth of research on single homeless adults, there is little known about homeless families. This paper describes a study of 75 homeless families in Ottawa, Ontario, conducted in 2012-2013. This sample of homeless families includes a large number of newcomer families, including immigrants and refugees. Participants are poor and unemployed, but many are educated, and there is little evidence of alcohol or substance abuse....
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...
Organization: BC Housing, by Pathways PtH Housing First, Inc. and the Centre for Research on Educational and Community Services, University of Ottawa
Publication Date: 2017
BACKGROUND
This report is prepared for BC Housing as part of the evaluation of the Vulnerability Assessment Tool (VAT). The VAT was created by the Downtown Emergency Service Centre in Seattle, Washington, to objectively determine the vulnerability of their clients to continued housing instability. The VAT involves a structured interview to assess an individual experiencing homelessness or marginal housing on 10 domains: survival skills, basic nee...
Publication Date: 2014
This paper describes the implementation of Housing First in a small Canadian city. Given that the majority of Housing First research has been conducted in large American cities, providing a Canadian context in a small city contributes significant insights for similarly sized areas. The main objectives were to determine the adaptations made to the Housing First model and the contextual realities that affected implementation. Data were collected fr...
Organization: American Public Health Association
Publication Date: 2013
Objective:
The At Home/Chez Soi randomized controlled trial examines the effectiveness of a less resource-intensive Housing First intervention using Intensive Case Management (HF-ICM) for homeless individuals with mental illness and moderate levels of unmet mental health needs.
Method:
Homeless individuals with mental illness (N=1198) in four Canadian cities (Vancouver, Winnipeg, Toronto and Montreal) were randomized to HF-ICM or treatment-as...
Publication Date: 2014
The At Home / Chez Soi project, funded by Health Canada through the Mental Health Commission of Canada, involves evaluating the implementation and effectiveness of the Housing First (HF) approach, a complex community-based intervention that addresses homelessness in people with severe and persistent mental illness. This paper examines the perspectives of community partners on the implementation of HF in Moncton, New Brunswick. Engagement varied,...
Publication Date: 2015
Objective:
To provide a review of the extant research literature on Housing First (HF) for people with severe mental illness (SMI) who are homeless and to describe the findings of the recently completed At Home (AH)–Chez soi (CS) demonstration project. HF represents a paradigm shift in the delivery of community mental health services, whereby people with SMI who are homeless are supported through assertive community treatment or intensive case ma...
Publication Date: 2017
Objective
This study compares the effect of Housing First on older (≥50 years old) and younger (18–49 years old) homeless adults with mental illness participating in At Home/Chez Soi, a 24-month multisite randomized controlled trial of Housing First.
Method
At Home/Chez Soi, participants (n = 2148) were randomized to receive rent supplements with intensive case management or assertive community treatment, based on their need level for mental hea...
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...
Publication Date: 2017
Abstract
The current longitudinal study used mixed methods to examine the relationship of housing and neighborhood characteristics and community integration among a population of homeless and vulnerably housed individuals. Participants were recruited at homeless shelters, meal programs, and rooming houses in Ottawa, Canada, and participated in 3 in-person interviews, each approximately 1 year apart. Participants were placed into either a “high” o...
Publication Date: 2016
This study examined predictors of physical and psychological integration in homeless adults with problematic substance use. Homeless adults with problematic substance use (n = 115) in Ottawa, Canada, completed questionnaires regarding their demographics (age, gender, Aboriginal ethnicity), health and social functioning (physical health, mental health, alcohol use problems, drug use problems, social skills), environmental factors (satisfaction wit...
Publication Date: 2016
Purpose
The purpose of this study was to examine whether homeless or vulnerably housed individuals experienced response shift over a 12-month time period in their self-reported physical and mental health status.
Methods
Data were obtained from the Health and Housing in Transition study, a longitudinal multi-site cohort study in Canada (N = 1190 at baseline). Multi-group confirmatory factor analysis (MG-CFA) and methods for response shift detec...
Publication Date: 2016
Abstract
Background
Homelessness is a major concern in many urban communities across North America. Since vulnerably housed individuals are at risk of experiencing homelessness, it is important to identify predictive factors linked to subsequent homelessness in this population. The objectives of this study were to determine the probability of experiencing homelessness among vulnerably housed adults over three years and factors associated with h...
Organization: Centre for Urban Health Solutions, St. Michael’s Hospital
Publication Date: 2016
Executive Summary:
In 2012, with funding from the Canadian Institutes for Health Research (CIHR), the REACH3 network initiated a two-year study led by Dr. Stephen Hwang of the Centre for Urban Health Solutions (C-UHS) at St. Michael’s Hospital in Toronto. The Research Alliance includes some of Canada’s leading academic researchers and community organizations with expertise on homelessness.
In light of recent policy shifts at federal and provincia...