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Strategies to Balance Fidelity to Housing First Principles with Local Realities: Lessons from a Large Urban Centre
Author(s): Patricia O’Campo, Suzanne Zerger, Agnes Gozdzik, Jeyagobi Jeyaratnam, Vicky Stergiopoulos
Publication Date: 2015
The importance of program implementation in achieving desired outcomes is well-documented, but there remains a need for concrete guidance on how to achieve fidelity to evidence-based models within dynamic local contexts. Housing First (HF), an evidence-based model for people experiencing homelessness and mental illness, provides an important test-case for such guidance; it targets a uniquely underserved subpopulation with complex needs, and is de...
Dynamic Sustainability Practitioners’ Perspectives on Housing First Implementation Challenges and Model Fidelity Over Time
Author(s): Vicky Stergiopoulos, Suzanne Zerger, Jeyagobi Jeyaratnam, Jolynn Connelly, Katherine Kruk, Patricia O’Campo, Stephen Hwang
Publication Date: 2015
Objectives Although Housing First (HF) is a popular evidence-based intervention for persons experiencing homelessness and mental illness, research exploring its sustainability over time is scant. This mixed methods study captures practitioners’ perspectives on key shifts in implementation of Housing First in a large urban center, and factors affecting fidelity to the model over time. Methods This study uses fidelity assessments, at baseline an...
The role and meaning of interim housing in housing first programs for people experiencing homelessness and mental illness
Author(s): Suzanne Zerger, Katherine Francombe Pridham, Jeyagobi Jeyaratnam, Jolynn Connelly, Stephen Hwang, Patricia O’Campo, Vicky Stergiopoulos
Publication Date: 2014
The housing first (HF) model for individuals experiencing homelessness and mental illness differs by design from traditional models that require consumers to achieve “housing readiness” by meeting program or treatment prerequisites in transitional housing settings prior to permanent housing placement. Given a growing body of evidence for its favorable outcomes and cost effectiveness, HF is increasingly seen as an alternative to and argument again...
At Home/Chez Soi Project: Toronto Site Final Report
Author(s): Vicky Stergiopoulos, Pat O'Campo, Stephen Hwang, Agnes Gozdzik, Jeyagobi Jeyaratnam, Vachan Misir, Rosane Nisenbaum, Suzanne Zerger, Maritt Kirst
Organization: Mental Health Commission of Canada
Publication Date: 2014
This report documents the final results of the At Home/Chez Soi Toronto site’s research demonstration project, which examined Housing First as a means of ending homelessness for people who are living with mental illness with a particular focus on those from ethnoracial backgrounds. The project followed 575 participants for two years and compared Housing First to available local services. Also available on the Mental Health Commission of Canada we...
Housing First: Exploring participants’ early support needs
Author(s): Vicky Stergiopoulos, Agnes Gozdzik, Patricia O’Campo, Alixandra R. Holtby, Jeyagobi Jeyaratnam, Sam Tsemberis
Publication Date: 2014
Background: Housing First has become a popular treatment model for homeless adults with mental illness, yet little is known about program participants’ early experiences or trajectories. This study used a mixed methods design to examine participant changes in selected domains 6 months after enrolment in a Canadian field trial of Housing First. Methods: The study sample included 301 participants receiving the Housing First intervention at the Toro...
Understanding Housing Delays and Relocations Within the Housing First Model
Author(s): Suzanne Zerger, Katherine Francombe Pridham, Jeyagobi Jeyaratnam, Stephen W. Hwang, Patricia O’Campo, Jaipreet Kohli, Vicky Stergiopoulos
Publication Date: 2014
This study explores factors contributing to delays and relocations during the implementation of the Housing First model in Toronto, Ontario. While interruptions in housing tenure are expected en route to recovery and housing stability, consumer and service provider views on finding and keeping housing remain largely unknown. In-person interviews and focus groups were conducted with 48 study participants, including 23 case managers or housing work...
Meaningful inclusion of consumers in research and service delivery
Author(s): Jenna van Draanen, Jeyagobi Jeyaratnam, Patricia O’Campo, Stephen Hwang, Dawnmarie Harriott, Michael Koo, Vicky Stergiopoulos
Publication Date: 2013
Objective: Although participatory methods have become increasingly popular, people with lived experience of mental illness and homelessness have been historically excluded from service planning and research. To better plan for meaningful inclusion of consumers, this study examines lessons learned from the People with Lived Experience Caucus in the Toronto Site of the At Home/Chez Soi Research Demonstration Project on Homelessness and Mental Healt...
Follow-Up Implementation and Fidelity Evaluation of the Mental Health Commission of Canada's At Home/Chez Soi Project: Toronto Site
Author(s): Vicky Stergiopoulos, Stephen Hwang, Patricia O’Campo, Jeyagobi Jeyaratnam, Katherine Kruk
Organization: Mental Health Commission of Canada; St. Michael's Hospital
Publication Date: 2013
This report reflects findings from the one year follow-up Implementation Evaluation conducted at the Toronto site. It includes the results of a fidelity assessment completed in April 2012 by a Quality Assurance team for the At Home project, as well as the perspectives of service providers from the Toronto Site. The purpose of this evaluation is to identify changes in program fidelity as well as to understand continued and emerging strengths, chal...
Implementation and Fidelity Evaluation of the Mental Health Commission of Canada's At Home/Chez Soi Project: Toronto Site
Author(s): Vicky Stergiopoulos, Stephen Hwang, Patricia O’Campo, Jeyagobi Jeyaratnam, Katherine Kruk
Organization: Mental Health Commission of Canada; St. Michael’s Hospital
Publication Date: 2011
This report describes findings from the Implementation Evaluation phase of the Toronto Site. It describes the context and pathways by which the MHCC intervention works (refer to Appendix A for description of local project context: site description, characteristics of homelessness situation, and description of Care as Usual). The purpose of this report is threefold: (1) to highlight key program components for the Housing First/ACT and Housing Firs...
Baseline Consumer Narratives of Lived Experience of the Mental Health Commission of Canada’s At Home/Chez Soi Project: Toronto Report
Author(s): Maritt Kirst, Deborah Wise Harris, Erin Plenert, Jeyagobi Jeyaratnam, Bonnie Kirsh, Patricia O’Campo, Vicky Stergiopoulos, Stephen Hwang
Organization: Mental Health Commission of Canada; St. Michael’s Hospital
Publication Date: 2012
The ‘At Home/Chez Soi’ Research Demonstration Project (henceforth referred to as “the Project”) is a health intervention that explores a ‘Housing First’ approach to improving the lives of clients who experience both homelessness and serious mental health problems.1 ‘Housing First’ is a promising service model that has been increasingly implemented in North America, in which individuals experiencing homelessness and severe mental health problems a...
Moving from rhetoric to reality: adapting Housing First for homeless individuals with mental illness from ethno-racial groups
Author(s): Vicky Stegiopoulos, Patricia O'Campo, Agnes Gozdzik, Jeyagobi Jeyaratnam, Simon Corneau, Aseefa Sarang, Stephen Hwang
Publication Date: 2012
Background The literature on interventions addressing the intersection of homelessness, mental illness and race is scant. The At Home/Chez Soi research demonstration project is a pragmatic field trial investigating a Housing First intervention for homeless individuals with mental illness in five cities across Canada. A unique focus at the Toronto site has been the development and implementation of a Housing First Ethno-Racial Intensive Case Manag...