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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
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...
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...
Publication Date: 2017
The purpose of this study was to understand the sustainability of the At Home/Chez Soi (AHCS) project with respect to its wider impact on homelessness policy in Canada and internationally. Using a qualitative case study approach with 15 key informant interviews (with project leaders and decision-makers) and archival data, we examined the strategies adopted to achieve sustainability of the Housing First (HF) programs implemented during this demons...
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: 2013
An interesting question concerns how large-scale (mental) health services policy initiatives come into being, and the role of evidence within the decision-making process behind their origins. This paper illustrates the process by which motivation to address homelessness, in the context of the upcoming 2010 Vancouver Olympics, was leveraged into a pan-Canadian project including sites in Vancouver, Winnipeg, Toronto, Montreal and Moncton, New Bruns...
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...
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...
Organization: Mental Health Commission of Canada National Qualitative Research Team for the At Home/Chez Soi Project
Publication Date: 2017
Executive Summary
The current research examines the policy impacts of the AHCS project beyond the demonstration project period. Part of a larger study about the sustainability of the services and their long-term impacts, the current report examines AHCS’s wider impact on homelessness policy in Canada. The study describes how efforts to achieve sustainability in a limited sense – that is, to attain transitional funding and secure a “safe landing”...
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)....
Publication Date: 2016
Objective: Although youth homelessness presents a significant public health problem, the needs of homeless youths with mental illness, as distinct from adults, are not well understood. This study examined the unique demographic, clinical, and service use characteristics of homeless youths.
Methods: At Home/Chez Soi was a large randomized controlled trial of the Housing First model in five cities in Canada. Of 2,255 participants, 7% (N=164) were y...
Publication Date: 2015
Background
At Home/Chez-Soi was a 24 month randomized controlled trial of Housing First (HF) conducted in five Canadian cities.
Aims
This article attempts to identify the characteristics of participants who experienced housing instability one year after entering HF. Methods: Those defined as experiencing housing instability were housed <50% of the last 9 months of the first year, excluding time in institutions, unless they were housed 100% of...
Publication Date: 2016
Objective
This study examined whether Housing First fidelity ratings correspond to program operation descriptions from administrative data and predict client outcomes.
Methods
A multisite, randomized controlled trial (At Home/Chez Soi) in five Canadian cities included two assessments of 12 programs over two years. Outcomes for 1,158 clients were measured every six months. Associations between fidelity ratings and administrative data (Spearm...
Publication Date: 2015
The present study explored the prevalence of volatile substance use (VSU) in a community of homeless adults. The importance of individual life history characteristics (history of traumatic events, residential school history, mental and physical health conditions) were also examined with respect to past-year volatile substance use in this sample. Overall, the results indicate that a variety of traumatic events, particularly residential school hist...
Organization: Canadian Observatory on Homelessness; Mental Health Commission of Canada
Publication Date: 2015
The Homelessness Partnering Secretariat (HPS) has developed several directives to assist communities with the shift to a Housing First framework. The first directive states that chronically and episodically homeless individuals should be prioritized to receive Housing First services. Therefore, it is imperative that communities are equipped with the necessary information and skills so as to facilitate the screening and prioritization of homeless...
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...
Publication Date: 2014
The At Home/Chez Soi (AHCS) project was a multisite pragmatic randomized controlled trial evaluating the effectiveness of providing housing and psychosocial support for individuals who were previously homeless and suffered from a moderate or severe psychiatric illness. Over a two-year period, the project provided rent subsidies and housing as well as either assertive community treatment or intensive case management to help meet mental health need...
Organization: Mental Health Commission of Canada
Publication Date: 2014
This report documents the final results of the At Home/Chez Soi research demonstration project, which examined Housing First as a means of ending homelessness for people living with mental illness in Canada. The project followed more than 2,000 participants for two years, and was the world’s largest trial of Housing First, with demonstration sites in Vancouver, Winnipeg, Toronto, Montréal, and Moncton.
This report is also available on the Mental...
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...
Organization: Mental Health Commission of Canada
Publication Date: 2012
This report presents a synthesis of the findings of the baseline consumer narrative interviews collected for the At Home/Chez Soi project1. This pan Canadian project, which is funded by the Mental Health Commission of Canada (MHCC), is a five-year research demonstration study exploring interventions for homeless adults who have mental illnesses. At Home/Chez Soi applies evidence-based interventions in the Canadian context to better understand whi...