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Organization: Lived Experience Lab, A Way Home Canada, Covenant House
Publication Date: 2020
Goal: The overall goal of this project is to rapidly synthesize real-world knowledge on promising mental health and substance use practices utilized by front-line providers serving young people who are experiencing or have experienced homelessness during the COVID-19 pandemic.
Background: An estimated 35,000-40,000 Canadian youth (aged 13 – 24 years) experience homelessness at some point during the year and at least 6,000 on any given night (Gaet...
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...
Organization: Centre for Urban Health Solutions
Publication Date: 2020
In Toronto, the Medical Officer of Health issues an extreme cold weather alert when temperatures fall below -15C. Recently, researchers led by St. Michael’s Hospital reviewed coroner’s records and emergency department charts from five downtown hospitals to explore the relationship between weather conditions and hypothermia among adults experiencing homelessness between 2004-2015. They found that while extreme cold temperatures put people at highe...
Publication Date: 2018
Abstract
Housing is a key social determinant of health that contributes to the well-documented relationship between socioeconomic status and health. This study explored how individuals with histories of unstable and precarious housing perceive their housing or shelter situations, and the impact of these settings on their health and well-being. Participants were recruited from the Health and Housing in Transition study (HHiT), a longitudinal, mul...
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: 2017
Research suggests that individuals experiencing homelessness have high rates of overweight and obesity. Unhealthy weights and homelessness are both associated with increased risk of poor health and mortality. Using longitudinal data from 575 participants at the Toronto site of the At Home/Chez Soi randomized controlled trial, we investigate the impact of receiving a Housing First intervention on the Body Mass Index (BMI) and waist circumference o...
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...
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...
Publication Date: 2014
Objective: To determine the incidence of influenza vaccination among homeless individuals with mental illness in Toronto.
Methods: A retrospective chart review was carried out using a random sample of homeless individuals with mental illness who were participants of the At Home/Chez Soi Study. Primary care charts were obtained and reviewed for the incidence influenza vaccination within a 1-year period.
Results: Of the 75 participants for whom cha...
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...
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...
Publication Date: 2014
The literature has identified housing as a fundamental unmet need for people living with HIV; yet there has been little qualitative evidence exploring housing and HIV, particularly from a Canadian context. This paper focuses on our qualitative analyses of the housing experiences of 48 HIV-positive people living in Ontario. Findings from our interviews illustrate healthy housing as a dynamic interconnection between health, housing and other social...
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...
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...
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...
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...
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...
Publication Date: 2009
This study provides reliable and valuable information on the characteristics of Domiciliary Hostel tenants in Ontario. Since the inception of the Domiciliary Hostel Program more than three decades ago, this program has clearly evolved from housing frail seniors to housing a diverse group of vulnerable adults, including individuals with mental and physical illness, developmental disabilities, as well as the elderly. While it is beyond the scope of...
Publication Date: 2009
The goal of this project is to support policy work and service planning by providing reliable information about the characteristics and service needs of tenants in the Domiciliary Hostel Program in Ontario. The specific objectives of this research project were: 1) To describe the characteristics of Domiciliary Hostel Program tenants; 2) To describe Domiciliary Hostel Program tenants’ use of community supports and services, use of health care,...