Homelessness and Mental Health Research and Demonstration Project 2008-2013

1. Homelessness and Mental Health Research and Demonstration Project2008-2013 Mental Health Commission of Canada (MHCC) Sonia Côté, Project Coordinator, At Home Montréal Cécile Leclercq, Research Coordinator, Montréal

2. At Home/Chez Soi Project • In 2008, the federal government allocated $110 million to the Mental Health Commission of Canada to undertake a research project that would take place in five Canadian cities. • Duration of research: 5 years

3. Homelessness in Canada • Homelessness is steadily rising in Canada • Estimates suggest there are 50,000 to 300,000 homeless Canadians • Homelessness is very costly to Canadians • Many people experiencing homelessness face marginalization and isolation

4. At Home/Chez Soi is: • the largest study of its kind in the world; • a research project that aims to provide evidence about what services and systems best help homeless people with mental health issues; • a study based on the Housing First model; • a study implemented in five Canadian cities.

5. Five Sites in Canada

6. MonctonSmaller city with few services for homeless people with mental health problems.Pilot project among the rural population.

7. MontréalGreat diversity of services offered to homeless people

8. TorontoLarge urban centre with ethnocultural diversity

9. WinnipegUrban Aboriginal population

10. VancouverPeople who have alcohol and drugabuse problems in addition to mental health issues

11. Research Design • Common research design for all sites • Customized demonstration projects for each of the sites • Local sub-studies specific to the provincial contexts

12. Some Key Notions • Have people with lived experience play a central role • Promote knowledge sharing • Encourage collaboration and development of partnerships (cross-sectoral approach) • Plan based on sustainability of services • etc.

13. Teams • 1 assertive community treatment (ACT) team • 2 intensive case management (ICM) teams • 1 housing team • 1 team of interviewers • 1 team of researchers

14. OrganizationsAssociated with the Project • CSSS Jeanne-Mance (Health and Social Services Centre) • Diogène • CHUM (Université de Montréal Hospital Centre) • Douglas Mental Health University Institute

15. Intervention ModelHousing First and Street to Home • Model originated in NY and already evaluated: proven effective approach • Go directly from street to home with minimal requirements • Culture focused on recovery • Housing component integrated into clinical component

17. Participant Numbers • Total participants: 2,285; participants receiving services: 1,325 • Number of participants enrolled: 430 • Current enrolment at 18% of our target • Number of people housed: 135

18. Participant Numbers Number of participants in each service group by site(March 31, 2010) *ACT – Assertive community treatment *ICM – Intensive case management

19. Challenges related to: • Empirical aspects • Clinical aspects • Political aspects • Organizational aspects • Public aspects • Ethical aspects

20. Early Findings • About a hundred people who were homeless are now housed and receive services • We are learning about what services and interventions foster housing stability and improve health and well-being • People having experienced homelessness have a place within the different organizations to influence decisions in the project implementation process • This project showcases new collaborations and different ways of doing things and seeks to improve the current system

21. This project is all about teamwork to reacha safe harbour