A High-Level Policies and Procedures Guide for Isolation Sites for People Experiencing Homelessness [2020-03]
In response to the global COVID-19 pandemic and risks associated with local transmission in municipal settings, the Inner City Health Associates and the City of Toronto are collaboratively developing a plan to support people experiencing homelessness during times with heightened
A Needs Assessment for Planning Mental Health and Justice Housing – 2019-11-04
For people with justice involvement and mental health or addictions issues, supportive housing can foster stable lives, better health, and reduced service use. But who sets priorities when needs are complex and multiple service systems are involved? CMHA Toronto and
A Safe Place to Land – Bridging the Gap Between Custody and Secure Housing – 2019-11-05
This presentation explores the efficacy and advantages of maintaining and sustaining housing for Indigenous individuals being released from custody. Together, the Canadian Mental Health Association – Sudbury/Manitoulin and the N’Swakamok Native Friendship Centre manage an eight month transitional housing unit
Barriers and Facilitators to Implementing a Short-Term Transdiagnostic Mental Health Treatment for Homeless Persons [2019]
Despite the significant mental health needs and comorbidity in homeless individuals, there is a “science-practice gap” between the available evidence-based treatments (EBTs) and their lack of use in community health centers servicing homeless populations. To address this gap, it is
Bridging Hospital and Community Care for Homeless Adults with Mental Health Needs: Outcomes of a Brief Interdisciplinary Intervention [2018]
Objective: This study examines health and service use outcomes and associated factors among homeless adults participating in a brief interdisciplinary intervention following discharge from hospital. Method: Using a pre-post cohort design, 223 homeless adults with mental health needs were enrolled
Bringing it All Together: Integrating Services to Address Homelessness [2019]
In Canada, approximately $27 billion is spent annually to fund services that deal with homelessness, including the related issues of poverty, mental illness, addiction, domestic violence, poor health and childhood trauma. Another $6.5 billion annually is spent on social assistance
Building Bridges to Housing for homeless adults with intellectual and developmental disabilities: outcomes of a cross‐sector intervention [2020]
BackgroundAdults with intellectual and developmental disabilities (IDD) have high rates of homelessness. This observational study evaluates Bridges to Housing, a cross‐sector intervention offering immediate access to housing and supports to this population in Toronto, Canada. MethodsTwenty‐six participants, enrolled between April
Canadian Alliance to End Homelessness releases new guide to help communities with housing-based responses to COVID-19 [2020-05-05]
Housing cures homelessness and is the best protection against COVID-19. During the COVID-19 pandemic, coordinating quick access to housing is more important than ever. That’s why the Canadian Alliance to End Homelessness (CAEH) has developed a new COVID-19 resource, “Getting
Caring for patients with lived experience of homelessness [2020]
Objective To guide family physicians working in a range of primary care clinical settings on how to provide care and support for patients who are vulnerably housed or experiencing homelessness. Sources of information The approach integrates recommendations from evidence-based clinical
Changes in the health status of newly housed chronically homeless: the Alaska Housing First program evaluation – 2018
The Housing First (HF) model is an evidence-based supportive housing initiative that provides permanent housing for the homeless without preconditions such as sobriety or treatment compliance. This three-year longitudinal study investigated the effects of Alaska’s inaugural Housing First projects in
Changing the method of working with homeless people: a photovoice project in Italy – 2018
In Italy, many organizations are experimenting with the Housing First (HF) model to promote a change in how they work with homeless people. This change creates some difficulties, especially in promoting freedom of choice in people involved in the HF
Chronic Pain Among Homeless Persons with Mental Illness [2017]
Objective Chronic pain is an important public health issue. However, characteristics and needs of marginalized populations have received limited attention. Studies on prevalence and correlates of chronic pain among homeless persons are lacking. We assessed chronic pain among homeless persons
City of Kingston & County of Frontenac – 2017 Housing & Homelessness Report
The Street Outreach Pilot Program, the extension of the Portable Housing Benefit to help safely house survivors of domestic violence, the opening of the One Roof Kingston Youth Services Hub and the completion of energy-saving updates to social housing, are
Clinical and cognitive correlates of unsheltered status in homeless persons with psychotic disorders [2018]
Homeless persons with psychosis are particularly susceptible to unsheltered homelessness, which includes living on the streets, in cars, and other places not meant for human habitation. Homeless persons with psychosis have distinct barriers to accessing care and comprise a high-need
Common trust and personal safety issues: A systematic review on the acceptability of health and social interventions for persons with lived experience of homelessness [2019]
BackgroundPersons experiencing homelessness and vulnerable housing or those with lived experience of homelessness have worse health outcomes than individuals who are stably housed. Structural violence can dramatically affect their acceptance of interventions. We carried out a systematic review to understand
Comparison of 30-day readmission and emergency department revisit rates among homeless patients at teaching versus non-teaching hospitals [2020]
HighlightsTeaching hospitals exhibited lower hospital revisit rates for homeless patients. • No differences in revisit rates by hospital teaching status for non-homeless patients. • Disparities in ED revisits existed for medical and surgical conditions. • Dipartites in readmissions was observed
Comparisons of Social Support and Social Networks in Homeless and Vulnerably Housed Women [2020]
Social support is closely connected to mental health and well-being as well as experiences of housing vulnerability. This study explored differences between homeless and vulnerably housed women in their experiences of social support. Forty-nine homeless and 43 vulnerably housed women
Content Analysis of Advantages and Disadvantages of Drinking Among Individuals With the Lived Experience of Homelessness and Alcohol Use Disorders – 2018
Background: Alcohol use disorders (AUDs) are more prevalent among people who are homeless than in the general population. Thus, homeless individuals experience disproportionately high levels of alcohol-related problems and associated publicly funded criminal justice and healthcare system utilization. Available treatment
Contested Development: Homeless Property, Police Reform, and Resistance in Skid Row, LA [2019]
Since the late 1990s, Downtown Los Angeles’ Skid Row has undergone private and state‐sanctioned policing practices within the fifty‐block neighborhood. These policing practices are fueled by increased commercial and real‐estate development to dispossess and contain the mostly Black homeless and
Controlling Homeless People? Power, Interventionism and Legitimacy – 2018
There is intense debate over the legitimacy of interventions which seek behavioural change on the part of street homeless people. ‘Hard’ measures, such as arresting people for begging, are particularly controversial, but ‘softer’ interventions such as motivational interviewing have also
Coping and resilience among ethnoracial individuals experiencing homelessness and mental illness – 2018
Background: The multiple challenges that ethnoracial homeless individuals experiencing mental illness face are well documented. However, little is known about how this homeless subpopulation copes with the compounding stressors of racial discrimination, homelessness and mental illness. Aims: This study is
Coping and resilience among ethnoracial individuals experiencing homelessness and mental illness – 2018-01-01
Background: The multiple challenges that ethnoracial homeless individuals experiencing mental illness face are well documented. However, little is known about how this homeless subpopulation copes with the compounding stressors of racial discrimination, homelessness and mental illness. Aims: This study is
Correlates of Posttraumatic Stress Symptoms among Formerly Incarcerated, Homeless Women [2020]
Posttraumatic stress symptoms are a pressing issue among women experiencing incarceration and homelessness. Baseline data were collected among formerly incarcerated homeless women (N = 130) who were on average 38.9 (SD = 11.36, range 19–64) years of age and recruited into a
Correlates of Treatment Readiness Among Formerly Incarcerated Homeless Women [2018]
Treatment readiness is a key predictor of drug treatment completion, rearrest, and recidivism during community reentry; however, limited data exist among homeless female offenders (HFOs). The purpose of this study was to present baseline data from a randomized controlled trial
Cost Analysis of a High Support Housing Initiative for Persons with Severe Mental Illness and Long-Term Psychiatric Hospitalization [2018]
Objective: The objective of this article was to conduct a cost analysis comparing the costs of a supportive housing intervention to inpatient care for clients with severe mental illness who were designated alternative-level care while inpatient at the Centre for
Cost Savings of Housing First in a Non-Experimental Setting [2020]
We investigate the impact of supportive housing (Housing First, or HF) programs on public service utilization of people experiencing homelessness in Calgary, Alberta. We use data on clients between 2012 and 2016, and, using a pre–post design, we assess the
Cost-effectiveness of Housing First Intervention With Intensive Case Management Compared With Treatment as Usual for Homeless Adults With Mental Illness: Secondary Analysis of a Randomized Clinical Trial [2019]
Question Is a Housing First intervention with Intensive Case Management for homeless people with mental illness cost-effective compared with treatment as usual? Findings In this economic evaluation study of data from the At Home/Chez Soi randomized clinical trial with 1198
Cost-Effectiveness of Housing First With Assertive Community Treatment: Results From the Canadian At Home/Chez Soi Trial [2020]
Objective:The At Home/Chez Soi trial for homeless individuals with mental illness showed scattered-site Housing First with Assertive Community Treatment (ACT) to be more effective than treatment as usual. This study evaluated the cost-effectiveness of Housing First with ACT and treatment
Costs of services for homeless people with mental illness in 5 Canadian cities: a large prospective follow-up study [2017]
Background: Limited evidence on the costs of homelessness in Canada is available. We estimated the average annual costs, in total and by cost category, that homeless people with mental illness engender from the perspective of society. We also identified individual
Court-imposed fines as a feature of the homelessness-incarceration nexus: a cross-sectional study of the relationship between legal debt and duration of homelessness in Seattle, Washington, USA [2019]
BackgroundLegal system involvement is a policy-driven risk factor for homelessness. Legal financial obligations (LFOs), such as court fees, fines and restitution, can endanger the financial security of those ensnared in the criminal justice system. In this study we measured the
COVID pandemic as an opportunity for improving mental health treatments of the homeless people [2020]
Background:Homeless population has been severely affected by the COVID-19 pandemic. Their living conditions, comorbidity with different pathologies and a greater frequency of mental disorders, make this population vulnerable. Method:We implemented a program of serial visits in a hostel for confined
COVID-19 and Persons Experiencing Homelessness or Vulnerable Housing [2020-04]
Across Canada, over 200,000 people experience homelessness, with nearly 130,000 in emergency shelters. Their situation presents unique challenges for controlling the spread of COVID-19: People residing in shelters are at an increased risk of transmission due to crowded conditions and lack
COVID-19 Response Framework for People Experiencing Homelessness [2020-03]
The below guidance was developed by a number of public health professionals, primary care physicians, psychiatrists, addictions medicine specialists, Municipal shelter and housing leadership, community health, social support, housing and addictions agencies, provides practical information and guidance to reduce the
Current emergency response in Montreal: How does it fit in the services offered to homeless people who use substances?
Highlights• Insufficient availability of services is the most important barrier in the service trajectory of people experiencing homelessness and substance use. • Stakeholders agree that the emergency response is relevant in some contexts: danger to the person’s life or to
Determinants of Tenancy Sustainment Following Homelessness: A Systematic Review [2018]
Background. Tenancy sustainment—maintenance of a tenancy to avoid a premature end of tenure—is fundamental to prevention of homelessness. Understanding what enables a successful tenancy is essential in informing interventions designed to support people in leaving homelessness. Objectives. To conduct a
Determinants of Unmet Mental Healthcare Needs of Single Adults Who Are Homeless or Vulnerably Housed – 2018
Persons who are homeless experience higher levels of mental illness, unmet mental healthcare needs, and physical healthcare needs than the general population. This study aimed (1) to determine the reasons contributing to having unmet mental healthcare needs (UMHCN) and (2)
Discharge policies for homeless people and immigrants: Compromising professional ethics [2020]
Discharging a homeless patient from hospital raises ethical issues which are compounded when the patient is from outside the United Kingdom. This article begins with an extended case study of a 30-year-old homeless man from Lithuania describing his complex medical
Don’t Let Me Fall Through the Cracks: Homelessness amongst Care-Experienced Young People in Wales [2020]
This report is based on the voices and experiences of care experienced young people who have been, or are currently, homeless across Wales. The aim of this research is to amplify these young people’s voices to highlight the challenges they
Effect of Housing First on Suicidal Behaviour: A Randomised Controlled Trial of Homeless Adults with Mental Disorders [2017]
Objective: This study attempted to determine if Housing First (HF) decreased suicidal ideation and attempts compared to treatment as usual (TAU) amongst homeless persons with mental disorders, a population with a demonstrably high risk of suicidal behaviour. Method: The At
Effectiveness of Dialectical Behavioral Therapy on Reduction of Recidivism Among Recently Incarcerated Homeless Women: A Pilot Study [2018]
The purpose of this pilot randomized controlled trial (RCT) was to compare the 6-month outcomes of a Dialectical Behavioral Therapy–Corrections Modified (DBT-CM) program versus a Health Promotion (HP) program on mitigating recidivism among 130 female parolees/probationers between baseline and 6-month
Effectiveness of interventions targeting community integration among individuals with lived experiences of homelessness: A systematic review [2020]
Community integration (CI) has been identified as a key outcome of programs designed to improve the lives of homeless and recently housed individuals (Gaetz, The State of Homelessness in Canada 2016, 2016). Although researchers have explored the extent to which Housing
Effects of a service‐learning experience on health‐related students’ attitudes toward the homeless [2020]
ObjectivesA community engagement service‐learning experience was planned to provide health services for the homeless during a local 1‐day event. The objectives were to (a) determine the feasibility of a service‐learning experience, and to (b) examine the effects on students’ attitudes
Effects of Housing First approaches on health and well-being of adults who are homeless or at risk of homelessness: systematic review and meta-analysis of randomised controlled trials [2019]
Background Homelessness is associated with poor health. A policy approach aiming to end homelessness across Europe and North America, the ‘Housing First’ (HF) model, provides rapid housing, not conditional on abstinence from substance use. We aimed to systematically review the
Employment experiences of formerly homeless adults with serious mental illness in Housing First versus treatment first supportive housing programs [2020]
Objective: This paper examines how formerly homeless adults with serious mental illness living in Housing First (HF) and “treatment first” (TF) supportive housing programs experience employment. Research questions include: How do these individuals experience employment in the context of their
Engaging Adults Experiencing Homelessness in Recovery Education: A Qualitative Analysis of Individual and Program Level Enabling Factors [2020]
Purpose: Recovery Education Centres (REC) in mental health offer a new model of providing recovery supports through emancipatory adult education and recovery-oriented service principles. Despite the widespread adoption of RECs, there is limited evidence regarding factors enabling engagement and participation,
Establishing need and population priorities to improve the health of homeless and vulnerably housed women, youth, and men: A Delphi consensus study [2020]
BackgroundHomelessness is one of the most disabling and precarious living conditions. The objective of this Delphi consensus study was to identify priority needs and at-risk population subgroups among homeless and vulnerably housed people to guide the development of a more
Evaluating transdiagnostic, evidence-based mental health care in a safety-net setting serving homeless individuals [2019]
Homeless individuals experience higher rates of mental illness than the general population, though this group is less likely to receive evidence-based psychological treatment for these difficulties. One explanation for this science-to-service gap may be that most empirically supported interventions are
Eviction Prevention in the Community (EPIC) Pilot Program Evaluation [2018]
The EPIC program was launched in March 2017 by the Shelter, Support and Housing Administration (SSHA), a Division of the City of Toronto. EPIC is a one-year pilot project that provides wrap around eviction prevention services in order to help
Evolving an evidence‐based model for homelessness prevention [2020]
While some progress has been made in addressing chronic homelessness through supportive models, a comprehensive solution for housing loss must include prevention. The purpose of this article is twofold: to conduct a review of the literature on the domains of
Examining the Relationships between Cumulative Childhood Adversity and the Risk of Criminal Justice Involvement and Victimization among Homeless Adults with Mental Illnesses after Receiving Housing First Intervention [2020]
Objectives: Exposure to adverse childhood experiences (ACEs) is associated with increased risk of criminal justice involvement and repeated victimization among homeless individuals. This study aimed to (1) examine whether the relationship between cumulative ACE score and odds of experiencing criminal