7/29/2019 How we can end chronic homelessness

1/2

Canada can end chronic homelessness

National study the largest randomized trial of its kind in the world, puts Housing

First

by Paula Goering and Stephen Hwang

We have the knowledge, the evidence and the strategies to improve the plight of those who fallbetween the cracks and stay there for long periods of time. But every night, the shelters continueto fill up, and every day, the many people who are homeless on our streets watch as we pass bywith eyes averted.

At this moment, Canada has an opportunity to take action and reduce homelessness dramaticallyby expanding strategies we already know can work.

The federal government launched the National Homelessness Initiative in 1999, after asignificant rise in homelessness. This initiative allocated more than $1 billion to fundingsolutions such as community programs and beds in shelters. Programs such as these play an

important role, but have not measurably reduced the number of homeless people country-wide.For that reason, the current government has sought evidence on the cost-effectiveness ofalternative options, such as Housing First.

Housing First is based on the principle of providing housing to those in need before theyredeemed ready to re-enter society. To qualify for housing, individuals dont need a job or astable lifestyle, and they dont need to enter rehab, though once they get a home, many ofthemwill accomplish all of these things and more.

Canada will soon finish the largest randomized trial of its kind on Housing First in the world.Overseen by the Mental Health Commission of Canada with funding from Health Canada,At

Home/Chez Soi has housed about 1000 people with mental illness in five cities across Canada.Each participant was given a choice of apartments to live in, a rent subsidy and an assigned caseworker for support.

The study randomly assigned 990 participants to a control group of people who only received theservices already available in their cities.

About 85 per cent of participants who were housed are still in the first or second apartment theychose. Not only thatmany of them are thriving. Many are volunteering and enrolling in school.Many participants have accepted professional help for their mental illnesses.

Results from this study will help governments invest cost effectively in the reduction of chronichomelessness and in doing so willradically improve peoples lives.

For every two dollars spent on Housing First, the system saved a dollar by reducing the costs ofpolice detentions, hospital services and shelters. For those who used services the most, thosesavings were even greater, with three dollars saved for every two dollars spent.

7/29/2019 How we can end chronic homelessness

2/2

Homelessness is more than a social issue, its a health issue. The participants inAt Home/Chez

Soi all live with mental illness and they are at a much higher risk of physical illness than mostCanadians. Getting appropriate health care is just one of the things that community supportteams help participants with.

A chronic lack of affordable housing and stable employment opportunities that pay a living wagefor low-skilled workers are often the reason people end up homeless in the firstplace. Its a gameof musical chairs, and when the music stops, often those who need support the most are leftstanding outside the circle. But once they have a decent place to live, they can begin to reconnectwith friends and rejoin the community.

TheAt Home/Chez Soi model is a wise investment in addressing the inequalities faced by thosewith complex illness.

This is ground-breaking research with the potential to help governments drastically improveCanadas approach to homelessness, social policy and our entire health care system. Continued

support for At Home/Chez Soi and similar Housing First programs will help ensure we dont losethe crucial ground weve gained in improving the lives of Canadians.

Paula Goering at the Centre for Mental Health and Addiction and Stephen Hwang at the Centre

of Research on Inner City Health, St. Michaels Hospital, are experts advisors with

EvidenceNetwork.ca and investigators with the At Home/Chez Soi study. They are both

researchers at the University of Toronto.