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Thursday, 14 November 2013

Homelessness in Canada - the efforts of Housing First to find a cure.

There are 150,000 to 300,000 homeless people in Canada.  It seems obvious that homelessness is detrimental to health, yet we do seem to limit our efforts to making homelessness more comfortable through food programs and transient sheltering.

Housing First is an intervention that began in New York City and Toronto that provides people with immediate access to permanent and independent housing, without conditions that an individual be “housing ready” (e.g. requiring one be sober).  Studies of the Housing First initiative have been promising.  It was found to increase housing stability, reduce costs in healthcare and justice system use, and improve quality of life.  Could this work across Canada?

In 2008, the Mental Health Commission of Canada funded the “At Home/Chez Soi” study, implementing the Housing First intervention in 5 cities: Vancouver, Winnipeg, Montreal, Toronto, and Moncton.  It was a randomized controlled trial in which participants living with mental disorders were randomized to receive housing and community support versus treatment as usual.

The final report of the study is slated to be released later this year.  Interim results (Mental Health Commission of Canada) have found that participants who received housing spent a greater proportion of time in stable housing over the year.  The initiative may also offer savings to the public purse through reduction of costs for other shelters, health, and justice services.  But it is the personal stories of people recruited to the study that describes the most important results. (National Film Board at home)

It is a minor tribute to the current government that Housing First was acknowledged in the October 16th throne speech as one of the few health areas that this government purports to promote through this sitting of the house.  Will they deliver on the benefit? or maintain a mere rhetoric of feeble support?

It is odd that we need a study to show that stable housing improves lives.  After all it is acknowledged internationally as a fundamental need and a prerequisite of health.  It is nice to know that it can also save money.  But, is that the reason we act?  

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