Sherbrooke Record

A proven way to end homelessne­ss in Canada

- By Jino Distasio Professor of Geography and Vice President of Research and Innovation, University of Winnipeg

Adecade ago, five Canadian cities stepped forward to address mental health and homelessne­ss using an emerging approach called Housing First, which launched in 1992 in New York City. Housing First provides rapid access to independen­t housing combined with other supports for those with the most chronic issues like mental health and addiction challenges.

Housing First has been shown effective in ending homelessne­ss in American cities like New York, but less was known about whether it could work in Canada.

Canada’s homeless population can total approximat­ely 35,000 persons on any given day.

The At Home/chez Soi Project (AHCS) launched in Canada in 2009 to explore the impacts of Housing First. Initial reactions were mixed. Policymake­rs and the general public questioned a program that used taxpayer’s money to give housing and furnishing­s to persons struggling with mental health challenges, homelessne­ss or addiction.

Others gasped at the $110 million price tag Health Canada allocated to the At Home/chez Soi Project. The project was a large research project led by academics, which unnerved many given the scale and vulnerabil­ity of the population being studied. The intent of At Home/chez Soi was to test the American Pathways model in Canada to see if the successes observed in New York could be replicated.

So, what happened to the At Home/chez Soi project and the $110 million? And where did Canada end up in its approach to ending homelessne­ss?

Looking back

Before 2009, few Canadian cities had developed plans to end or reduce homelessne­ss; they struggled with action or innovation beyond the use of shelters that provided a place to sleep and a meal.

Nationally, federal funding did not focus much attention on root causes or preventati­ve approaches either.

Homelessne­ss changed in two fundamenta­l ways in the mid-2000s. First, in 2006, then-senator Michael Kirby released “Out of the Shadows at Last” — a report which highlighte­d the struggles of those living with mental illness. Kirby’s report said they said they felt buried in systems not designed to address the complex needs of people experienci­ng homelessne­ss.

That same year, Malcom Gladwell portrayed Murray Barr, a homeless veteran on the streets of Reno, Nev. Gladwell’s article in the The New Yorker, “Million Dollar Murray,” helped policymake­rs and others understand both the human struggles and the massive economic costs of homelessne­ss.

The rise of Housing First

By the early 1990s after a decade-long rise, New York City’s homeless population exceeded 20,000. The result was increased signs of human distress, addiction and mental health challenges. These had become more acute and harder to address in a high-cost city that lacked the appropriat­e resources.

In 1992, New York City launched its Housing First model: Pathways to Housing. Led by Canadian psychologi­st Sam Tsemberis, Pathways to Housing showed great promise in getting the hardest to house off the streets and into stable, long term, permanent accommodat­ion.

Pathways worked by offering access to a range of supports, dedicated case management and rapid access to housing. This combinatio­n proved more effective than traditiona­l approaches.

In the old model, clients would normally have to earn their way back into independen­t housing and prove they were clean of drugs. Housing First changed this and used a harm reduction approach instead. It also included the provision of permanent housing as a means to work with clients on issues. The housing itself acted much like a form of treatment.

In 2009, Moncton, Montréal, Toronto, Winnipeg and Vancouver launched a comprehens­ive Canadian version of the Pathways model. The intent was to adapt the American approach and collect informatio­n on whether the findings would hold in the Canadian context.

In the decade since the launch of At Home/chez Soi, the number of cities using Housing First increased dramatical­ly from just over five to approximat­ely 70. As well, both the National Housing Strategy and the federal Reaching Home program both consider Housing First as foundation­al to ending homelessne­ss.

The effective results of At Home/chez Soi are well documented. It has been shown to offset the average cost of homelessne­ss in Canada of $55,000 per person. The approach has helped more than 1,000 Canadians move into safe, stable and affordable housing, with many remaining a decade later.

In each of the five cities, practition­ers and academics tinkered with the American mechanics of the model to create localized approaches. In Winnipeg, a strong Indigenous approach emerged. Winnipeg brought together communityb­ased organizati­ons, health agencies and academics to work collaborat­ively to align the model with the needs of the local Indigenous and non-indigenous population­s.

This past month, The Institute of Urban Studies at the University of Winnipeg, in collaborat­ion with members of the Winnipeg At Home/chez Soi team and Indigenous Elders, released its report. The researcher­s emphasize the importance of the leadership of the local community to help localize complex health interventi­ons.

The Winnipeg model demonstrat­es that when communitie­s use their existing skills and knowledge and combine that with a strong tool-kit like At home/chez Soi, they can help to address the needs of local population­s and go a long way to curbing homelessne­ss.

Canada has not ended homelessne­ss yet. But many more communitie­s have better tools to address issues in more meaningful ways than they did just 10 years ago.

Jino Distasio receives funding from SSHRC. I was also the CO-PI on the AHCS project and part of the National Work Group that oversaw the project

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