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A four-year project in five cities that aimed to provide practical and meaningful support to Canadians experiencing homelessness and mental health problems by providing homeless people with immediate access to subsidized housing, together with supports. At Home/Chez Soi is a Canadian adaptation based on the Housing First (HF) model. Officially launched in 2009 and with the research officially ending in March 2013, the project sought to determine whether the Housing First approach works in Canada—and, if so, for whom and at what cost.
To gather the most comprehensive data, projects were established in five cities, each with a particular area of focus:
- People also experiencing problematic substance use (Vancouver)
- Urban Aboriginal population (Winnipeg)
- Ethno-racialized populations, including new immigrants who do not speak English (Toronto)
- Vocational study of population (Montréal)
- Services in smaller communities (Moncton)
Participants living with moderate or serious mental illness were randomized into two different intervention categories: 1. Control Group: where participants continued to receive “Treatment as Usual (TAU)”, the services regularly available in their community; or 2. Intervention Group: where participants received “Housing First”, housing plus services Intensive Case Management (ICM) or Assertive Community Treatment (ACT) over the course of the project
Findings across all cities indicate that compared to the Treatment as Usual group (TAU), HF participants obtained and retained housing at a much higher rate, demonstrated more improvement, described fewer negative experiences and demonstrated somewhat better quality of life and community functioning outcomes.
Findings also demonstrated that the support and treatment services offered by HF contributed to appropriate shifts away from many types of crisis, acute and institutional services towards more consistent community and outreach-based services. In addition, results indicate that the HF model can be successfully adapted to serve Aboriginal, immigrant and ethno-racial groups in a culturally sensitive manner. Finally, findings demonstrated that housing stability, quality of life and community functioning outcomes were all more positive for programs that operated most closely to Pathways HF Standards.
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