A ground-breaking study could change the way homeless people with mental illnesses are treated in Canada. Currently the focus is on providing short-term, emergency shelter.
But this study suggests a better approach is to try to get people into permanent housing. It is better for their functioning in society and, for the heaviest users of social and health services, it is less expensive.
30,000 Canadians homeless every night
An estimated 30,000 Canadians are homeless on any given night and the issue of homelessness costs the economy seven billion dollars annually, according to the Mental Health Commission of Canada, a body funded by the federal government to help develop a mental health strategy and reduce the stigma surrounding mental illness.
Testing a new approach
In 2008, the government set aside $110 million for an experiment to test a new approach to mental health care called Housing First for homeless people with serious mental illness in five cities across Canada.
The program approached people who had lived on the street or in emergency shelters for some time and offered them a place of their own in the community. They were asked where they wanted to live, with whom and what kind of housing they wanted. That was then provided to them with no preconditions.
One thousand people were made this offer and one thousand were not, and the outcomes were compared. Those who received rent supplements and support to help them stay in the homes had good outcomes, says Paula Goering, a professor at the University of Toronto and an affiliated scientist with the Centre for Addiction and Mental Health.
Having a home ‘helps people get motivated’
“It helps people to get motivated to work on other problems in their lives and to reconnect with families and for some, to go back to work and to go back to school,” says Goering. “The Housing First group had significantly greater quality of life and social functioning.”
And for those who had been the heaviest users of various social services there was a big cost savings in that every ten dollars spent on housing them, $21.72 was saved.
A tool to transform services
Some provincial governments have already responded to a preliminary report indicating the same kinds of results and are beginning to change their own approaches to mental health care. While the federal government in Canada funds health care, it is the provinces which organize and deliver that care.
Goering says it will take some time to train staff in the mental health field to work differently and the Mental Health Commission is developing a tool kit to help them. It is an interactive implement that will be available on line in May.
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