Innovative Approaches to Housing the Homeless

Megan Dumas

Reprinted from "Housing and Homelessness" issue of Visions Journal, 2007, 4 (1), pp. 26-27

Last year the Social Planning and Research Council of BC (SPARC BC) released a report entitled Housing and Services for People with Substance Use and Mental Health Issues.1 The report highlights the key findings of two studies conducted for the federal government.2,3 It reviews housing programs for the high number of homeless people who have mental illness and/or addiction issues. Twenty-one groundbreaking housing programs in North America and the UK are recognized for offering innovative approaches to this complex issue. Outlines of five of these programs follow.

Canadian Mental Health Association (CMHA), Ottawa Branch

  • Where: Ottawa, Ontario

  • Type of clients: Participants must have a serious mental illness. Most also have substance use problems.

  • Type of housing: Permanent.

  • Scattered or dedicated site: Scattered.

  • Services offered: CMHA Ottawa provides integrated treatment services. The client controls where, when and if they participate in treatment.

  • Harm reduction or abstinence based: Harm reduction. While clients are encouraged to reduce their use or to opt for less harmful substances, there is no expectation that they practise abstinence while in housing.

  • Why they're unique: While most housing programs find it challenging to find suitable housing for their clients, CMHA Ottawa has successfully formed agreements with both non-profit housing providers and private landlords. This allows CMHA to provide a higher calibre of housing for their residents. Most of their units have amenities such as exercise rooms, pools, in-suite laundry and one even has a Jacuzzi! They believe that by placing their clients in better apartments, they are setting them up for success. So far it's working: "90% of the clients using their services were still housed after nine months."1

Mainstay Residence, Winnipeg

  • Where: Winnipeg, Manitoba

  • Type of clients: Single men and women with a history of substance use make up 30% of the residents, 20% have mental health issues and 40% have concurrent disorders.

  • Type of housing: Transitional.

  • Scattered or dedicated site: Dedicated.

  • Services offered: Residents have access to a community mental health worker specially trained to work with patients with concurrent disorders. Case managers offer a wide range of services designed to help residents reintegrate into the community.

  • Harm reduction or abstinence based: Abstinence based. Residents are expected to remain abstinent or be working toward abstinence. Residents may be sent temporarily to another treatment facility if they suffer a relapse, but are not discharged from the program for using.

  • Why they're unique: Residents are required to work toward abstinence during their stay and must also actively work on developing life skills to help them stay off the streets.

Westview Dual Diagnosis Program

  • Where: Regina, Saskatchewan

  • Type of clients: All clients must have a concurrent diagnosis of severe mental illness and substance abuse.

  • Type of housing: Transitional. Westview is considered a treatment facility.

  • Scattered or dedicated site: Dedicated.

  • Services offered: The focus is on integrated services concentrating on both mental health and addictions issues. Each resident works with a key worker to develop a personal recovery plan.

  • Harm reduction or abstinence based: Abstinence and harm reduction based. While the residence itself is "dry" and residents are to be working towards abstinence, it is understood that relapse is part of the recovery process and residents will not be evicted for using drugs or alcohol. Those who relapse are expected to commit to a detox plan.

  • Why they're unique: By adopting elements of both harm reduction and abstinence based approaches, they are able to focus on abstinence as an ultimate goal but support their residents during periods of relapse.

Anishnabe Wakiagun

  • Where: Minneapolis, Minnesota, US

  • Type of clients: Residents are mostly American Indians* who suffer from late stage chronic alcoholism. This is a population that is much more likely than the average American to have substance abuse issues.

  • Type of housing: Permanent.

  • Scattered or dedicated site: Dedicated.

  • Services offered: Services focus primarily on medical care and health issues. Program participation is not mandatory.

  • Harm reduction or abstinence based: Residents may consume alcohol in their own rooms, but it is forbidden in all common areas. The possession and use of other drugs is strictly prohibited and residents caught using will be discharged immediately.

  • Why they're unique: Treatment reflects American Indian cultural value.

New York Pathways Program

  • Where: New York City, New York, US

  • Type of clients: Accepts people with mental illness, who are chronically homeless. Ninety percent of residents suffer from a substance abuse disorder.

  • Type of housing: Permanent.

  • Scattered or dedicated site: Scattered.

  • Services offered: Support services are centred around what the client wants; participation is totally optional.

  • Harm reduction or abstinence based: Harm reduction based. There is no expectation of sobriety or participation in treatment programs; however, addiction services are available. Relapses are accepted as a part of the recovery process.

  • Why they're unique: By building the program around what each client wants, Pathways has achieved success: "Between 1993 and 1997, 88% of Pathways clients remained in their housing compared to 47% of those who went through a New York City treatment system."1

Each program offers a variety of support services ranging from mental health and addictions counselling to money management and life skills training. CMHA Ottawa offers staff access until 10:00 p.m. and the other four organizations offer 24-hour on-site staffing.

The common thread

The key to success across all these programs seems to be offering housing and services based on the clients' strengths, goals and needs. While this approach may seem like common sense, it has not traditionally been used. A client-centred approach requires access to a range of housing options - that is, wet and dry, scattered and dedicated - as well as a variety of service options for the residents. This allows clients to decide what is best for themselves, effectively reducing the chances of relapse.

While this report does lend some hope to a desperate situation, it also makes clear there is still much research that needs to be done.

*The terms American Indians and Native Americans are commonly used in the U.S. even today.

 
About the author

Megan is a communications Officer at CMHA BC Division and is the Editorial Assistant for Visions.

Footnotes:
  1. Kraus, D., Serge, L. & Goldberg, M. (2006). Housing and services for people with substance abuse and mental health issues. Prepared for the Housing and Homelessness Branch, Human Resources and Social Development Canada. www.sparc.bc.ca/index.php?option=com_docman&task=doc_download&gid=155&catid=127&Itemid=11

  2. Zamprelli, J. (2005). Homelessness, housing, and harm reduction: Stable housing for homeless people with substance use issues (Research Highlight: Socio-economic Series 05-027). Prepared for Canada Housing and Mortgage Corporation. www03.cmhc-schl.gc.ca/b2c/b2c/mimes/pdf/64031.pdf

  3. Kraus, D., Serge, L. & Goldberg, M. (2006). Services to homeless people with concurrent disorders: Moving towards innovative approaches. Prepared for the Housing and Homeless Branch, Human Resources and Social Development Canada. www.sparc.bc.ca/index.php?option=com_docman&task=doc_details&gid=154&catid=127&Itemid=110

 

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