Partnerships for Success
Reprinted from the "Housing and Homelessness" issue of Visions Journal, 2007, 4 (1), pp. 4-5
We immediately said 'yes' when asked to guest edit this issue of Visions. The topic of housing for people with mental illnesses and addictions is a key direction for both BC Housing and housing providers such as Pacifica Housing Advisory Association. We are especially pleased that the link between housing and health is being recognized. Programs are emerging that ensure both these elements are present to support successful outcomes for people with mental illnesses and addictions.
In 1974, the federal Minister of Health at the time, Mark Lalonde, issued a report establishing the key factors that influence health status.1 These were lifestyle, the environment, human biology and health services.
Since 1974, additional evidence has greatly expanded the list of factors influencing population health. Key factors now include income and social support networks, education, employment and working conditions, social environments, physical environments, personal health practices and coping skills, healthy childhood development, biology and genetic endowment, health services, gender and culture.2
People with mental illnesses and/or addictions experience many challenges. Without a secure, stable home and without services and supports to help them stay stable, their ability to manage the rest of their lives is impaired. Something that seems so simple - having a place to sleep at night, receive mail, keep personal goods, cook meals and socialize - provides the foundation from which people live their lives. As such, this issue of Visions is both timely and important in its in-depth exploration of housing, homelessness and health.
Homelessness is a complex matter. It is overwhelming for those in the cycle of homelessness - and for those trying to address the problem. And there is no one model for addressing the problem of homelessness. But it's clear that 'bricks and mortar' (i.e., buildings) alone will not solve this problem.
Complexity, however, leads to innovation and creativity. One place this innovation can be seen is through the Premier's Task Force on Homelessness, Mental Illness and Addictions. Created in 2004, the task force is a collaboration between the provincial and local governments to develop new resources to address issues related to homelessness, and its innovation is the recognition that people with mental health and addictions issues may need specialized strategies for stabilizing in housing.
Linking housing and health has certainly led to supported environments that are working. The focus is on creating a range of options that enable the best fit possible between a person's needs and their environment.
And, while there are many models of housing with support services, there are simply not enough supportive housing units available. Economically, supportive housing as part of the solution to end homelessness makes sense. In 2001, the BC Ministry of Community, Aboriginal and Women's Services published a study that found: "When combined, the service and shelter costs of the homeless people ... ranged from $30,000 to $40,000 on average per person for one year (including the costs of staying in an emergency shelter)."3 On the other hand: "The combined costs of services and housing for the housed individuals ranged from $22,000 to $28,000 per person per year."3
Fortunately, various provincial government initiatives, including the Premier's Task Force on Homelessness, Mental Illness and Additions, have created excitement about the possibilities of new programs and housing units being developed. While it will take some time to see new units built and in operation, there have been other measures announced that will help to preserve low-income housing stock for the future. The recent purchase of 10 single room occupancy (SRO) hotels in Vancouver, two townhouse developments in Burnaby and three apartment buildings in Victoria is an example. And the Provincial Homelessness Initiative, launched as a result of the Premier's Task Force, has also resulted in nearly 1,300 new supportive housing units being developed across BC.
The Addiction Recovery Program is an example of a successful initiative. Through a partnership between BC Housing and Vancouver Coastal Health, this program provides transitional, supported housing to people in recovery from problematic substance use. Over the last five years, the program has expanded from providing 15 units of alcohol- and drug-free housing to 125 units scattered throughout the Lower Mainland. This partnership between BC Housing and the regional health authorities speaks to the success of providing housing and delivering needed services to people where they live. More examples of initiatives that link services to housing are described in this issue of Visions.
Matching supply with the demand will always be a challenge - although committed and passionate members at all levels of our communities are working together to end homelessness. Community-based non-profit societies continue to actively seek the financial means and strategic partnerships, in both the private and public sectors, to create more housing units with support services. This issue provides many examples of effective partnerships.
These innovative and effective projects can and do make a difference in people's lives - and in the communities we call home. It's up to us to continue developing this system of combined housing and support services. We encourage you to continue the conversation. Find ways to take the ideas shared in this Visions forward in your own communities.
About the authors
Karyn is Executive Director of Pacifica Housing Advisory Association in Victoria. She has worked and volunteered in the public and non-profit sectors in BC and Washington State. Her career has focused on services and housing for seniors, people with disabilities, families and hardest-to-house individuals.
Margaret is Vice-President of Operations for BC Housing. She has served those in need through nursing, health management and various senior leadership positions. As regional director for Mental Health and Addictions for the Vancouver Island Health Authority, she led the first integration of mental health and addictions programs in BC.
Lalonde, M. (1981). A new perspective on the health of Canadians: A working document. Ottawa: Ministry of Supply and Services. www.hc-sc.gc.ca/hcs-sss/com/lalonde/index_e.html.
Public Health Agency of Canada. (2003). What determines health? Population Health Approach. www.phac-aspc.gc.ca/ph-sp/phdd/determinants/index.html.
Eberle, M., Kraus, D., Pomeroy, S. et al. (2001). Homelessness: Causes and effects. Volume 3. The costs of homelessness in British Columbia. Victoria: BC Ministry of Social Development and Economic Security and BC Housing Management Commission. www.housing.gov.bc.ca/housing/homeless/vol3.htm.