Visions Journal, 2011, 7 (2), p. 5
Income is a key determinant of health and is related directly to other determinants of health, including access to adequate healthy food and access to safe and secure housing. Many people in our communities take for granted that their income allows them to access things that are so important for their health and for their lives. However, about 11% of people in British Columbia—over 500,000 people— are in a low-income category.1 Many of these people face difficult day-to-day decisions directly related to their low income. As costs continue to increase and incomes do not keep pace, people will face increasing challenges. People with mental illness are over-represented in this low-income category and many live in poverty. This can undermine their ability to achieve health and wellness.
In Canada, as in many other countries, there is a growing gap between rich and poor. In British Columbia, people in the richest category earn 10 times more than people in the poorest category. This gap continues to grow.2 While we have many social programs designed to address poverty, including income assistance and social housing, people accessing these programs often continue to struggle with low incomes. The Vancouver Foundation’s recent “Vital Signs” report from the Metro Vancouver region identified affordability as a key issue facing the region.
The Mental Health Commission of Canada’s At Home/Chez-Soi project is exploring a Housing First approach for people who have experienced homelessness and mental illness. The project focuses on providing housing subsidies and outreach-based supports to help people maintain their housing and make connections in their communities. Members of the project’s Speaker’s Bureau speak about the critical importance of being able to access safe and secure housing. This provides a basis for them to begin to address other issues in their lives and achieve well-being.
Vancouver is a site for the project, and the project team is working with 290 people over the next few years to secure and maintain housing and work with people to achieve other important goals in their lives. Through the project, we subsidize people’s income and increase their housing options, which has often been limited to single room occupancy (SRO) hotels. The housing subsidy allows people to have housing options throughout Vancouver, well beyond the Downtown Eastside or the Downtown core.
Social and Enterprise Development Innovations (SEDI) in Ottawa has recently published work on Independent Living Accounts for people living in shelters, many of whom have mental illness. This approach includes connecting people to a financial institution and working with people on financial skills such as banking and budgeting. It also provides matched savings as an incentive to save money towards the cost of securing housing, which is a frequent barrier for people. This work encourages us to think beyond budgeting with very low incomes. It moves to working with people to understand their relationship to money, connecting them to financial institutions, identifying financial goals and working with hem to achieve these goals.
Taking this financial literacy approach as we work with people with mental illness provides another vehicle for us to help support people as they continue to struggle with poverty. Advocating for increased employment of people with mental illness, living wages and other more systemic solutions are also critical. As psychiatrist and Pathways to Housing founder Dr. Sam Tsemberis has said, recovery from mental illness is a real possibility, but recovery from poverty can often be the more significant hurdle.3
About the author
Catharine is Project Site Co-ordinator for the Mental Health Commission of Canada’s At Home/Chez-Soi project in Vancouver and Director of Grants and Community Initiatives at the Vancouver Foundation
Human Resources and Skills Development Canada. (2011). Indicators of Well-Being in Canada. Financial Security — Low-Income Incidence. Ottawa, ON: Author. www4.hrsdc.gc.ca/[email protected]?iid=23#M_5.
Vancouver Foundation. (2010). Vancouver Foundation’s Vital Signs for Metro Vancouver [report]. Vancouver, BC: Author. www.vancouverfoundationvitalsigns.ca/wp-content/uploads/public-opinion-poll/regional-comparisons/vitalsignsreport.pdf.
Tsemberis, S. (2006, January). The Top Ten Concerns About Housing First. Treatment for Homeless Program Technical Assistance Workshop, Baltimore, MD. www.conferences.jbs.biz/tx_for_homeless_06/presentations/Thursday, Jan 26/Housing First, Tsemberis.pdf.