Focusing on Housing First, an emerging strategy to combat homelessness, the Salvation Army's National Advisory Board heard a presentation from Catharine Hume, director of housing and homelessness, Mental Health Commission of Canada, at its January 15, 2015 meeting in Toronto. The National Advisory Board is a group of 12 members who support the Army with strategic guidance on its national operations and services.
Hume's experience with homelessness and Housing First includes coordinating the Vancouver At Home/Chez-Soi Project, a multi-site research demonstration project on Housing First. With 497 participants, the project examined Housing First as a means of ending homelessness for people living with mental illness, with a particular focus on those who also had challenges with substance use.
Hume began her presentation by outlining three principles that guide this strategy: immediacy, choice and harm reduction. Housing First provides immediate access to permanent housing with no readiness requirements, such as sobriety or treatment compliance. The program's primary goal is giving clients safe, secure housing.
The second principle, choice and self-determination, means giving clients options in terms of the housing they end up in and the support they receive. It involves working with clients one-on-one to identify their goals and then helping them to accomplish those goals. Unpacking the barriers that prevent clients from achieving their goals often leads to addressing issues such substance abuse and mental illness.
Speaking about the third principle, Hume emphasized that harm reduction “is where the conversation starts, but it's not where the conversation ends.” Harm reduction is about creating relationships with clients and helping them shift their perspective on what is possible in their lives. When clients have set personal goals, “they begin to see substances as barriers to things they hold dear,” Hume noted.
Though Housing First is still in its “early days,” Hume shared that the research project demonstrated a high success rate: Housing First resulted in stable housing for 87 percent of clients. She also noted that there were no “predictors” of success or failure (such as substance abuse, length of homelessness or type of mental illness) for clients.
Concluding the meeting, Mary Ellen Eberlin, territorial social services secretary, thanked Hume for her enlightening presentation, after which Lt-Colonel Junior Hynes, secretary for program services, closed the meeting with prayer.
Hume's experience with homelessness and Housing First includes coordinating the Vancouver At Home/Chez-Soi Project, a multi-site research demonstration project on Housing First. With 497 participants, the project examined Housing First as a means of ending homelessness for people living with mental illness, with a particular focus on those who also had challenges with substance use.
Hume began her presentation by outlining three principles that guide this strategy: immediacy, choice and harm reduction. Housing First provides immediate access to permanent housing with no readiness requirements, such as sobriety or treatment compliance. The program's primary goal is giving clients safe, secure housing.
The second principle, choice and self-determination, means giving clients options in terms of the housing they end up in and the support they receive. It involves working with clients one-on-one to identify their goals and then helping them to accomplish those goals. Unpacking the barriers that prevent clients from achieving their goals often leads to addressing issues such substance abuse and mental illness.
Speaking about the third principle, Hume emphasized that harm reduction “is where the conversation starts, but it's not where the conversation ends.” Harm reduction is about creating relationships with clients and helping them shift their perspective on what is possible in their lives. When clients have set personal goals, “they begin to see substances as barriers to things they hold dear,” Hume noted.
Though Housing First is still in its “early days,” Hume shared that the research project demonstrated a high success rate: Housing First resulted in stable housing for 87 percent of clients. She also noted that there were no “predictors” of success or failure (such as substance abuse, length of homelessness or type of mental illness) for clients.
Concluding the meeting, Mary Ellen Eberlin, territorial social services secretary, thanked Hume for her enlightening presentation, after which Lt-Colonel Junior Hynes, secretary for program services, closed the meeting with prayer.
When I worked in sheltering & housing in Victoria, beginning in 2009, this was the model that the rest of the community providers were already sold-out on. The Salvation Army, however, historically had operated on the Continuum of Care model, which essentially means moving people through a system before they have their own housing (i.e. from the street, to emergency shelter or addictions program, to some sort of transitional housing and finally to independent living). The traditional model is more focused on readiness for housing, whereas the housing first model focuses more on the right to housing.
I think there are pros and cons of both, which ultimately leads me to conclude that there is not a “one size fits all” solution to dealing with homelessness. In Victoria, our working group of community housing providers decided to take on an ambitious goal of housing the one hundred “hardest to house” people through a Housing First model. While it had some success, there was a lot of frustration. Landlords who had agreed to allot a portion of their units for this began backing out due to concerns about tenant safety, property damage and criminal activity. Our group had to revamp what “Housing First” would mean (because they didn’t want to abandon the philosophy) and that included supportive housing being the first option for some. Some would argue then that facilitating people’s entry into supportive housing is not really “housing first” after all. There is some truth in that.
On the other side, there was some learning for the Army. When my wife and I took over in 2009, our “transitional housing” program had people living there for over 20 years. Hardly transitional. We had to admit that our programs didn’t work that well. We had not done a good job in helping people move on to independence, mainly because that was not our specialty. Therefore there was this cultural acceptance that some people would be with us forever. We began limiting our transitional housing program residents to a two-year stay (not written in stone) and got our staff fully engaged in helping residents work towards their own goals that would lead to independence. The number of people who left us and secured housing began to trend significantly upwards. It was an eye-opener for many of the team members.
There are also philosophical underpinnings to our preference for the traditional model that we need to look at as well. They are perhaps too many to get into, but we should note that they also often inhibit the progress of those we serve.
At the end of the day, we need to think about a variety of ways to deal with homelessness. Housing First and Continuum of Care are just two options in the overall answer. But being proactive in this means a couple of things for us. First, there must be better engagement and cooperation with other providers. Secondly, we need to think critically about our ability to quickly respond to and engage with new ideas.