Volume 33 • Number 4 • December 2014
Special Issue
Articles
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Evaluating the Planning and Development Phase of a Demonstration Project: At Home / Chez Soi Moncton
This research focused on the planning and development phase of the Moncton site of At Home / Chez Soi, a multisite research demonstration project funded by the Mental Health Commission of Canada, developed to test an innovative approach to working with homeless people living with severe and persistent mental illness in 5 Canadian cities. Using qualitative methods, 11 local key informants participated in semistructured interviews focusing on: (a) early planning processes; (b) principles and values guiding the planning process; (c) planning actions; and (d) stakeholder relationships. We found that contextual elements, especially those related to the small size and bilingual nature of the city and the lack of mental health services in the area, had a significant impact on the planning and development of the project in Moncton. The implications of findings for future planning of complex community interventions are noted.
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This paper describes the implementation of Housing First in a small Canadian city. Given that the majority of Housing First research has been conducted in large American cities, providing a Canadian context in a small city contributes significant insights for similarly sized areas. The main objectives were to determine the adaptations made to the Housing First model and the contextual realities that affected implementation. Data were collected from two sources: (a) a fidelity assessment by an external team of experts; and (b) key informant interviews and focus groups with program staff and consumers. Results demonstrate that Housing First can be successfully implemented in a small city but with certain constraints and adaptations, notably more limited consumer choice of housing, challenges related to consumer access to transportation, and adaptations to program staffing. Implications for practice are discussed.
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Cet article présente une évaluation formative d'un programme Logement d'abord (Housing First) offert en région rurale. Les deux objectifs consistent à décrire les personnes desservies et comment le modèle Logement d'abord fut adapté afin d'offrir des services en milieu rural. La recherche repose sur une méthodologie mixte. Le volet quantitatif, de nature descriptive, porte sur 23 participants et participantes. Le volet qualitatif s'attarde à ce qui a pu contribuer à l'implantation du modèle et les défis qui subsistent, selon 15 informateurs clés. Les leçons tirées de l'expérience et les retombées pour les politiques et les programmes de logement au Canada sont discutées.
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Cette étude utilise le modèle de Gelberg-Andersen afin de cerner les caractéristiques des personnes itinérantes de la région de Moncton ayant recours aux services de santé, sociaux et communautaires. Les 194 participants et participantes ont été recrutés dans le cadre du projet At Home / Chez Soi. Ceux et celles souffrant d'un état de stress post-traumatique ont moins eu recours aux services hospitaliers ambulatoires que ceux et celles présentant un autre diagnostic. Les femmes utilisent davantage les services sociaux et communautaires. Nos résultats amènent un éclairage sur la nécessité d'adapter les pratiques et les services de santé, sociaux et communautaires aux besoins et conditions de vie des personnes itinérantes.
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Many veterans at risk of homelessness also suffer from mental health problems. The aim of this study was to identify correlates of veteran status among housing, mental health, and service use variables in a Canadian sample of homeless people with mental illness. The data were obtained from At Home / Chez Soi, a Canadian multisite study. The participants were 99 veterans and a matched comparison group of 297 non-veterans. Data were gathered at baseline and were analyzed using logistic regression. The veteran and non-veteran groups were found to be similar, although veterans attended school longer, and were more likely to have been victims of a robbery in the 6 months prior to enrolment in the study. Veterans were not overrepresented in this sample as compared with the general population.
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Le site de Moncton se trouve à être la plus petite des 5 villes canadiennes participant au projet de recherche At Home / Chez Soi visant à expérimenter et évaluer le modèle Logement d'abord. Une des conséquences de cette petite taille est la proximité et l'importance de l'environnement rural. Nous avons ajouté un sous-projet rural (n = 22) au volet qualitatif pour la région de Moncton (n = 20). Nous procédons à une analyse comparative de ces 2 volets de façon à mettre en évidence les opportunités et les contraintes propres à chacun, surtout liés aux transports et à la concentration des services.
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Dans le cadre du projet At Home / Chez Soi visant à évaluer l'efficacité de l'approche Logement d'abord, un volet a été consacré à une recherche qualitative basée sur le récit de vie en vue de mieux comprendre les impacts du projet au niveau du mode de vie et des perceptions des participants. Deux groupes de participants, expérimental (n = 10) et de comparaison (n = 10), ont été interviewés au début de l’étude ainsi qu'après 18 mois (groupe expérimental, n = 9; groupe de comparaison, n = 8). L’étude tend à montrer que ce modèle d'intervention contribue à des changements significatifs dans la perception des participants d'eux-mêmes et de leur condition de santé mentale.
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Housing First (HF) effectively houses the majority of homeless individuals suffering from mental illness; however, a small subset continues to struggle with unstable housing. This paper describes a supportive housing pilot program developed at the Moncton site of the At Home / Chez Soi demonstration project for HF participants who have experienced difficulty achieving housing stability while receiving HF services. Specifically, Peer Supportive Housing (PSH) was created for participants demonstrating ongoing unstable housing in the HF program. Results from structured interviews with five program staff and nine tenants of PSH describe the successes, challenges, and perceived outcomes of the early implementation of the program. PSH can supplement HF, and may help to meet the needs of some tenants who are unable to achieve stable housing after a trial of receiving HF services.
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The At Home / Chez Soi project, funded by Health Canada through the Mental Health Commission of Canada, involves evaluating the implementation and effectiveness of the Housing First (HF) approach, a complex community-based intervention that addresses homelessness in people with severe and persistent mental illness. This paper examines the perspectives of community partners on the implementation of HF in Moncton, New Brunswick. Engagement varied, but overall, HF was seen as fitting well within the network of existing community resources and filling a long-standing gap in services. Community will for sustaining HF was present, though concerns were expressed about sources for ongoing funding.
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