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A five-year study that housed people with mental illness and drug addictions in apartments scattered throughout Vancouver found most participants stabilized their lives and coexisted peacefully with their neighbours.
The findings mean residents should not be afraid of social housing mixed into neighbourhoods throughout the city, concluded the Mental Health Commission of Canada’s final report into the Vancouver At Home/Chez Soi research project.
“Historically, projects in Vancouver that have tried to house people who were formerly homeless or experiencing mental illnesses in neighbourhoods outside of the Downtown Eastside have met opposition and sentiments of ‘not in my backyard’,” says the report, to be released today.
“That has not been the case for (Vancouver At Home) participants, who have successfully joined neighbourhoods scattered throughout the City of Vancouver.”
Indeed, just last year, Yaletown residents used social media to fight a winter homeless shelter in their neighbourhood and a group of Abbotsford business owners protested the creation of 20 housing units for homeless men because the building could scare away customers.
At Home study participants chose to live in apartments outside the Downtown Eastside, and acceptance from landlords and other tenants was “a hugely powerful part” of their transformation, said SFU health sciences Prof. Julian Somers, the Vancouver study’s lead investigator.
“I think people now understand to a greater degree that housing preference matters,” he said. “Regardless of the state of your mental health or your economics, within reason being able to exercise choice is pretty important to thrive in life.”
The final report into the Vancouver portion of the national Mental Health Commission of Canada (MHCC) study was provided early to The Sun.
The local arm of the $110-million federally funded study took 200 chronically homeless people off the street and put them in random apartments all over the city, where participants were living next door to the buildings’ other tenants.
The research project, which concluded a year ago, found those given homes, compared to a control group of 200 homeless people who were not given housing, had more stable living conditions, committed fewer crimes and relied less on social services.
The final results of the study — which was held in five Canadian cities — were released by MHCC in April, and found that paying for housing and support services for high-needs, homeless people cost nearly the same as leaving them on the street to rotate through shelters, emergency rooms and jails.
The price breakdown in Vancouver was similar: it cost, on average, $28,282 annually to provide housing and support to high-needs participants living in the scattered apartments; as a result, their lives stabilized and they used, on average, $24,190 less per year in social services, the MHCC report said.
That means that for every $10 invested in providing this “housing first” model of support, there was an average savings of $8.55 in avoided use of social services.
For the difference of $1.45, the participant went from living a chaotic life on the street, to living inside and starting to address challenges such as mental illness, addictions, terrible health, poverty and poor quality of life.
“It’s more possible than we thought to support rehousing and recovery for people who have been left out of housing and support for far too long,” said Somers.
“And their success stories can be remarkable, and surprising.”
Those in the high-needs group who were housed relied on emergency rooms “significantly” less and had far fewer criminal convictions compared to their years before entering the study.
They reduced their use of drop-in centres, ambulances and food banks, although more research is required to determine why in some categories use by the unhoused group also fell.
A portion of the 500 Vancouver participants were classified as moderate needs, and the financial and social results for them were not as black-and-white.
For example, intervention costs to provide services to the moderate needs group were, on average, $15,952 per year in Vancouver. But, instead of costing the health and social welfare system less once they were housed (such as the high needs group did), this less-marginalized group actually cost the system $2,667 more each year because their increased use of some services (community health centres and hospital medical units) were not offset by their reduction of use of other services.
Somers, though, argued the moderate needs folks would have cost the system more while living on the street (and, therefore, offset the study intervention costs) if there were more services available — such as drug treatment and mental health services — that they desperately need.
He also insisted this outcome does not mean this model doesn’t work for moderate-needs homeless people — only that intervention early can stop them from becoming a high-needs person, which ultimately costs the system more in crisis response.
“Just because it is cheaper (to leave moderate needs people on the street) than housing them, doesn’t some how lead to the inference that that is acceptable,” he said.
The 300 Vancouver study participants who were given homes are no longer receiving the same social services — and in some cases not living in the same housing — as they did during the study, although most are receiving some form of support.
The MHCC study increased the talk in Canada about the Housing First model — giving a chronically homeless person a place to live first, and then addressing other obstacles such as addictions and mental health.
The federal government pledged in 2013 to spend $600 million over the next five years on Housing First initiatives, because of the findings of the At Home study.
In a speech in Surrey Wednesday, federal secretary of state for social development, Candice Bergen, said $41 million of that money will be allocated to Metro Vancouver and implied it would be invested in neighbourhoods outside the Downtown Eastside.
“The Downtown Eastside is where many of the region’s homeless are found. It is an eye-opening experience to see their conditions firsthand,” Bergen said.
“That’s why our government has placed such an important priority on addressing the issue of homelessness through ... Housing First.”
Somers applauded Ottawa’s move, but said other governments and agencies need to do more.
“There is definitely a movement in the support for Housing First, we are moving in the right direction, but we are not there yet,” he said.
The Downtown Eastside is crammed full of service agencies because it is the last chance for people to rent a room near the welfare rate of $375. Ten years before the study started, Somers said, most participants lived in other neighbourhoods but gravitated to the DTES when their situations deteriorated.
The study’s final report found Vancouver’s homeless population, compared to the rest of Canada, was unique for its “geographic concentration” in the Downtown Eastside.
“The housing options available for people in these circumstances are limited and often of poor quality, which contributes to worsening health conditions and social exclusion,” the MHCC report says.
“Alongside the SROs, a high concentration of drop-in centres, community health clinics, outreach support services, and emergency shelters can be found in the DTES, which comprise a substantial proportion of usual care services for people experiencing homelessness and mental illnesses in Vancouver.”
The MHCC report says its research provides new evidence in the ongoing debate about how best to service Vancouver’s sizable homeless population.
“While service agencies and institutions have struggled to overcome differences of organizational cultures, mandates, and styles of work, the (Vancouver At Home) study has encouraged diverse stakeholder groups to come together and establish a common framework.”
Starting Saturday, The Vancouver Sun launches a four-day series that, for the first time in recent history, tallies the organizations providing services to the Downtown Eastside, as well as the annual costs in the neighbourhood.
The newspaper spoke to many experts about whether these services need to be scattered, in central hubs, to other neighbourhoods throughout the city to better serve our most vulnerable residents.
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