how to implement housing first presented by: sylvia starosta, director of clinical operations, cota...

How to Implement Housing First

Presented by:

Sylvia Starosta, Director of Clinical Operations, Cota

Pam Nir, Senior Manager, Clinical Services, Cota

Jo Connelly, Program Manager, Toronto North Support Services (TNSS)

2015 Annual Addictions and Mental Health Conference

May 25, 2015

Learning Outcomes

1. Enhance knowledge of the Housing First Model in ACT and Case Management

2. Widen the discussion about possible adaptations to standard ACT and Case Management to better meet the needs of homeless individuals with serious mental illness and addictions

3. Identify steps taken to promote a recovery orientation

4. Q & A

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What is Housing First (HF)?

• An intervention that supports people who are homeless to move quickly from the street or emergency shelters into permanent housing, with supports that vary according to participant need

• An effective tool for working on chronic or episodic homelessness while reducing pressure on other emergency services

• An evidence-based approach with measurable outcomes

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Housing First is…

PhilosophySystems Approach

Program Model Intervention

HF

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Step Model from Sam Tsemberis

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Evidence-Based Approachin Canada

In 2009, the MHCC launched the At Home /Chez Soi 4-year research demonstration project in 5 cities across Canada

The Study Objectives: To determine the effectiveness

and

cost-effectiveness of Housing First

for homeless people with mental

illness in the Canadian context8

Toronto Context

Homelessness • City population: 2.5 million• 5000 people are homeless every

night• 27,000 people use shelter each

year• 25-33% have schizophrenia, major

depressive disorder, or bipolar affective disorder

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Housing First: Study Results (Toronto)

After 2 years in study: Participants receiving

Housing First services were stably housed 80% of time compared to 54% of the control group

• In the last 6 months of the study, 12% of HF clients were homeless compared to 39% of the control group.

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Costs

Housing First costs (average per participant per year)

• High needs (ACT): $21,089• Moderate needs (ICM): $14,731

Every $1 invested in Housing First resulted in average saving of:

$1.50 for high needs participants

$0.30 for moderate needs participants

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HF Systems Approach: Toronto

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Lessons Learned

• Get Housing First right – teams demonstrating higher fidelity to the model achieved better outcomes

• Housing stability, quality of life, and community functioning outcomes were all more positive for programs that operated more closely to HF standards

• This finding indicates that investing in training and technical support can pay off in improved outcomes

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Resources

• Canadian Housing First Toolkit– http://www.housingfirsttoolkit.ca/

• National Film Board – http://athome.nfb.ca/#/athome

• Homelessness Partnering Strategy.– http://actionplan.gc.ca/en/initiative/homelessness-partnering-

strategy

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Thank you!

Sylvia Starosta

starosta_s@cotainspires.ca