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Fostering Successful Tenancies A Comprehensive Guide for Social, Affordable and

Supportive Housing Providers

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Project Overview

The Best (Practice) Way to End and Prevent Chronic Homelessness in Windsor Essex was a project funded

by the Ontario Ministry of Municipal Affair and Housing’s Innovation, Evidence and Capacity (IEC)

Building Fund. The project led by the City of Windsor in collaboration with Family Services Windsor-

Essex and Canadian Mental Health Association Windsor Essex County. The purpose of the project is to

increase the capacity in the housing sector, which will help to reduce and prevent individuals and families

from experiencing and/or returning to homelessness by creating new systems to support and prioritize

people seeking and requiring service.

This resource toolkit was created as a component of the project supporting social, affordable and

supportive housing providers, to assist in building their capacity and to foster successful tenancies in a

proactive manner that are based on best and emerging practices.

Special thanks to the IEC Steering Committee, Family Services Windsor-Essex and Canadian Mental

Health Association Windsor Essex County for contributing their experience and expertise to ensure the

project’s success.

Funding for this project was provided by the Province of Ontario

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Table of Contents

Introduction

Module One: Challenging Behaviour & Response Strategies 4

Module Two: Hoarding 12

Module Three: Addictions 23

Module Four: Best Practices in Housing 31

Module Five: How to Best Stress at Work 36

Appendix A: Community Resources 64

Version 1.0: January 2019

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Introduction: Approaches for Fostering Successful Tenancies

This Resource Toolkit is a five-module professional development package for social, affordable and

supportive housing providers and their front-line staff, intended to enhance staff competency, and

improve relationships with tenants. Each module will provide strategies, tips and resources to help turn

challenging tenancies into successful ones.

The five-module series focuses on the following topics:

1. Challenging Behaviour and Response Strategies

2. Hoarding

3. Addictions

4. Best Practices in Housing

5. How to Beat Stress at Work

Module 1, Challenging Behaviour and Response Strategies is an introduction to the series, encompassing

core resources that can be transferred into each module. Each subsequent module provides specific

topic information and resources.

The focus of the series is to provide strategies, tips and resources on how to foster successful tenancies

by providing more insight into topic areas that have high re-occurrence amongst landlord/tenant

relationships.

Looking for community supports? At the end of this toolkit, you will find information on helpful

community resources. For additional resources or information, you can also dial 2-1-1 or chat online at

www.211ontario.ca and speak with a specialist about other community, social, health and government

supports available. Free, confidential and available 24/7!

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Module One: Challenging Behaviour & Response Strategies

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Challenging Behaviour & Response Strategies

This introductory module provides strategies, tips and resources or “tools” on how to manage

challenging tenancies. It offers insight into challenging behaviour and responses that can be used by

landlords when interacting with tenants. A challenging behavior can be something a tenant says or does

that you may not feel comfortable or equipped to deal with.

All behaviour is simply a response to a situation, and because we all have unique backgrounds and

experiences, some individuals might have more difficulty responding to everyday challenges and stresses

of life. Challenging behaviour often reveals itself in different forms, including but not limited to:

aggression, anger, avoidance, manipulation and inappropriate conduct. In many circumstances,

challenging behaviour are directly related to trauma, addictions, mental illnesses, situational stress or

other health concerns. When interacting with someone in distress, it is beneficial not to try to diagnose

“what is wrong” with the person, but rather to consider what has happened to the individual.

Identifying and understanding challenging behaviour and learning some effective response techniques

will empower you to control your reaction(s) and effectively choose the best strategy to achieve a

satisfactory outcome for all concerned.

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WHAT ARE CHALLENGING BEHAVIOURS

Challenging behaviour is sometimes interpreted as ‘problem behaviour’, ‘difficult behaviour’ or ‘socially

unacceptable behaviour’. A best practice approach would view a person’s behaviour not as a ‘problem’

that needs to be fixed or that the person may be doing something ‘wrong’ but would seek to understand

what else is going on beyond the behaviour in that person’s life. The expressed behaviour may be an

indication there is an unmet need or potential difficulty with communication.

Recognizing the signs when a person may be experiencing emotional distress or showing signs of mental

illness, and understanding the possible causes may assist in helping the person through the difficulty

they are facing.

UNDERSTANDING AND RECOGNIZING EMOTIONAL DISTRESS OR SIGNS OF MENTAL

ILLNESS

Recognizing the signs of emotional distress and/or mental illness and understanding the possible causes

can empower you to respond more effectively to a challenging situation and to better empathize with

another person’s struggles.

It is important to note that most encounters with people experiencing emotional distress or demonstrating symptoms of mental illness do not pose a safety risk or threat of violence; however, some individuals do present a danger to themselves or others. The behaviours a person is exhibiting may be affected by untreated mental illness, medical problem, substance use and/or external situation stress that is unusually extreme (i.e. divorce, loss of job, death of a significant person, and past trauma and/or a combination of these or other factors).

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INDICATORS OF EMOTIONAL DISTRESS AND MENTAL ILLNESS

Understanding the indicators of emotional distress and mental illness is the first step in knowing how to

respond to tenants who may be exhibiting challenging behaviour. This section will outline some of these

indicators and will be followed by suggested strategies for you to employ when interacting with tenants

who display such behaviour.

Emotional distress can be described as [overwhelming] unpleasant feelings or emotions that impact

one’s level of functioning.1

There are five indicators that a person may be in a state of emotional distress including:

1. A change in personality

2. Agitation

3. Withdrawal

4. Decline in personal care

5. Hopelessness

Five Factors Contributing to Emotional Distress

1. Mental Illness (acute phase)

2. Under the influence of a substance

3. Experiencing serious or complex medical conditions

4. Experiencing extreme situational stress

5. Combination of the above

According to the Canadian Mental Health Association, mental illnesses can take many forms, just as

physical illnesses do. Mental illnesses are still feared and misunderstood by many people, but the fear

will disappear as people learn more about them. If you, or someone you know, has a mental illness, there

is good news: all mental illnesses can be treated.

Mental illness refers to a wide range of mental health conditions — disorders that affect your mood,

thinking and behavior. Examples of mental illnesses include depression, anxiety disorders, schizophrenia,

bipolar disorder, eating disorders and addictive behaviors.2

1 https://study.com/academy/lesson/what-is-psychological-distress-definition-quiz.html 2 https://www.mayoclinic.org/diseases-conditions/mental-illness/symptoms-causes/syc-20374968

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Common characteristics of mental illness when psychosis is present are described below:

A person experiencing emotional distress and/or mental illness may exhibit the following four types of responses.

1. Verbal Indicators

When a person says things that do not seem to make sense or seem inappropriate, this may be an

indication that they are experiencing emotional distress and/or mental illness. Key verbal indicators are

listed in the chart below.

Common Characteristics of Mental Illness

MOOD

unusual, inappropriate, and/or extreme emotions

THINKING & PERCEPTION

illogical thoughts, false beliefs –hallucinations –seeing, hearing, feeling things with no basis in reality, delusions

BEHAVIOUR

isolating self, talking to oneself (responding to voices), suspicion/fear of

others

Verbal Hostility or Excitement

Talking excitedly or loudly

Argumentative, belligerent, unreasonably hostileThreatening harm

Unusual Speech Patterns

Nonsensical speech or chatter

Word repetition

Pressured speech

Extremely slow speech

Illogical Thoughts

Obsessive thoughts

Grandoise thougthsIdeas of persecution

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2. Environmental Indicators

When a person is experiencing emotional distress and/or mental illness, there may be aspects of an

individual’s surroundings that may be unusual or inappropriate, such as:

3. Behavioural Indicators

A person’s behaviour may be an indicator of emotional distress and/or mental illness. Some behaviours

to be aware of include:

Inappropriate Objects

Toys, dolls

Waste/Matter/Trash/Hoarding

Unusually large accumulation of personal belongings or trash

Decoration

Strange trimmings and/or inappropriate use of household items (ex. Tinfoil window coverings)

Body Movements

Strange posture or mannerisms

Lethargic, sluggish movements

Pacing, agitation Repetitious, ritualistic movements Rocking/Shifting from side to side

Physical Appearance

Inappropriate to environment (ex. shorts in winter, heavy coats in summer)

Lack of self care or poor hygiene

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4. Other Indicators

Lastly, a person may present with other indicators. Some to be aware of include:

Important to note: When making observations take note of as many indicators as possible. Put the indicators in the context of the situation and be mindful of environmental factors and cultural influences.

REFLECTION Can you think of a time when you had to interact with a tenant who was exhibiting verbal, environmental or behavioural indicators of emotional distress or mental illness? How did you handle the interaction? If you reflect on such an example and think, about how difficult the interaction may have been; keep reading to learn more about recommended ways to more effectively respond to such challenging behaviour.

Inappropriate emotional reactions

Overreacting to a situation in an overly angry or frightened manner

Lack of emotional response or excessive emotional response

Reacting in opposite of expected emotion

Other Indicators

Responding to voices or objects that are not there

Confusion, disorientation or unawareness of surroundings / time of day date/ address, etc.

Causing injury to self

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RESPONSE STRATEGIES FOR CHALLENGING BEHAVIOUR

When you, as a landlord notice any of the above verbal, environmental, behavioural and/or other

indicators, you can utilize a number of strategies to engage with an individual who may be experiencing

mental illness or emotional distress.

When communicating with a person in distress or experiencing symptoms of mental health consider the

following listing of “do’s” and “don’t’s”:

DO’s DON’T’s

Do collect as much information as possible from all possible sources prior to intervening. Assess risk as you would in any other situation.

Do not deceive – be honest and open in all situations – you are reality

Do take your time and eliminate noise and distractions e.g., television, radio, bright lights

Do not challenge his/her perceptions of reality (rather than say, “that isn’t happening” say, “I don’t see/hear that, can you tell me more about ...”

Do ask permission first Do not minimize the person’s concerns

Do treat the person with compassion, dignity and respect (as you would want a family member to be treated)

Do not forget the pain and fear he/she is experiencing – remember emotions can be painful

Do keep your distance and respect personal space Do not violate personal space

Do talk slowly and quietly – identify yourself and others and explain your intentions/actions – your actions should be slow and prior warning should be given if you intend on moving about the room

Do not forget to ask about medications that are being used

Do explain in a firm but gentle voice that you want to help. Ask how you can be of assistance. Try to locate a contact – caseworker, family member, a friend

Do not get into long complicated explanations, keep instructions brief and as simple as possible

Do develop a sense of working together “help me to understand what is happening to you”

Do not assume that usual strategies employed to achieve compliance of individuals who are not experiencing symptoms will work with people with mental illness

Do, if they are fearful of your equipment, take the time to explain that you carry the equipment to enable you to perform your job which is to protect the public and them

Do not engage in a power struggle

Do give choices whenever possible to allow some level of control

Do not forget to use a Trauma Informed Approach (Think: What’s happened to you rather than what’s wrong with you)

Source: Adapted from Not Just Another Call, Police Responses to People with Mental Illnesses in Ontario3

3 Centre for Addiction and Mental Health, Queen’s Printer for Ontario for the Ontario Police College and Regional Health Care, London.

Full document available on line: http://www.oacp.on.ca/Userfiles/Files/NewAndEvents/PublicResourceDocuments/2004_Not%20Just%20Another%20Call_%20Police%20Response%20to%20People%20with%20Mental%20Illnesses%20in%20Ontario.pdf

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The following 10 Tips for Crisis Prevention is copyrighted material and the property of Crisis Prevention

Institute, used with their consent. It is in no way a substitution for Nonviolent Crisis Intervention®

training. Please visit www.crisisprevention.com for more information about training for your

organization.

1. Be empathetic: Avoid using or discounting the feelings of others. Whether or not you think

their feelings are justified, those feelings are real to the other person. Pay attention to them.

2. Clarify messages: Listen for the person’s real message. What are the feelings behind the

facts? Ask reflective questions and use both silence and restatement.

3. Respect personal space: Stand at least 1.5 to 3 feet from the person. Invading personal space

tends to increase the individual’s anxiety and may lead to acting-out behaviour.

4. Be aware of your body posture/position: Standing eye-to eye and/or toe-to-toe with a

person can send a challenging message. Standing one-leg length away and at an angle off to

the side is less likely to escalate the individual.

5. Ignore challenging questions: When a person challenges your authority or a facility policy,

redirect the individual’s attention to the issue at hand. Answering challenging questions often

results in a power struggle.

6. Permit verbal venting when possible and safe to do so: Allow the individual to release as

much energy as possible by venting verbally. If you cannot allow this, state directives and

reasonable limits during lulls in the venting process (don’t try and yell over his/her voice).

7. Set and enforce reasonable limits: If the person becomes belligerent, defensive or disruptive,

state limits and directives clearly and concisely. When setting limits, offer choices and

consequences to the individual (start with the positive consequences first).

8. Keep your nonverbal cues nonthreatening: The more an individual loses control, the less that

individual listens to your actual words. More attention is paid to your non-verbal

communication. Be aware of your gestures, facial expressions, movements and tone of voice.

9. Avoid overreacting: Remain calm, rational and professional. Your response will directly affect

the person’s behaviour.

10. Use physical safety techniques only as a last resort: Always use the least restrictive method

of intervention possible. Physical techniques should only be used when individuals are a

danger to themselves or others.

If any of the above are not effective in deescalating a situation, discontinue the conversation and agree

to talk at another time.

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The following are some General Communication Tips when Interacting with Someone in Distress:

Be aware of your approach and that you have the person’s attention before speaking

Ensure to keep an open posture and adequate space – close proximity can increase anxiety

Do not assumes/he sees you, especially if the person seems to be listening to or conversing

with someone who is not there

Simple and clear – give one message at a time – avoid more than one person speaking to the

person – pause and allow time for the person to process what is being asked

Avoid sensory overload – if possible, speak to the individual in a quiet environment – this can

reduce confusion and upset

Really listen to the person’s issue. Ask for clarification. Sometimes people need to be heard,

not given a solution

Speak in a calm voice, even tone (raising one’s voice and giving ultimatums is like throwing

gasoline on a fire

The following are strategies for Dealing with Suicidal Thoughts or Behaviour:

Seek Help Immediately when any of the following are present:

1. Suicide Plan – specific, with available method.

2. History of Suicide Attempts – information gathered from person or family/friends etc.

3. Psychotic Thought Processes – command auditory hallucinations.

Take all threats seriously – direct or indirect. Do not be afraid of putting the idea into the person’s

head. Ask direct questions. Talk about suicide in clear language, for example:

“Are you thinking of suicide?”

“Do you plan to kill yourself?”*

“Have you thought about how you would do it?”

“When and where are you planning to do it?”

“What preparations have you made, i.e., hidden a rope/gun/pills, completed a will, gave away a

pet...”

“Have you ever tried to kill yourself in the past?”*

“Are voices telling you to kill yourself?”*

“Do you hear voices?”

*If the answer to any of the asterisked questions is “YES”, do not leave the person alone. Escort the

person to the hospital immediately if medical attention is required. Otherwise consult with a Crisis

Worker (519) 973-4435 (24 hours) for further direction.

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Note: CMHA intake staff are located at the TSC Crisis and Mental Wellness Centre at 744 Ouellette

Ave. Direct all individuals needing crisis intervention or looking for mental health services to the TSC

(open 7 days/week 8 am to 8 pm) – no appointment necessary. If person attending is seeking

community referrals, it is best to arrive prior to 4 pm Monday through Friday.

Crisis and Coordinated Access: (519) 973-4435

In-person Crisis Supports after 8 pm are directed to Windsor Regional Hospital Ouellette

Campus or the closest hospital with an Emergency Department or call 911.

Should you call the police out of concern for the safety of a tenant and/or others the following is the

protocol the police are required to follow when faced with a mental health related matter as per the

Mental Health Act, R.S.O. 1990, c. M.7:

“Action by police officer

17 Where a police officer has reasonable and probable grounds to believe that a person is

acting or has acted in a disorderly manner and has reasonable cause to believe that the person,

(a) has threatened or attempted or is threatening or attempting to cause bodily harm to

himself or herself;

(b) has behaved or is behaving violently towards another person or has caused or is

causing another person to fear bodily harm from him or her; or

(c) has shown or is showing a lack of competence to care for himself or herself,

and in addition the police officer is of the opinion that the person is apparently suffering from

mental disorder of a nature or quality that likely will result in,

(d) serious bodily harm to the person;

(e) serious bodily harm to another person; or

(f) serious physical impairment of the person,

and that it would be dangerous to proceed under section 16, the police officer may take the

person in custody to an appropriate place for examination by a physician. 2000, c. 9, s. 5.”

When the above legislative factors are met a police officer may bring a person before physician for

section 15 examination. The officer must have reasonable grounds to believe the person is acting or

has acted in a disorderly manner. (The courts have interpreted this to mean behaviour that is to some

Note:

Mental illness rarely causes a person to become violent; however, an individual who experiences

command hallucinations and delusions of persecution, may exhibit violent, agitated and/or aggressive

behaviour.

If for any reason, you believe the safety of the person or someone else is at risk contact the police.

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extent irrational, although not necessarily unruly. There is no need for the officer to have reasonable

or probable grounds to believe that criminal conduct is occurring or has occurred.)

NOTE:

The officer does not have to directly observe the behaviour but may form his/her opinion based

on the information gathered from other sources.

The word “imminent” has been removed from the Act.

When collecting information to pass on to police and/or emergency medical service (EMS) gather and

document as much detail as possible:

Record/document comments/conversation verbatim, particularly comments that are directives,

messages (voices) the person perceives he/she hears directing him/her to say or do something

i.e., talking to self, plans to take an overdose of (specific) pills, receiving a message (voices)

directing him/her to say or do ...

Refrain from using psychiatric terms

Note any change in the pattern of behaviour of the individual, i.e., indication that the individual

is behaving more aggressively than in the past, (i.e., physically assaulting others, self-abuse);

and other more subtle indicators such as giving valued possessions away, attempting to obtain

a weapon, etc.

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CARP METHOD

An additional strategy that can be utilized to diffuse a challenging situation is to use the CARP (Control,

Acknowledge, Refocus, Problem Solve) method which was developed by Canadian psychologist and

workplace consultant Robert Bacal. This method is used to defuse individuals that are presenting in a

hostile manner. The CARP system was originally developed for the customer service industry but is an

effectively transferrable method for housing and service providers.4

Control

The key in reasserting control and maintaining calm is to be self-aware of triggers that may make you

become defensive, angry or off-balance.

Acknowledge

When a person is exhibiting challenging behaviours, best practice recommends using empathy and active

listening to understand his/her emotional state and the situation.

Empathy is the ability to understand and share the feelings of others. Active listening is where you make

a conscious effort to hear not only the words that another person is saying but, more importantly, the

complete message being communicated5.

Refocus

Refocusing involves making the transition from dealing with the emotions to dealing with the actual

problem.

Problem solve

Problem-solving involves actions like getting and giving information, suggesting possibilities and

appearing helpful, offering choices and following through.

Brene´ Brown on Empathy

This video describes the research of Brene´ Brown from the University of Houston researcher and

Daring Greatly (2012) author. It will describe the difference between empathy and sympathy,

highlighting how empathy is a skill.

https://www.youtube.com/watch?v=1Evwgu369Jw

4 Robert Bacal, Defusing Hostile Customers Workbook: A Self-Instructional Workbook for Public Sector Employees (3rd edition, 2010)

5 https://www.mindtools.com/CommSkll/ActiveListening.htm

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Additional Resources: If you are interested in learning more about challenging behaviour and how to respond to them, please see the following resources. Dealing with Challenging Behaviour: https://www.ombudsman.vic.gov.au/getattachment/5e3f1e81-959b-404e-ae5f-12581afcc9b1//publications/guides/guide-to-dealing-with-challenging-behaviour.aspx Challenging Behaviour Overview: https://www.scope.org.uk/support/parents/challenging-behaviour/overview Five Signs of Emotional Suffering: https://www.changedirection.org/wp-content/uploads/2015/08/Five-signs_Color_April-2016_Avenir.pdf What is the CARP System: http://customerservicezone.com/what-is-the-carp-system-for-defusing-angry-and-difficult-customers/

WHAT IS TRAUMA?

In addition to being aware of the indicators of emotional distress and mental illness, it is important to understand how trauma can affect a person’s behaviours. Trauma is defined as a psychological, emotional response to an event or an experience that is deeply distressing or disturbing experience6. Trauma may persist throughout a person’s life and the impact of the trauma may present itself in various forms. Trauma may affect the way a person responds or reacts to situations. A trauma-informed approach, “A program, organization, or system that is trauma-informed:

1. Realizes the widespread impact of trauma and understands potential paths for recovery; 2. Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with

the system; 3. Responds by fully integrating knowledge about trauma into policies, procedures, and practices;

and 4. Seeks to actively resist re-traumatization."7

Trauma informed best practice provides appropriate responses that have been proven to cultivate a more effective way to communicate. The following chart provides appropriate response strategies in a trauma informed framework8.

6 http://centerforanxietydisorders.com/what-is-trauma/ 7 https://www.samhsa.gov/nctic/trauma-interventions 8 Catherine C. Classen, PhD, CPsych

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Five Principles to Trauma Informed Practice

The five generalized principles to trauma informed care are a guide of strategies that can be

implemented as appropriate to various settings.

For additional information, questions or community supports available, call 211 to speak to a specialist in person.

The helpline is free, confidential and available 24/7/365 in 150+ languages.

Call: 2-1-1

Live Chat or Search online: www.211ontario.ca

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NOTES

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Module Two: Hoarding

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HOARDING

This module will provide insight into the facets of hoarding behaviour and how it differs from a cluttered

environment. It is important to note that hoarding behaviour is classified as a mental health issue. The

Diagnostic and Statistical Manual (DSM) of Mental Illness relates hoarding behaviour as an obsessive-

compulsive disorder. Oftentimes an individual will isolate themselves out of fear or other emotions.

Simply clearing/cleaning out a person’s possessions will cause further emotional distress, and would do

nothing to solve the hoarding issue. Therefore, it is recommended that counselling be included as part

of the solution and/or plan when addressing an individuals hoarding behaviour. A best practice would

be to address the clutter and emotional distress/mental health of the person simultaneously. Using a

trauma informed approach, which is explained further in Module 1 can demonstrate understanding of

the person’s situation and create a better partnership.

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HOARDING

Hoarding disorder is defined as a persistent difficulty with discarding and/or parting with possessions

due to a perceived need to save them; thus, excessive accumulation occurs. A person with a hoarding

disorder experiences significant distress at the thought of discarding their possessions9.

There are three types of hoarding:

1. Compulsive Hoarding

Is a persistent difficulty discarding or parting with possessions because of a perceived need to

save them. A person with hoarding disorder experiences distress at the thought of getting rid of

the items. Excessive accumulation of items, regardless of actual value, occurs.

2. Animal Hoarding

Animal hoarding can be identified by the following characteristics:

o more than the typical number or companion animals that the person can reasonably care for; and

o inability to provide even minimal standards of nutrition, sanitation, shelter, and veterinary care, with this neglect often resulting in starvations, illness and death and denial of the inability to provide this minimal care and the impact of that failure on the animals, the household and human occupants of the dwelling10.

If you suspect animal hoarding, contact your local Humane Society or 211.

3. Diogenes Syndrome

Diogenes syndrome is a behavioural disorder that affects older adults. It occurs in both men and

women. The main symptoms are excessive hoarding, dirty homes, and poor personal hygiene.

People with diogenes syndrome also withdraw from life and society11.

9 https://www.mayoclinic.org/diseases-conditions/hoarding-disorder/symptoms-causes/syc-20356056 10 Canadian Federation of Humane Societies, 2013 11 https://www.healthline.com/health/diogenes-syndrome

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The following approaches can be effective when addressing a hoarding situation:

CLUTTER IMAGE RATING SCALE

As a landlord, you may receive complaints from other tenants or encounter a unit that may require a

unit inspection due to the presence of odours and/or pests (i.e. mice, cockroaches, bed bugs, etc.). In

these situations, it is important to express empathy towards the tenant while taking appropriate

action.

The following pages show images of varying levels of clutter in a kitchen, a bedroom and a living room. The clutter image rating scale below provides explanation on the severity, ranging from level 1-3 (none) to level 7-9 (major).

Use the clutter image rating scale below to determine the levels of clutter severity. When a residence reaches a level four (minor category) or higher, it is recommended that professional resources become involved. At any time if tenant safety (the occupant or other tenants in the building) becomes a concern, it is advisable to contact the fire department who may issue an order to declutter within a specified period (60 to 90 days).

STEP 1

•Assess the risk and respond accordingly

•Utilize the clutter rating scale on the following pages to determine next steps

•Reminder: Hoarding is a behaviour linked to mental health and best practice to resolve instances of hoarding will require addressing the clutter as well as the underlying emotional distress

STEP 2

•Make referrals to community resources

•Refer to community resources, see resources in Appendix A or contact 211

•If ther are no clear pathways for firefighters contact your local fire department

STEP 3

•Allow time

•The professionals will work with the tenant on solutions

•Progress will take time

STEP 4

•Be Patient

•The hoarding behaviours will take time and support in order for changes to occur

•Discuss follow up with the tenant in order to ensure the unit is meeting fire safety standards

•Acknowledge small successes

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1 to 3 = None 4 to 6 = Minor 7 to 9 = Major

Living Room: 1 2 3 4 5 6 7 8 9

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1 to 3 = None 4 to 6 = Minor 7 to 9 = Major

Bedroom 1: 1 2 3 4 5 6 7 8 9 Bedroom 2: 1 2 3 4 5 6 7 8 9 Bedroom 3: 1 2 3 4 5 6 7 8 9 Bedroom 4: 1 2 3 4 5 6 7 8 9

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1 to 3 = None 4 to 6 = Minor 7 to 9 = Major

Kitchen: 1 2 3 4 5 6 7 8 9

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THINGS TO CONSIDER WITH HOARDING BEHAVIOURS

Focus on supporting the person to be connected to the appropriate resources

Except in crises, it is not about cleaning piles of stuff; it is about a person changing their feelings

and attitudes towards their possessions

Withhold addressing the hoarder’s denial, until an established relationship is developed

Placing blame will not be beneficial

Additional tips and approaches from professional

staff to support a household with hoarding

behaviours:

Use open ended questions – what, when, where, how

Summarize what they said, keeping it brief

Provide positive reinforcement regarding progress

Explore pros and cons of keeping excessive belongings

Remember to:

Express empathy

Avoid confrontations. Instead, ask the person what they

are willing to do about their clutter

Encourage and acknowledge ANY good self-care

techniques

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Examples of Hoarding Situations

Case Scenario One

Situation:

A woman who was residing in a rent geared to income (RGI) unit was facing threat of eviction due to severe hoarding. She resided with her husband and two children, and there was family conflict due to the excessive clutter. The hoarding behaviour escalated after her mother passed away and she had difficulty parting with her mother’s belongings. Additionally, she brought all of her mother’s items to her home for storage. The family was issued an order from the local fire department and from the social housing landlord.

Intervention:

The family received extensive supports and was motivated to save their tenancy. They followed through with weekly planned goals, which are case specific. Even though challenges or minor setbacks presented occasionally, with supports in place, the family was able to overcome these obstacles.

Result:

The family made significant progress to address the issues identified in the order from the fire department and was able to avoid eviction.

Case Scenario Two

Situation:

A woman with significant mental health and substance use concerns is facing eviction due to severe hoarding. She had experienced homelessness a couple of years prior to being referred for services.

In addition, was previously involved in a crime with an ex-boyfriend, and as a result, had stayed in detention centre awaiting sentencing for a few months.

She was in a bachelor unit that was completely packed with belongings that she had acquired in the past two years, as well, there was severe cockroach infestation. At the time, the unit was not functioning as a livable space and resembled a storage unit.

Intervention:

She received assistance to de-clutter for several months; however, due to substance use and significant mental health issues no progress was made.

Result:

After several months of extensive intervention and supports from two separate agencies, the tenant was not able to move forward with the treatment plan, and unfortunately, this resulted in her eviction from the unit. Addressing hoarding is a time intensive process to resolve.

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NOTES

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Module Three: Addiction

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ADDICTION

This module will discuss addictions with a focus on substance use. Addiction can be described as the

repeated involvement with an activity or use of a substance, regardless of the risk of harm associated

with the substance or activity.

Harm reduction strategies discussed throughout the module are ideas, interventions and actions

intended to reduce negative consequences. Harm reduction is person-centered with a focus on reducing

the person’s harm in their current environment. There is no set formula for implementing harm

reduction as it can vary from person to person.

Canadian psychologist Bruce K. Alexander, carried out a series of studies on addictions in the late 1970’s

titled Rat Park Study. The study was undertaken to gain a better understanding of addiction, the value

of social interactions and how they contribute a major role in addictions. To learn more about the Rat

Park Study see the video link at the end of the module.

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OVERVIEW OF ADDICTIONS

Addiction is a condition where a person engages in the use of a substance or in a behaviour for which the effect(s) provide a compelling incentive to repeatedly pursue the behaviour despite detrimental consequences. Addiction may involve the use of substances such as alcohol, inhalants, opioids, cocaine, nicotine, and others. Behaviours such as gambling and extreme shopping can also be addictive. Scientific evidence indicates that the addictive substances and/or behaviours share a key neurobiological feature—they intensely activate brain pathways of reward and reinforcement, many of which involve the “feel good” hormone, dopamine.

Both substance use disorders and addictive behaviours have an increased likelihood of being accompanied by mental health conditions such as depression, anxiety or other pre-existing disorder. Substance use and addictive behaviours not only engage many of the same brain mechanisms of

compulsivity, they also respond to many of the same approaches during treatment.

There are different reasons for addiction, with no one specific cause. Likewise, there is no specific personality type that predisposes a person to addiction. Although genetic or other biological factors may contribute to one’s vulnerability, many social, psychological, and environmental factors have a powerful influence on substance use. Oftentimes, the inability to navigate through a stressful situation can also be linked to an increase in substance use, as a coping mechanism.

The following is a list of the 10 most common addictions:

1. Alcohol

2. Smoking

3. Drug

4. Gambling

5. Food

6. Video games

7. Internet

8. Sex

9. Shopping

10. Work12

12 https://www.brainz.org/10-most-common-addictions/

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PRIMARY INDICATORS OF ADDICTION

Uncontrollable need to seek drugs

Repeatedly engaging in harmful behaviour

Neglecting or losing interest in activities that do not involve the harmful substance or behaviour

Relationship difficulties, which often involve lashing out at people who identify the dependency

An inability to stop using a drug, though it may be causing health problems or personal

difficulties, such as issues with employment or relationships

Hiding substances or behaviours and otherwise exercising secrecy; for example, refusing to

explain injuries that occurred while under the influence

Profound changes in appearance, including a noticeable abandonment of hygiene

Increased risk-taking, to access and engage in the substance or activity

ADDICTION FACTS

Addiction is a serious, chronic dependence on a substance or an activity

Substance misuse is common, and does not mean an addiction will occur. It simply means that a

substance is not being used as it was intended.

Characteristics of addiction can range from person to person, and can include but is not limited

to a decline in physical health, irritation, challenging behaviours, dilated pupils, isolating

behaviours, etc.

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Harm Reduction

Harm reduction is an evidence-based, client-centered approach that seeks to reduce harm. We engage

in harm reduction in our everyday lives to minimize risk, such as wearing a seatbelt while in a car or a

helmet while riding a bike. Similarly, as it implies, harm reduction for drug dependency focuses on

reducing harm during active substance use. While recognizing that abstinence may be neither a realistic

nor a desirable goal for some people (especially in the short term), the primary focus in harm reduction

is to reduce the harm and accept that substance use will continue.

Stigma and language is one of the largest barriers for people linking to support. Using person centered

language that does not link a negative stigma to an individual will assist in reducing the challenges and

barriers a person experiences, and may increase the ability for accessing services. The chart below

provides examples of person center language.

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HARM REDUCTION STRATEGIES FOR LANDLORDS TO CONSIDER

The following strategies can assist a landlord who becomes aware that substance use is occurring or

may be occurring in a unit / building. These approaches can help to reduce harm to both the tenant

using the substance and others residing in the building. Harm reduction strategies give people the

opportunity to get assistance. Some strategies include but are not limited to:

Having a sharps container in the building and/or surrounding area;

Having information available on how to access harm reduction supplies in our community; and

Posting information on community outreach strategies, peer support networks, groups, health

services, community resources, etc.

Also Remember:

It is best when a person is able to consume a substance in a safe environment to reduce

potential harm;

If you find sharps on your property, please contact 311 for disposal; and

If you or your tenants are at imminent risk, contact 911, as appropriate

The following pages contain educational materials regarding the safe disposal of sharps as well as

where sharps containers are located.

Harm Reduction

is

strengths-based

and

person-centered

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Rat Park Study on Addictions

The Rat Park was a series of studies examining drug addiction conducted in the late 1970s and

published between 1978 and 1981 by Canadian psychologist Bruce K. Alexander and his colleagues at

Simon Fraser University in British Columbia, Canada. https://www.youtube.com/watch?v=ao8L-0nSYzg

Additional Resources:

Addiction: https://www.psychologytoday.com/ca/basics/addiction https://www.medicalnewstoday.com/articles/323465.php

Harm Reduction: https://ontario.cmha.ca/harm-reduction/ https://www.healthlinkbc.ca/healthlinkbc-files/substance-use-harm-reduction Stigma and Language: https://campusmentalhealth.ca/toolkits/cannabis/cannabis-use-on-campus/language-stigma/

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NOTES:

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Module Four: Best Practice in Housing

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BEST PRACTICES IN HOUSING

Best practice in housing looks at techniques and practices that can be put in place to assist with

achieving successful tenancies for both the landlord and tenant. This module will provide various

practices that will assist in creating an environment for tenants that provides a sense of belonging,

community, and safety.

Each technique that is described in the module can be modified to fit the needs of your tenants, as the

information provided is intended to be used a guide.

The Housing First framework has been proven as a best practice in ending long-term chronic

homelessness. The module has a video link where Dr. Sam Tsemberis discusses the Housing First

framework. ‘Housing First’ is a recovery-oriented approach to ending homelessness that centers on

quickly moving people experiencing homelessness into independent and permanent housing and then

providing additional supports and services as needed. Housing is provided first and then supports are

provided including physical and mental health, education, employment, substance abuse and

community connections.13

13 https://www.homelesshub.ca/solutions/housing-accommodation-and-supports/housing-first

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WHAT IS A BEST PRACTICE?

Developed through extensive scientific research and studies, a best practice is an intervention, method or technique that has consistently proven to be effective through replication. In addition, a best practice must be able to show that it produces better results than other approaches and is a practice that has the potential to be adapted with success in other contexts and/or scaled up to a systems-wide approach. In other words, there is a sufficient body of evidence that allows us to confidently say that the described practice is a generalizable example of something that works. It should be noted that some interventions might demonstrate scientific rigor, but can never be generalizable in other contexts. For example, what works in Northern Canada may not, or should not, be expected to work in Toronto. An intervention for Aboriginal people might not be effective for new immigrants, for instance, despite being a best practice in its original context. Thus, an intervention that is generalizable within a specific context should also have merit as a best practice14.

Dr. Sam Tsemberis TED talk on Housing First

Canadian clinical and community psychologist, Dr. Sam Tsemberis, has developed a world-renowned best practice to successfully house a person experiencing long-term chronic homelessness. Following extensive work with people experiencing homelessness in New York City, he founded Pathways to Housing, a Housing First program for individuals with long histories of homelessness and oftentimes co-occurring mental health and substance use issues.

The video link below provides further information on the Housing First framework:

https://www.bing.com/videos/search?q=sam+tamberis&ru=%2fsearch%3fq%3dsam%2btamberis%26FORM%3dHDRSC1

&view=detail&mid=CF95E090B61B10D87822CF95E090B61B10D87822&&mmscn=vwrc&FORM=VDRVRV

14 http://homelesshub.ca/solutions/best-promising-and-emerging-practices

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EXAMPLES OF BEST PRACTICES IN HOUSING

The following examples and techniques of best practices can be used by landlords to assist and build

good landlord/tenant relationships, to sustain tenancies and to provide opportunities for tenants to be

invested in their tenancy/housing. These examples of best practices/strategies/techniques are not

intended to be an extensive list:

Move in dates:

Plan move in dates between Monday and Wednesday. Generally, building staff are more readily

available Monday to Friday; therefore scheduling move in dates during this timeframe will give

new tenants the opportunity to seek assistance during office hours

If a move in date must be completed on a Friday and/or weekend, consider providing the new

tenant with contact information and a building tour/orientation package prior to move in

Building tour/Orientation package:

Includes key aspects of the building namely where to locate: garbage and laundry facilities,

building access and security features, parking, main office hours of operation, etc.

Helps the tenant become familiar with the building features and keeps all tenants informed

allowing for open communication

Building orientation materials includes the following:

o Landlord/property manager contact information

o Landlord/property manager office hours

o Rent due dates, where and how to pay the rent

o Safety information (fire evacuation, etc.)

o Apartment checklist

o Budget checklist

o Maintenance checklist

o Maintenance request form

o Move in/out checklist

o Map indicating the amenities

o Tenant liaison

o Social groups/building events

o After hours contact information

As a landlord, it is recommended to follow up with the new resident within the first week of moving in

to see how they are adjusting to the new unit and to address any questions and/or concerns.

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Sample Building Orientation Welcome Home

Landlord Information Name: Contact number: How should I contact my landlord about concerns: Call:______________________________ Email:_________________________________ Complete concern report located at: __________________________________________ *Please note once a unit concern is received an inspection may be required. Repair time frames will be provided and may be subject to change. When should I call the landlord immediately:

If there is flooding – toilet overflowing, water from unit above coming into unit, leak in the ceiling, suspected broken pipes

The heating system is not functioning in the winter

A short circuit in the wiring – risk of fire

A lock is no longer functioning

The refrigerator is not working Other Staff Contact Information Maintenance personal name: Contact number: Reception name: Contact number: Laundry The laundry room is located: You will require: coins reloadable card Reloadable card station is located: For a replacement laundry card please see: Replacement cost will be: Laundry card reload station: Garbage/Recycle The garbage room is located: The recycle room is located: A quick list of recycable and non-recycable items chart is provided on the next page.

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Social Activities

The following is an example of a social activities calendar:

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Sample Maintenance/Repair Request Form Date: ______________________ Submit Request to: ________________________________________________________ Resident Name: ___________________________________________________________ Address: _________________________________________________________________ Apartment Number: _______________________________________________________ Problem/Repairs Needed:

Best time to make repairs: ____________________________________________________ Resident Signature: __________________________________________________________ Resident Phone Number: ______________________________________________________

FOR MANAGEMENT USE ONLY: Scheduled Appointment: _______________________________________________________ Service Request Completed by: __________________________________________________ Date Repairs Completed: ______________________________________________________________ Comments:

Landlord/manager signature: ____________________________________________________

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COLLABORATIVE CONVERSATION TIPS

Communication is a key component to create good landlord and tenant relationships. A collaborative

conversation creates open dialogue to jointly and purposefully address a concern and to arrive at a

mutually satisfactory outcome.

The following are tips and techniques that can be used to create a solution-focused conversation:

Listen to each person’s perspective

o Allow everyone involved in the conversation to state their concerns, desired outcomes,

etc. Check to ensure each person understands by repeating the main points of the

conversation Brainstorm ideas jointly

o When exploring solutions to a concern or situation, having everyone contribute ideas can

create a collaborative way to include all parties in the solution Follow up on conversations

o Once a decision is agreed upon, the landlord and tenant can decide on how, when, and

who will be provide follow up. This will allow for any further items to be addressed Be transparent

o When working collaboratively it is important to be transparent on what you can offer,

commit to, provide, etc.

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NOTES:

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Module Five: How to Beat Stress at Work

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HOW TO BEAT STRESS AT WORK

This module provides information on how staff can combat stress that may be related to work or other

aspects of life and how employers can create a supportive environment. Having an awareness of stress

triggers, situations and emotions is key in creating a work/life balance that provides optimal self-care.

The Stress Index Quiz is included in the module as a tool that can be used to generate a baseline to

measure your current stress level. Helpful tips and strategies are offered and can be used to assist you

to act rather than react. When feeling stressed it is key to examine the situation and recognize the

aspects that you can control and accept those that are out of your control.

The latter part of the module provides self-care strategies and tips on how you can create wellness and

balance in your life. Self-care is not a onetime event/approach that is completed, but rather the

constant repetition of many small habits, which altogether calm you and ensure you are at your

optimum health—emotionally, physically, and mentally15.

15 https://tinybuddha.com/blog/45-simple-self-care-practices-for-a-healthy-mind-body-and-soul/

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GOOD MENTAL HEALTH HELPS US TO ACHIEVE BALANCE AND COPE WITH STRESS

Everyone has a role to play in creating a healthy workplace, and simple strategies can help achieve this. Research has identified many job characteristics that are positive, that result in work being more motivating or less stressful.

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WHAT IS YOUR STRESS INDEX?

Stress can be difficult to understand. The emotional chaos it causes can make our daily lives miserable. It can also decrease our physical health, sometimes drastically. Strangely, we are not always aware that we are under stress. The habits, attitudes, and signs that can alert us to problems may be hard to recognize because they have become so familiar16.

Find your stress level by completing this test.

Do You Frequently: YES NO

Neglect your diet? (poor eating habits, skip meals or overeat”

Try to do everything yourself?

Blow up easily?

Seek unrealistic goals?

Fail to see the humour in situations others find funny?

Act rudely?

Make a ‘big deal’ of everything?

Look to other people to make things happen?

Have difficulty making decisions

Complain you are disorganized?

Avoid people whose ideas are different from your own?

Keep everything inside?

Neglect exercise?

Have few supportive relationships? (friends/family to listen/help)

Use sleeping pills and tranquilizers without a doctor’s approval?

Get too little rest?

Get angry when you are kept waiting?

Ignore stress symptoms?

Put things off until later?

Think there is only one right way to do something?

Fail to build relaxation time into your day?

Gossip?

Spend a lot of time complaining about the past?

Fail to get a break from noise and crowds?

16 https://cmha.ca/whats-your-stress-index

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Your score: (Add up all the ‘Yes’ answers)

0-6 There are few hassles in your life. Make sure, though, that you are not trying so hard to avoid problems that you shy away from challenges.

7-13 You’ve got your life in fairly good control. Work on the choices and habits that could still be causing you some unnecessary stress in your life.

14-20 You are approaching the danger zone. You may well be suffering stress- related symptoms and your relationships could be strained. Think carefully about choices you’ve made and take relaxation breaks every day.

21-25 Emergency! You must stop now, re-think how you are living, change your attitudes, and pay careful attention to diet, exercise, and relaxation.

Regardless of your score, examine all of your “yes” answers. To improve your mental health, look for strategies to reduce the frequency of each statement.

Ask yourself: Do I need to make changes in this area? If yes, then: Do I want to make changes in this area? If yes, then: Am I ready to make changes in this area? If no, what are my barriers? If yes, then: Do I know how to and/or feel confident in my ability to make changes in this area? If no, seek help.

If yes, then, make a plan and a commitment to yourself!

Above all else: Be gentle with yourself. If you slip up, don’t berate yourself, simply get back on track. NOBODY is perfect! Like Quizzes? Take the Work/Life Balance Quiz: https://cmha.ca/work-life-balance-quiz

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Ten General Tips for Mental Health The following chart provides key aspects to help you build self-care into your daily routine:

1. Build confidence Identify your abilities and weaknesses together, accept them

build on them and do the best with what you have

2. Eat right, keep fit A balanced diet, exercise and rest can help you to reduce stress.

3. Make time for family and friends

These relationships need to be nurtured; if taken for granted they will not be there to share life's joys and sorrows.

4. Give and accept support Friends and family relationships thrive when they are "put to the test"

5. Create a meaningful budget Financial problems cause stress. Over-spending on our "wants" instead of our "needs" is often the culprit.

6. Volunteer Being involved in community gives a sense of purpose and satisfaction that paid work cannot.

7. Manage stress We all have stressors in our lives but learning how to deal with them when they threaten to overwhelm us will maintain our mental health.

8. Find strength in numbers Sharing a problem with others who have had similar experiences may help you find a solution and will make you feel less isolated.

9. Identify and deal with moods We all need to find safe and constructive ways to express our feelings of anger, sadness, joy and fear.

10. Learn to be at peace with yourself

Get to know who you are, what makes you really happy, and learn to balance what you can and cannot change about yourself.

Source: Canadian Mental Health Association - National Office www.cmha.ca

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MENTAL HEALTH FITNESS TIPS

Give yourself permission to take a break from your worries and concerns. Recognize that dedicating

even a short time every day to your mental fitness will reap significant benefits in terms of feeling

rejuvenated and more confident.

"Collect" positive emotional moments: Make a point of recalling times when you have experienced

pleasure, comfort, tenderness, confidence or other positive things.

Do one thing at a time: Be "present" in the moment, whether out for a walk or spending time with

friends, turn off your cell phone and your mental "to do" list.

Enjoy hobbies: Hobbies can bring balance to your life by allowing you to do something you enjoy

because you want to do it.

Set personal goals: Goals don't have to be ambitious. They could be as simple as finishing a book,

walking around the block every day, learning to play bridge, or calling a friend instead of waiting by

the phone. Whatever goal you set, reaching it will build confidence and a sense of satisfaction.

Express yourself: Whether in a journal or talking to a wall, expressing yourself after a stressful day

can help you gain perspective, release tension, and boost your body's resistance to illness.

Laugh: Laughter often really is the best medicine. Even better is sharing something that makes you

smile or laugh with someone you know. Adapted from: Canadian Mental Health Association Mental Fitness Tips

Additional Resources:

Understanding the characteristics that make up good mental health will help you determine how mentally fit you are: Mental Health Meter: https://cmha.ca/mental-health-meter Canadian Mental Health Ontario: https://www.cmha.ca

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Self-Care Inventory

Review the lists below. Check the self care activities that you already participate in, then go back and place a star on the ones you would consider trying. From those, circle the one(s) you will start with, and make a commitment to yourself!17 *Adapted from the work of Françoise Mathieu, M.Ed., CCC 2012

Physical Self-Care

17 www.tendacademy.com

Make time away from phones

Eat regularly (breakfast, lunch,

dinner)Eat healthy

ExerciseGet regular medical care for prevention

Dance, swim, walk, run, play sports, sing, or do some physical activity that is fun

Get enough sleep Wear clothes you likeTake day trips or mini-

vacations

Other:

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Emotional Self-Care

Psychological Self-Care

Laugh, find things that make you

laugh

Spend time with others whose

company you enjoy

Give yourself positve affirmation and praise yourself

Stay connected to important people in

your life

Reread favourite books, watch

favourite movies

Allow yourself to cry

Other:

Be curiousMake time for self-

reflectionAttend counselling Write in a journal

Read literature that is unrelated to work

Do something that you are not an expert or in

charge of

Decrease stress in your life

Notice your inner experience - listen to

your thoughts, judegements, beliefs, attitudes and feelings

Listen to your thoughts, judgments, beliefs, and

attitudes

Let others know different aspects of you

Engage your intelligence in a new

area

Practice receiving from others

Say no to extra responsibilities

sometimesOther:

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Spiritual Self-Care

Balance

The one thing I commit to doing in the next 7 days:

Read inspirational literature, listen to

music

Make time for reflection

Spend time in nature

Find a spiritual connection or

community

Be open to inspiration

Cherish your optimism and hope

Be aware of non-material aspects of

life

Try at times not to be in

charge/expert

Be open to not knowing

Identify what is meaningful to you and notice its place

in your life

Meditate Pray

SingSpend time with

childrenHave experiences

of awe

Contribute to causes in which

you believe

Other:

Strive for balance within your work life

and work day (searching for work

counts!)

Strive for balance among work, family, social relationships, care-giving, play and

rest

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STRATEGIES AN EMPLOYER CAN USE TO SUPPORT WELLNESS AT WORK

Work place wellness programs have been proven to increase employee wellness, reduce sick days,

improve productivity and create a positive culture. The following are strategies and techniques that

can be implemented or posted for staff to utilize while at work:

Provide training opportunities on various topics

Be aware of signs and symptoms related to compassion fatigue and vicarious trauma

Message boards to keep employees up to date on information

Have a designated times that staff can use for exercise, wellness programs, etc.

Bring in wellness activities: massages, yoga, ergonomic demonstrations/furniture

An office walking group

Post wellness strategies in staff areas

Be aware of staff stress levels related to multiple life changes/events

Offer and participate in an Employee Family Assistance Program (EFAP)

What is Compassion Fatigue, Vicarious Trauma and Burnout?

The three terms are complementary and yet different from one another.

1. Compassion fatigue refers to profound emotional and physical erosion that takes place when

helpers are unable to refuel and regenerate.

2. Vicarious trauma was coined by Pearlman & Saakvitne (1995) to describe the profound shift in

world view that occurs in helping professionals when they work with clients who ohave

experienced trauma.

3. Burnout is a term that has been used since the early 1980s describe the physical and emotinal

exhaustion that worker can experience when they have low job satisfaction and feel powerless

and overwhelmed at work.

What is Compassion Fatigue?

Françoise Mathieu explains compassion fatigue and how it develops over a period of time and the

warning signs that let you know that you are overwhelmed.18

18 https://www.tendacademy.ca/what-is-compassion-fatigue/

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Examples of wellness documents:

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NOTES:

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Appendix A: Community Resources 2018

CRISIS INTERVENTION Windsor Regional Children’s Centre (519) 257-5215 3901 Connaught Avenue Crisis Services Distress Centre of the Downtown Mission (519) 256-5000 12:00 noon – 12:00 midnight 7 days/week Text to 741741 from 2 pm to 2 am 7 days/week Crisis and Mental Wellness Centre (519) 973-4435 (24 hours) 744 Ouellette Ave. Walk-in 8 am – 8pm WRH Emergency Dept. after 8 pm 1030 Ouellette Ave

ASSAULT / VIOLENCE Sexual Assault Crisis Centre (519) 253-3100 1770 Langlois Avenue 24 Hour Crisis (519) 253-9667 SOS Femmes Crisis Line 1-877-336-2433 Francophone Women Eligibility 24 Hour Crisis located in Toronto, ON

EMERGENCY SHELTERS Downtown Mission (519) 973-5573 664 Victoria Avenue Salvation Army (Men Only) (519) 253-7473 355 Church Street Welcome Centre (Women Only) (519) 971-7595 263 Bridge Avenue Hiatus House (519) 252-7781 Emergency shelter and Toll Free: 1-800-265-5142 Crisis intervention for women TDD: (519) 252-2768 and their children experiencing domestic violence.

SUICIDE PREVENTION AND MENTAL HEALTH EDUCATION Canadian Mental Health Association, Windsor Essex (519) 255-7440 1400 Windsor Ave.

HOSPITALS Windsor Regional Hospital – Ouellette Campus (519) 973-4411 1030 Ouellette Avenue Windsor Regional Hospital – Met Campus (519) 254-5577 1995 Lens Ave. Hotel-Dieu Grace Healthcare (519) 257-5111 1453 Prince Rd.

MENTAL HEALTH SERVICES Crisis and Mental Wellness Centre (formerly TSC) (519) 257-5224 Coordinated Access (help to access mental health supports) 519-973-4435 744 Ouellette Ave. Mon-Fri 8:30-4:30 Mental Health Connections (519) 256-4854 370 Erie Street East

COUNSELLING Family Service Windsor-Essex (519) 966-5010 1770 Langlois Avenue (walk-in clinics available – call for days/times/locations) or https://fswe.ca Teen Health Centre (up to age 24) (519) 253-8481 1361 Ouellette Ave #101 Windsor Essex Community Health Centre (519) 258-6002 3325 College Ave.

SOCIAL & SELF-SUPPORT Mental Health Connections (519) 256-4854 370 Erie Street East Can-Am Friendship Centre (519) 253-3243

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GENERAL INFORMATION Community Information and Referral 211

ADDICTIONS Alcoholics Anonymous AA (519) 256-9975 For Meetings visit: https://essexcountyaa.com/meetings/ Brentwood Recovery (519) 253-2441 Assessment & Referral House of Sophrosyne (Women Only) (519) 252-2711 1771 Chappell Ave. Withdrawal Management Centre (519) 257-5225 1453 Prince Rd. Women for Sobriety (519) 256-1497 More information at: https://womenforsobriety.org

OLDER ADULTS Alzheimer Society of Windsor-Essex (519)974-2220 2135 Richmond Street Life After Fifty (LAF) 2 locations (519) 254-1108

FINANCIAL Ontario Works (519) 255-5600 400 City Hall Square – Windsor (519) 946-9988 215 Talbot Street – Leamington Ontario Disability Support Program (519) 254-1651 270 Erie Street East - Windsor Service Canada 1-800-277-9914 400 City Hall Square - Windsor Financial Fitness (519) 258-2030 1770 Langlois Ave.

MEDICAL City Centre Health Care (519) 971-0116 CMHA-WECB, 1400 Windsor Avenue Windsor Essex Community Health Centre (519) 258-6002 3320 College Avenue OHIP (519) 973-1385 400 City Hall Square, Suite 205 Essex County Medical Society (519) 256-4611 1720 Howard Ave.

LEGAL RESOURCES Community Legal Aid (519) 253-7150 443 Ouellette Ave #200 Legal Assistance of Windsor (519) 256-7831 443 Ouellette Ave. 2nd Floor Windsor-Essex Bilingual Legal Clinic (519) 966-5010 1770 Langlois Ave.

YOUTH Bulimia Anorexia Nervosa Association (519) 969-2112 1500 Ouellette Avenue, Suite 100 Maryvale Adolescent/Family Services (519) 258-0484 3640 Wells Street **Ages 11-17** Teen Health Centre, WECHC (519) 253-8481

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HOUSING Central Housing Registry (519) 254-6994 2470 Dougall Avenue, Unit 6 – Windsor (519) 776-4631 15C Talbot Street North – Essex Housing Information Services (519) 254-4824 3450 Ypres, Suite 200 - Windsor Windsor Residence for Young Men (226) 221-8464 1505 Langlois Ave **Ages 16-20 Men Only**

LGBTIQ FRIENDLY SERVICES 50+ Proud: Gay and Gray (519) 973-4656 440 Pelissier Street Out on Campus (519) 253-3000 ext. 4093 University of Windsor http://uwindsor.ca/ooc Windsor Pride Community (519) 973-4656 440 Pelissier Street Young and Proud (519) 973-0222 511 Pelissier Street Toll Free: 1-800-265-4858