East Kootenay Addiction Services SocietyHarm Reduction Program

throughSupportive Housing

Purpose of Inquiry:Homeless persons, or individuals at risk of homelessness who

have a significant addiction (Alcohol Use Disorder, Severe as per DSM 5) and/or a mental health illness have complex health needs that require consistent monitoring and management

These individuals do not have a family doctor, or do not use mainstream health care services and rely on the ongoing support of a unique collaborative approach to ensure primary care services are accessible

Sustainable housing is unavailable in the community of Cranbrook for individuals who are hard to be housed due to their addiction, mental and physical health challenges

Homeless People and Chronic Alcoholism

“Alcoholism affects 53%-73% of homeless adults with a high frequency of heavy alcoholism (i.e., > 20 drinks/day

Homeless people have higher rates of chronic illnesses, longer hospital stays with higher costs and increased mortality compared with those who have home addresses

Police encounters are recurrent for public drunkenness. In one study, 70% of alcoholic men had a history of imprisonment” (Podymow et al., 2006, p.45).

Why does it matter?

Compliance and participation to any kind of supportive programming will depend on whether the individual has sustainable housing, or is able to maintain stable housing

Individuals who are homeless, or at risk of homelessness are unable to maintain stable housing due to their challenges with addiction, mental and physical health, thus, are hard to be housed

Ongoing support of individuals needs to be provided in a unique collaborative approach to ensure primary care services are available/ accessible

Individuals with significant substance use and/ or mental health illness are more likely to use emergency departments, the emergency psychiatric ward or end up detained in the “drunk tank"

What we know…East Kootenay Addiction Services Society provided harm reduction

and mental health services to two individuals in our community. These individuals report that these services combined with the community- based, collaborative case management have improved the individual’s quality of life and their ability to manage their addiction better than prior to service provision

Both individuals report a decrease in their daily alcohol/substance use consumption prior to the supports being put in place

They report that housing has been an important aspect in each individual’s ability to stay engaged with the supports in the community and manage their addiction

What we propose

Short-term option:

Continue to provide program participants with harm reduction services by delivering daily dosages of alcohol and safe needles

Support participants through a collaborative multi-disciplinary, case management model to improve their daily living and well-being

Advocate and assist participants to rent and maintain stable housing

Long-term option: Purchase the building located on Van HorneProvide multi-disciplinary, case management support

on the first floor of the building Participants are unable to access independently the

mainstream health and addiction services due to the severity of their addiction

Create a “Wellness plan” with each individual, tailored to the unique needs of support of each participant (“Wellness plan” template received from Leland House, Kamloops , B.C.)

Supportive HousingProvided to support adults at risk of homelessness and

other barriersThe Supportive Housing Registration Service from BC

Housing offers long-term low-barrier supportive housing for homeless or homeless-at-risk who require support services to achieve successful tenancies and need safe, affordable housing.

Elements for the supportive housing model taken after Henry Leland House and Crossroads Inn, Ask Wellness Centre in Kamloops, B.C.

See more about support housing and registration at: http://www.bchousing.org/Options/Supportive_Housing#sthash.FddkASSK.dpuf

Aims of ProgramImprovement in health and well-being of

participants Reductions in the participant’s use of

emergency, hospital and police servicesEnhance participants safety by maintaining

stable housingLess hazardous patterns of alcohol or other

substance use

Program’s objectivesTo improve health and well-being of

participantsTo meet the unique needs of each client while

promoting client’s highest level of stabilization in the

community through co-ordination of community services To resort to less hazardous patterns of

alcohol useTo reduce the usage of emergency, hospital and

police services.

Method Supportive housing provided for 6 individuals in one bedroom or two

bedroom apartments.

Participants will enter into an agreement with East Kootenay Addiction Services Society (EKASS). The agreement will emphasize on the conditions of supportive housing and supports provided.

Participants are referred by community workers and are chronically homeless with Alcohol Use Disorder, Severe as per DSM 5. or other addiction

Program participants are housed at supportive housing, provided with individual apartments and receiving supports: mental health and addiction.

Community workers are working out of the supportive housing building from Monday to Friday from 8:30 a.m. to 4:30 p.m.

Ethics and Risk ManagementProgram participants will enter into the harm reduction through

supportive housing program voluntarily and be ready to attempt to make changes

Program participants will enter into an agreement with EKASS Program Participants agree to have their sobriety tested when signing

the agreementProgram Participants have the right to withdraw from the program at any

time, but need to give appropriate notice as per defined in the agreement Administration of alcohol will be prescribed and managed by a nurse

practitioner Program participants must be willing to receive breathalyzer at staff’s

discretionParticipants must keep suite neat and tidy, and follow rules and

regulations of program agreement in regards to a safe and crime free environment

Thank you