MONCTON FINAL REPORT at Home/Chez Soi Project
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MONCTON FINAL REPORT At Home/Chez Soi Project www.mentalhealthcommission.ca AT HOME/CHEZ SOI PROJECT: MONCTON SITE FINAL REPORT This report was prepared by a small team led by Tim Aubry, which included Jimmy Bourque, Jennifer Volk, Stefanie Leblanc, Danielle Nolin, and Jonathan Jetté. We would, most especially, like to acknowledge the contributions of At Home/Chez Soi participants, whose willingness to share their lives, experiences, and stories with us were central and essential to the project. A special thank you to Johanne Pettipas and Gerry Francis for their assistance throughout the project. We also thank Jayne Barker (2008-11), Cameron Keller (2011-12), and Catharine Hume (2012-present), Mental Health Commission of Canada At Home/Chez Soi National Project Leads; Paula Goering, National Research Lead; Claudette Bradshaw, Moncton Site Coordinator; the Moncton Research Team; the Housing First service team in Moncton; research staff from the Centre de recherche et de développement en education at the Université de Moncton and from the Centre for Research on Educational and Community Services at the University of Ottawa; and the people with lived experience who have contributed to this project and the research. We also gratefully acknowledge the contributions of the United Way of Greater Moncton, the not-for-profit community agencies, private landlords in the Greater Moncton Region and Southeast New Brunswick, the New Brunswick Department of Health, the Horizon Health Network, le Réseau de santé Vitalité, the New Brunswick Department of Social Development, the New Brunswick Department of Post-Secondary Education, Training and Labour, the New Brunswick Department of Public Safety, the RCMP, and Corrections Canada. Production of this document is made possible through a financial contribution from Health Canada. The views represented herein solely represent the views of the Mental Health Commission of Canada. Ce document est disponible en français. CITATION INFORMATION Suggested citation: Aubry, T., Bourque, J., Volk, J., Leblanc, S., Nolin, D., & Jetté, J. (2014). At Home/Chez Soi Project: Moncton Site Final Report. Calgary, AB: Mental Health Commission of Canada. Retrieved from: http://www.mentalhealthcommission.ca COPYRIGHT © 2014 Moncton At Home Research Team & Mental Health Commission of Canada Suite 320, 110 Quarry Park Blvd SE, Calgary, Alberta, T2C 3G3 2 AT HOME FINAL REPORT | MONCTON TABLE OF CONTENTS Main Messages ..........................................................................................................5 Executive Summary .....................................................................................................6 Chapter 1 - Introduction..................................................................................................9 Background and City Context .......................................................................................9 Chapter 2 - Description of the Housing First Program at the Moncton Site ...........................................10 Assertive Community Treatment (ACT) ............................................................................10 Subsidized Housing..................................................................................................11 Chapter 3 - Participant Characteristics..................................................................................12 Moncton Sample....................................................................................................12 Differences from the national sample characteristics ..............................................................13 Characteristics of the Rural Group..................................................................................13 Chapter 4 - Housing Outcomes ........................................................................................15 Moncton Site........................................................................................................15 Rural Arm ......................................................................................................15 Chapter 5 - Service Use Outcomes .....................................................................................17 Chapter 6 - Cost Outcomes.............................................................................................18 Chapter 7 - Social and Health Outcomes...............................................................................19 Comparison of HF vs. TAU in Moncton.............................................................................19 Chapter 8 - Other Findings ............................................................................................20 Qualitative Findings from the Moncton Site .......................................................................20 Qualitative Findings from the Rural Arm ...........................................................................21 Fidelity Assessments................................................................................................21 Findings of the Implementation Evaluation of the Peer Supportive House........................................22 Findings from Interviews with Community Partners in Moncton and the Rural Region ..........................22 3 AT HOME FINAL REPORT | MONCTON TABLE OF CONTENTS Chapter 9 - Discussion and Implications for Practice and Policy.......................................................24 References .............................................................................................................26 Appendicies.............................................................................................................27 Appendix A..........................................................................................................27 Appendix B.........................................................................................................29 Appendix C.........................................................................................................30 Appendix D .........................................................................................................33 Appendix E..........................................................................................................35 Appendix F..........................................................................................................37 4 MAIN MESSAGES FROM THE MONCTON AT HOME/CHEZ SOI PROJECT Housing First can be implemented in a small city and a HF facilitates an improved quality of life and other 1 rural region. The Moncton site study tested Housing 4 positive changes beyond improved housing stability. First (HF) in the context of a small city and a rural region. HF services produced a positive effect on perceived Moncton is a fast-growing, bilingual city of 139,000 where quality of life; the HF group reported greater homelessness tends to be mostly invisible. The Moncton improvement in this area than the TAU group over the site sample included 201 individuals (35 per cent female), course of the study. Both groups showed the same level more than half of whom were middle-aged. Almost all of improvement in community functioning over the participants were born in Canada, four per cent were course of the study. Qualitative interviews with a select Aboriginal, and three per cent reported another sub-sample of participants from the two groups (N = 42) ethnocultural status. Fifty-six per cent of participants were revealed a majority of the HF group (60 per cent) absolutely homeless when recruited; on average, reporting positive changes in their lives. In contrast, a participants had spent more than four years homeless in minority of TAU participants (30 per cent) described their lifetime. All participants presented with mental themselves experiencing positive trajectories since health problems (psychotic disorders: 23 per cent; entering the study. non-psychotic disorders: 86 per cent; substance-related problems: 73 per cent). Most participants had more than HF is a wise investment. The HF program costs one disorder and most had concurrent mental health and averaged $20,771 per person per year. Over the two-year substance related problems. 5 period, every $10 invested in the program resulted in an average savings in health care, social services, and justice HF is successful in ending homelessness in this use of $7.75 as a result of decreased hospitalization, office 2 context. HF participants demonstrated a consistently visits to community-based services, and stays in detox higher percentage of time housed (i.e., > 85 per cent) than facilities. the control group (TAU) participants throughout the study. As well, a higher percentage of HF participants were A Peer Supportive Housing Program may improve housed continually for the last six months of the study (i.e., outcomes for clients with additional needs. A Peer 74 per cent of HF participants versus 30 per cent of TAU 6 Supportive Housing Program was piloted and participants). Housing quality (unit and building demonstrated that this can be an effective back-up plan combined) was similar for HF residences compared to for individuals who do not find stable housing within the TAU residences, and the quality of HF units was much less Housing First program. variable than the quality of TAU units. Findings from the Moncton site demonstrate the feasibility of implementing HF in a rural region where individuals transitioned into HF is a very good choice for practice and policy. The independent living from Special