New research has shown that when considering how to move Canada's most vulnerable from unhoused to housed, the network of supports available within that housing is critical to its success.
Using Woodfield Gate, an Indwell permanent supportive housing building in London, Ont., as a case study, nursing professor Abe Oudshoorn and a team of researchers from the Centre for Research on Health Equity and Social Inclusion at Western explored the nuances that make permanent supportive housing successful, particularly for those with the highest support needs.
"Canada's National Housing Strategy has a number of priorities, and one is housing for Canada's most vulnerable people," said Oudshoorn. "We know housing is a foundation, but some folks need extra help to get that housing and then keep that housing."
When Oudshoorn learned Indwell was opening its first site in London and was moving thirty individuals out of long-term mental health care and others off the street, he wanted to dig into how their model worked both by speaking directly to residents themselves and by analyzing quantitative health and social outcomes. The team collected data from residents and staff as well as partners, members and leaders of the community over a two-year period.
"Permanent supportive housing is acknowledged as the critical tool for ending homelessness for people with complex needs," said Steven Rolfe, director of health partnerships at Indwell. "This research affirms the value of supportive housing and the need to create pathways to produce more."
A platform of supports
The final report demonstrated that the permanent supportive housing model works because it provides not just the bricks and mortar but a whole platform of supports including onsite health-care services, medication management, check-ins with health and social care providers and optional supports like meal programs and utilities. As a result, residents at Woodfield Gate had sustained tenancies, improved health and engaged more in community activities.
"What differentiates housing for the most vulnerable and marginalized is the support piece. That's what was missing that created their homelessness, and that's what's needed to end their homelessness," said Oudshoorn.
Cathy Woodward, resident at Woodfield Gate (Christopher Kindratsky/Western Communications)
After her landlord sold the building she was living in, Cathy Woodward was homeless twice before finding a permanent home at Woodfield Gate. Living with diabetes and using a wheelchair, Woodward said check-ins from the staff and access to an on-site nurse have been extremely important to her well-being
"They are very good here. If they don't see you for a day, they'll come in and check on you and see how you are," she said.
The residents interviewed for the report noted three interconnected themes were central to sustaining their housing over the long-term: affordability, a sense of community and available and timely supports, even something as simple as daily access to food.
The report also showed that while supportive housing is fundamental for helping Canada's most vulnerable, it is not currently built into the National Housing Strategy. There is no clear funding pathway for not-for-profit housing providers like Indwell to access funding to include these on-site supports for residents.
Prioritizing those with the highest needs
With the strategy currently under review, Oudshoorn hopes this report will help inform discussions about what's needed moving forward.
"It's no surprise to anyone that we are in a housing crisis, and the National Housing Strategy should be our pathway out of it," said Oudshoorn. "If we keep doing what we're doing, we're going to keep getting what we're getting, and that's failing to prioritize those who have the most needs. So, I hope that our governments see the value of this model and will find ways to fund the supports and care that will make affordable housing also permanent housing."
