The Centre for Research on Inner City Health (CRICH) was responsible for leading the Toronto arm of the five-city At Home/Chez Soi randomized controlled trial of Housing First (HF).

Housing First programs offer people experiencing homelessness and mental health problems access to independent housing and supports.

The researchers have compiled the findings from several scientific publications to share key aspects of the HF model, adaptations applied in Toronto, and needed enhancements.Key messages from the report for policy-makers and people responsible for designing and running HF programs:

• Urgently and concretely address the ongoing crisis related to the shortage of quality, affordable housing in Toronto.
• Build safe, clean, interim housing options into the HF program – purpose built if necessary. These are essential for the wellbeing of people who are waiting for permanent housing, or to be re-housed.
• Once people are housed, address social isolation on multiple fronts, including through service enhancements to the current program (for example, additional peer support, life skills training, recreational, educational or vocational opportunities).
• Invest staff time and resources in developing and maintaining relationships with landlords and working with people to maintain tenancies.
• Place a high priority on relationships between providers and participants, as strong, trusting alliances are associated with better outcomes related to both housing and wellbeing.
• A committment to anti-oppression/anti-racism should include concrete measures. For example: hiring frontline and management staff representative of communities served.