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Cancer Screening in the Homeless Population
Annually, 100 million people experience homelessness worldwide. Most adults that are struggling with homelessness are living to age 50 years or older and need age-appropriate screening for cancer. Cancer-related death in homeless adults is twice as high as the average in the adult population in the USA. However, few studies have examined the rates of and barriers to cancer screening in homeless people. This Review explores cancer-related health disparities between homeless people and the general population by providing a review of data and definitions relating to homelessness, an analysis of barriers to screening in this population, and a discussion of the current and potential interventions and strategies to improve cancer screening in homeless individuals. Recommendations include implementing appropriate data collection methods for this population, supporting cancer screening in places where homeless people usually access care, assessing the effectiveness of approaches to increasing cancer screening in homeless people, and addressing adequate housing as a fundamental social factor.
07/11/2018 - 16:14
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Cancer Screening in the Homeless Population
Annually, 100 million people experience homelessness worldwide. Most adults that are struggling with homelessness are living to age 50 years or older and need age-appropriate screening for cancer. Cancer-related death in homeless adults is twice as high as the average in the adult population in the USA. However, few studies have examined the rates of and barriers to cancer screening in homeless people. This Review explores cancer-related health disparities between homeless people and the general population by providing a review of data and definitions relating to homelessness, an analysis of barriers to screening in this population, and a discussion of the current and potential interventions and strategies to improve cancer screening in homeless individuals. Recommendations include implementing appropriate data collection methods for this population, supporting cancer screening in places where homeless people usually access care, assessing the effectiveness of approaches to increasing cancer screening in homeless people, and addressing adequate housing as a fundamental social factor.
07/11/2018 - 16:12
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The Invisibility of Disability for Homeless Youth
A largely unexplored complexity in the lives of youth who have experienced homeless is the presence of intellectual, developmental and/or learning disabilities. Although emerging research shows that youth with cognitive disabilities are more likely to become homeless and that rates of cognitive disabilities are higher among the homeless population than the population in general, exploring the intersection of disability and homelessness for youth has not been a priority. In this study, a critical disability and systems failure lens is brought to bear on the vulnerability of youth who experience this intersection. Based on interviews with key informants in the disability, homelessness, education, employment and child welfare sectors in three sites in Ontario, Canada, the invisibility of disability among homeless youth is brought to light. We explore the ways youth with a disability in the homelessness sector are made vulnerable, the insurmountable barriers to getting access to the requisite assessment for disability services and the siloed nature of the homelessness and disability service sectors. An argument is made that “working outside the box” to assist youth to navigate significant system disjunctures is insufficient.
07/11/2018 - 16:10
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National Map Project
Communities across Canada are faced with the growing crisis of youth homelessness. Many organizations are operating in isolation of a larger network. This National Map is a dynamic resource that will enable organizations to connect. Each organization on this map have completed a survey that gives a brief overview of their programs and services. The organizational summaries are searchable by: city/town, population size, program/service, organization name.
07/11/2018 - 16:07
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Winnipeg Street Census 2018
The Winnipeg Street Census 2018 marks the second attempt to gain a comprehensive view of homelessness in Winnipeg. In order to end homelessness we need to understand it. The Street Census is not an attempt to count the total number of people experiencing homelessness but provide a snapshot of who is experiencing homelessness, some of the reasons for it and barriers to exiting it. Between April 17 and 18, we surveyed approximately 1500 individuals experiencing homelessness.
07/11/2018 - 16:03
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A Roof Over My Head 2018 Enumeration Report
Information on homelessness is essential to understand the nature and extent of homelessness in the City and County of Peterborough, the needs of individuals and families experiencing homelessness, to plan services, and measure progress towards ending homelessness. The 2018 Homelessness Enumeration Report provides a profile of homelessness in our community based on the homelessness count and surveys conducted in the City and County of Peterborough from March 20th to March 23rd, 2018.
07/11/2018 - 15:53
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Reliability and Validity of the Vulnerability Index-Service Prioritization Decision Assistance Tool (VI-SPDAT) in real-world implementation
This study examined the reliability and validity of the Vulnerability Index-Service Prioritization Decision Assistance Tool (VI-SPDAT), a widely-used assessment of the health and social vulnerabilities and housing needs of individuals experiencing homelessness. Homeless Management Information System data were obtained for 1495 individuals who were administered the VI-SPDAT between 2014 and 2016. Subsamples were selected for reliability and validity assessments. Results suggest there are challenges to the reliability and validity of the VI-SPDAT in practical use. VI-SPDAT total scores did not significantly predict risk of return to homeless services, while type of housing was a significant predictor. Vulnerability assessment instruments have important implications for communities working to end homelessness by facilitating prioritization of scarce housing resources. Findings suggest that further testing and development of the VI-SPDAT is necessary.
07/04/2018 - 14:34
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Vancouver Street View
Vancouver Street View is an interactive site where you can see how homelessness has increased in the Greater Vancouver Area. The technology allows users to toggle between Google Street View images taken in the last four years to see how the number of people identifying as homeless has increased across Metro Vancouver.  The site hopes to encourage people to contact their local municipality to show support for social housing in their neighbourhood.
07/04/2018 - 14:00
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Cancer Screening in the Homeless Population
Annually, 100 million people experience homelessness worldwide. Most adults that are struggling with homelessness are living to age 50 years or older and need age-appropriate screening for cancer. Cancer-related death in homeless adults is twice as high as the average in the adult population in the USA. However, few studies have examined the rates of and barriers to cancer screening in homeless people. This Review explores cancer-related health disparities between homeless people and the general population by providing a review of data and definitions relating to homelessness, an analysis of barriers to screening in this population, and a discussion of the current and potential interventions and strategies to improve cancer screening in homeless individuals. Recommendations include implementing appropriate data collection methods for this population, supporting cancer screening in places where homeless people usually access care, assessing the effectiveness of approaches to increasing cancer screening in homeless people, and addressing adequate housing as a fundamental social factor.
07/04/2018 - 11:23
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“School definitely failed me, the system failed me”: Identifying Opportunities to Impact Educational Outcomes for Homeless and Child Welfare-Involved Youth
Children and youth who experience homelessness and child welfare involvement may experience high mobility, disruption of relationships with family and peer networks, and social stigma, all of which can have a negative impact on educational success for these youth. In this study, we explored the perspective of youth who were involved with child welfare and homeless serving systems, and who had experienced school challenges. Youth (n = 20) between the ages of 18 and 24 participated in semi-structured qualitative interviews. Using a life course framework, we asked youth about their experiences in these multiple systems across developmental stages, and asked them to highlight what might have been helpful to their educational outcomes. Data analysis was conducted by a research team of three scholars who each had expertise in these varied systems, and member checking was completed with four youth to increase credibility of the findings. Results highlighted the importance of youth having supportive adults in their lives, suggesting an opportunity for systems to better mobilize and support caring adults, including informal supports and professional staff within these systems that can advocate for youth. Results also stress the importance of using a trauma-informed approach with cross- systems youth, rather than punitive approaches to discipline that tend to exacerbate negative educational outcomes. Many of these youth felt like they had to “make it on their own,” underscoring the need to better connect youth to existing resources within their communities and building on youths' strengths and protective factors, in order to improve educational outcomes for vulnerable youth.
07/04/2018 - 09:09
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Family Care Curriculum: A Parenting Support Program for Families Experiencing Homelessness
In the United States, families with children characterize the fastest growing portion of the homeless population. Parenting for families experiencing homelessness presents unique challenges since families facing homelessness are disproportionately more likely to experience a myriad of interpersonal and contextual stressors that heighten the risk of parents engaging in suboptimal parenting approaches.  This article describes the development and implementation of the Family Care Curriculum (FCC) train-the-trainer parenting support program specifically designed to support positive parenting in families experiencing homelessness. Description The FCC is a 6-week theory-based parenting intervention aimed to create positive shifts in parental attitudes to enhance sensitive and nurturing parenting and positive parent–child relationships. FCC assists parents in reflecting on how their own experiences contribute to some of their parenting beliefs, patterns, and behaviors. Parents are coached to imagine and understand the emotions, attachment, and developmental needs behind their children’s behaviors so they can maintain empathic and nurturing parenting responses in the context of cumulative and chronic stress. Parents are supported through learning to engage in self-care. A unique and important feature of the FCC is the inclusion of a culturally sensitive approach that takes into consideration the effects of racism, classism, and oppression on parent–child relationships. 
07/04/2018 - 09:02
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Factors Associated with Drop-In Center Utilization Among Unaccompanied Youth Experiencing Homelessness
Drop-in centers for homeless youth take a low barrier approach to addressing both their basic needs (e.g., food, hygiene, clothing) and higher level needs (e.g., substance use treatment, mental health care, HIV/STD-related programs). Prior studies indicate that youth who use drop-in centers show improvements in health-related behaviors over time. The purpose of this study was to identify factors associated with drop-in center attendance in this population.
07/04/2018 - 08:57
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International Forum Report 2018
During Congress 2018 in April, CHRA hosted an International Forum for which a number of Canadian and international housing experts came together to discuss common issues in social and affordable housing. From that Forum, CHRA has produced a summary report providing an overview of the current state of housing – including broader market housing challenges, jurisdictional reflections, and homelessness – in Canada, the United States and the United Kingdom.
07/04/2018 - 08:50
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A Survey of Mental Disorder in the Long-Term, Rough Sleeping, Homeless Population of Inner Dublin
ObjectivesHomelessness causes huge distress to a vulnerable population and great concern to wider society. The aim of this study was to reflect the prevalence of mental disorder within a subset of the homeless population in Dublin. MethodLong-term rough sleepers in Dublin were identified by the relevant non-statutory agency (Dublin Simon Community’s Rough Sleepers Team). The authors attempted to assess all the identified individuals employing traditional clinical methods. ResultsWe managed to assess 16 of the 22 identified individuals. We detected no formal disorder in ~30%, severe mental illness in ~30% and either alcohol or substance misuse in another ~30%. We detected dual diagnosis (co-occurrence of severe mental illness and alcohol or substance misuse) in 10%. ConclusionMost but not all long-term rough sleepers in Dublin had a formal mental disorder identified. Just under one-third had a severe mental illness. This suggests that individualised patient centred health and social care will be required on a case by case basis in the long-term rough sleeping population.
06/26/2018 - 15:26
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A Shared Housing Agenda: Priorities for Ontario in 2018
Ontario has a housing crisis that affects people of diverse ages, income levels, family types, and cultural backgrounds. Affordable housing of decent quality is essential for the health and wellbeing of Ontarians. Some of the most critical barriers to safe and affordable housing are intersectional, especially around gender and racial discrimination. Young millennials getting by on low-paid or contract work struggle to find an affordable apartment, or to save for a home. Newcomers face similar barriers. People living on low wages, pensions or benefits, or in precarious jobs, find few options they can afford. People with disabilities – physical, mental health, age-related, or other – have particular needs not being met by the current housing system. People from racialized communities experience compound disadvantage in the housing market, and also discrimination. The same is true for Indigenous, Métis and Inuit communities. These issues require provincial leadership. Ontario can help make sure our housing market works well. It can help people who are struggling to afford market rental or to leave homelessness behind. In a province with escalating housing costs, housing supply shortfalls, but strong economic growth, it is time for action. Building on the opportunity the National Housing Strategy provides, action by Ontario can support local activity to meet community needs. Six housing priorities stand out for Ontario in 2018. These have been identified by the organizations named on this document. They are not listed in order of priority, and action is needed on all of them to meet the housing needs of Ontarians. In sum, this housing crisis is not inevitable. With action and alliances, Ontario can help create a system of housing that meets the needs of community, especially those who are disproportionately more vulnerable than others.
06/26/2018 - 15:11
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Moving Forward: Recommendations for Community Action
MOVING FORWARD – Recommendations for Community Action is the outcome of Community Conversations on Poverty in Hastings and Prince Edward counties, in which more than 500 community members came together to talk about poverty - their experience of it, what is working, what isn’t and how to end it. This is the SECOND report in a series of reports informed by the Community Conversations. The rst report LEANING IN – Community Conversations on Poverty in Hastings Prince Edward, is a summary of the stories we heard in the conversations. This action planning document, which will guide planning and future considerations for the eradication of poverty in our community, is the second community report on poverty.
06/13/2018 - 14:58
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Temporary Accommodation in Scotland: Interim Report
On behalf of HARSAG, Social Bite (an Edinburgh-based social enterprise with a mission to end homelessness in Scotland, whose co-founder Josh Littlejohn is a member of HARSAG) commissioned Heriot-Watt University’s Institute for Social Policy, Housing and Equalities Research (I-SPHERE) to conduct research mapping the current landscape, with a view to enabling an assessment of the nature of the transformation to TA in Scotland now required. The overall aim of the study is to provide a comprehensive analysis of the current situation, including key stakeholder and TA resident perspectives, to inform future policy development. This interim report details emerging findings from the initial stages of the study, these being: a review of existing research and literature; qualitative interview with 16 expert key informants; and analysis of national statistics on TA type and usage.
06/13/2018 - 14:53
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Clinical and functional characteristics of young adults living in single room occupancy housing: preliminary findings from a 10-year longitudinal stud
Objective Young adults living in single room occupancy (SRO) hotels, a form of low-income housing, are known to have complex health and substance problems compared to their peers in the general population. The objective of this study is to comprehensively describe the mental, physical, and social health profile of young adults living in SROs.  Methods This study reports baseline data from young adults aged 18–29 years, as part of a prospective cohort study of adults living in SROs in Vancouver, British Columbia, Canada. Baseline and follow-up data were collected from 101 young adults (median follow-up period 1.9 years [IQR 1.0–3.1]). The comprehensive assessment included laboratory tests, neuroimaging, and clinician- and patient-reported measures of mental, physical, and social health and functioning.  Results Three youth died during the preliminary follow-up period, translating into a higher than average mortality rate (18.6, 95% CI 6.0, 57.2) compared to age- and sex-matched Canadians. High prevalence of interactions with the health, social, and justice systems was reported. Participants were living with median two co-occurring illnesses, including mental, neurological, and infectious diseases. Greater number of multimorbid illnesses was associated with poorer real-world functioning (ρ = − 0.373, p < 0.001). All participants reported lifetime alcohol and cannabis use, with pervasive use of stimulants and opioids.  Conclusion This study reports high mortality rates, multimorbid illnesses, poor functioning, poverty, and ongoing unmet mental health needs among young adults living in SROs. Frequent interactions with the health, social, and justice systems suggest important points of intervention to improve health and functional trajectories of this vulnerable population.
06/13/2018 - 14:49
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Peer support critical elements and experiences in supporting the homeless: A qualitative study
Peer supporters are individuals with lived experience and are an integral part of health care systems, providing support to those affected by various phenomena such as homelessness and addictions. However, little is known about the critical elements that underpin peer support interventions. This qualitative study sought to understand the critical elements of intentional peer support with a homeless population, voiced by those who provide and/or receive this support. Twenty‐nine participants from 4 different homeless charities in England were interviewed about their experiences of providing/receiving peer support and what they felt were critical factors to its success. Participants defined peer support as an experience‐based relationship, built upon mutual understanding, empathy, and support. Thematic analysis was utilised to in developing 6 themes. Results identified peers' persistence in developing unique experience‐based relationships, providing social support, role modelling recovery, and peers' motivations were perceived as important factors involved in peer support. It was also found that peers described benefitting from helping, such as, undergoing transformative identity developments that helped them to escape homelessness. Through the retelling of their stories, they create meaning and restructure their autobiography, attributing experiences of homelessness as a catalyst for positive changes in their lives. Limitations and future research are discussed.
06/13/2018 - 14:44
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Advisory Committee on Homelessness Final Report
The Advisory Committee on Homelessness, chaired by Adam Vaughan, Parliamentary Secretary to the Minister of Families, Children and Social Development (Housing and Urban Affairs), was announced in June 2017. Consisting of 13 members from across the country with varied backgrounds, the Committee has worked diligently since the announcement through conference calls, online collaboration, in‑person meetings and attendance at regional roundtables.  Committee members bring a wealth and diversity of experience to the table. Their collective membership spans policy, advocacy and community service provision, and many have been in this field for over 20 years. In addition, two members have their own lived experience1 of homelessness and bring that perspective, and the perspective of their clients living in homelessness, to bear on each discussion. 
06/12/2018 - 14:12
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Submission to the National Consultation on a Human Rights-Based Approach to Housing
As the details of the National Housing Strategy roll out, the Government of Canada continues to make its intentions clear: the forthcoming housing strategy will be rooted in a human rights-based approach. The Canadian Observatory on Homelessness lauds this commitment.  During this consultation phase, we offer our perspective on how the government can develop, implement and most importantly, guarantee a right to housing. To do so, they must go beyond a human rights approach. To see an end to homelessness in Canada — and access to safe, affordable housing for all — the Government of Canada must make an explicit, actionable and judiciable commitment to housing as an inalienable human right.  Toward this effort, we make recommendations. These recommendations are formed in consultation with A Way Home Canada, the Canadian Alliance to End Homelessness and other knowledgeable stakeholders. We draw heavily from the recommendations made by Leilani Farha, UN Special Rapporteur on the Right to Adequate Housing. The strategies set forth by the Special Rapporteur provide a strong, principled foundation from which to build the National Housing Strategy on.
06/08/2018 - 10:38
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Seen or Unseen? The Role of Race in Police Contact among Homeless Youth
Abstract Homeless youth are at an increased risk of police contact—being stopped by police and arrested, yet it is less clear if this interaction is patterned by race. The current study draws on diverse scholarship to examine three possible effects of race on homeless youths’ interaction with police: that non-White homeless youth are more likely (disproportionate minority contact/symbolic assailants), less likely (out-of-place policing) or no different than White youth (master status) to experience police contact. Using the Midwest Longitudinal Study of Homeless Adolescents, we examine homeless youths’ odds of self-reported police harassment and arrest. Non-White homeless youth are more likely to report police harassment and arrest, but living on the street neutralizes these racial disparities. Further, prior police harassment is linked to subsequent arrest, operating similarly for White and non-White homeless youth. We discuss the implications of these findings for advancing scholarship on the challenges faced by homeless youth.
06/01/2018 - 09:55
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Australian Homelessness Monitor 2018
This study provides an independent analysis of homelessness in Australia. It analyses changes in the scale and nature of the problem and investigates the incidence of the many social, economic and policy drivers of homelessness.  The findings of this study can be summarised in terms of: (1) the changing scope and pattern of homelessness (2) the nature of broader social and economic drivers that condition the risk of homelessness, especially for some groups such as low-income households, and (3) the particular relevance of policy at federal, state and territory levels in both exacerbating and easing homelessness.  This is especially the case in respect to housing policies, income support policies and policies that support homelessness programs. Attention is also given in the study to Indigenous homelessness with a particular emphasis on remote communities.  We demonstrate how public policies, particularly housing and welfare policies, are firstly, critical drivers of homelessness in Australia, and secondly, areas that represent significant opportunities to demonstrably reduce homelessness. Thus, drawing on the prominent UK researchers such as Fitzpatrick and colleagues, who were involved with the original UK Homelessness Monitor, the report acknowledges the complexity of the causes of homelessness, but it similarly identifies a suite of public policy changes that can improve the housing and life outcomes of people who are homeless or at risk of homelessness.
06/01/2018 - 09:35
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More than a number: The scale of youth homelessness in the UK
Data collected for the Youth Homelessness Databank provides a clearer picture of the true scale of youth homelessness in the UK. There is no accurate source of information on the scale of youth homelessness in the UK. In England, while the Ministry for Housing, Communities and Local Government (MHCLG)1 publishes annual statistics on the number of young people accepted as statutorily homeless, this only represents a small proportion of the total number of homeless young people. Centrepoint’s Youth Homelessness Databank addresses this data shortfall by creating a central source of information on the number of young people presenting to their local authority as homeless or at risk of homelessness, as well as those who are assessed and subsequently accepted as being statutorily homeless or recorded as being successfully helped in some other way. Centrepoint has built a databank that can help to form a more accurate understanding of the state of youth homelessness in the UK. This report includes a number of findings from the Youth Homelessness Databank data. More data can be found on the Youth Homelessness Databank website2, the open access source of all data collected at a local, regional and national level. It was launched in 2015 and has since accumulated data on the majority of local authorities in England dating back to 2012/13.
06/01/2018 - 09:27
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BC CORONERS SERVICE DEATH REVIEW PANEL: Review of MCFD-Involved Youth Transitioning to Independence
Adolescence is a time of exciting and intense change. The process of moving from childhood to adulthood can be challenging for young people. For many young people, family continues to provide guidance and support well into early adulthood; however, youth transitioning to adulthood from government care face an additional, simultaneous transition from government support to independence often without similar resources, family support or guidance, and at a younger age than their peers. This report reviews the deaths of vulnerable youth and young adults who had been in government care or were receiving extensive support services and who died during their transition to adulthood. For the period of January 1, 2011 to December 31, 2016, 1,546 youth and young adults aged 17-25 years died from causes classified as accidental, suicide, undetermined, natural or homicide. Of these deaths, 200 (13%) deaths were among youth and young adults who at age of death or at age of majority were in care, were former children in care, or were on independent youth agreements or receiving extensive support services. These young people leaving government care died at five times the rate of the general population of young people in British Columbia. Although many young people leaving care or youth agreements show great resilience and strength as they transition to adulthood, they also face many more challenges than their peers. They may lack a family support network, have limited or no financial resources, often lack life skills, and often have not completed school. They may suffer from low self-esteem and be scarred by trauma associated to violence, childhood neglect and/or abuse. To better understand these deaths and identify prevention opportunities, a death review panel appointed under the Coroners Act was held in December 2017. The circumstances of 200 young people who died while transitioning to independence from government child services between January 1, 2011 and December 31, 2016 were reviewed in aggregate. The panel was comprised of professionals with expertise in youth services, child welfare, income support, mental health, addictions, medicine, public health, Indigenous health, injury prevention, education, law enforcement and academia. The review found:  A lack of documented transition planning for youth leaving care or on youth agreements;  A disproportionate number of Indigenous young people died;  High rates of suicide and drug overdose deaths;  High rates of health and mental health issues;  Lower completion of educational attainment; and,  Barriers (systemic and personal) to successfully transition to independence. The panel identified four key areas to reduce the deaths: 1. Extending service supports based on the young person’s needs; 2. Improved communication between service providers with the goal to increase engagement of youth; Page 4 3. Engage with youth on service planning and policy development; and, 4. Monitor outcomes and use findings to support service planning and policy changes.
06/01/2018 - 09:18
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Palliative care for homeless people: a systematic review of the concerns, care needs and preferences, and the barriers and facilitators for providing palliative care
Background Homeless people often suffer from complex and chronic comorbidities, have high rates of morbidity and die at much younger ages than the general population. Due to a complex combination of physical, psychosocial and addiction problems at the end of life, they often have limited access to palliative care. Both the homeless and healthcare providers experience a lot of barriers. Therefore, providing palliative care that fits the needs and concerns of the homeless is a challenge to healthcare providers. This systematic review aims to summarize evidence about the concerns, palliative care needs and preferences of homeless people, as well as barriers and facilitators for delivering high quality palliative care.
05/30/2018 - 10:35
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Where Will We Live? Ontario's Affordable Housing Crisis
The percentage of renters is increasing in Ontario and across Canada. Renters in Ontario now constitute over 30% of the total population. In the City of Toronto, almost half of all households rent their home. This increase has been largely driven by a growing proportion of renters within the younger generations. Over half of Ontario households between the ages 25 to 34 are renters. This trend may be due to the increasing cost of homeownership, the lack of well-paid and secure jobs and the increasing numbers of single-person households. Low- and moderate-income households are also much more likely to rent their homes. 71% of households with income below $20,000 are renters, compared to only 10% of households with income over $100,000. A significant percentage of renters across Ontario and in Toronto are facing unaffordable housing costs that limit their ability to spend money on other life necessities. Too many people are choosing to forgo a healthy diet or the medication they need just to keep a roof over their head. Many facing rising rents are being displaced from their communities and many more are commuting longer hours between home and work. The road to homelessness for renters living on lower incomes is a stark reality if they lose their job or face a health challenge. Renters are facing a combination of rising housing costs, stagnating incomes, and limited access to subsidized housing. Renters tend to have much lower incomes compared to homeowners. As rental housing costs continue to rise, all levels of government must focus on alleviating the burden of unaffordable housing, especially for low-income renters. Solving the affordable rental housing crisis in our province requires long-term commitment to targeted housing policies and investments that focus on the needs of low- to moderate-income renter households. Rents have risen across Ontario over the past 20 years, particularly since 2011. We know for a fact that our affordable rental housing crisis will not be solved by building more condominiums or luxury purpose-built rentals. We need a combination of targeted policies and investments including funding for social housing, government support for non-profit housing, and strong protections in place for tenants. Preserving the status-quo is no longer an option for the hundreds of thousands of renters struggling every day to keep a roof over their head.
05/29/2018 - 12:07
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Correlates of Treatment Readiness Among Formerly Incarcerated Homeless Women
Abstract Treatment readiness is a key predictor of drug treatment completion, rearrest, and recidivism during community reentry; however, limited data exist among homeless female offenders (HFOs). The purpose of this study was to present baseline data from a randomized controlled trial of 130 HFOs who had been released from jail or prison. Over half (60.8%) of HFOs had a treatment readiness score of ≥40 (n = 79, mean [μ] = 40.2, SD = 8.72). Bivariate analyses revealed that methamphetamine use, psychological well-being, and high emotional support were positively associated with treatment readiness. On the contrary, depressive symptomatology and depression/anxiety scores were negatively associated with the treatment readiness score. Multiple linear regression revealed that depressive symptomatology was negatively associated with treatment readiness (β = −0.377, p = .001). Further analyses revealed that the effect of emotional support on treatment readiness was mediated by depressive symptomatology.
05/29/2018 - 11:55
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Begging for Change: Begging Restrictions Throughout Washington
Abstract The act of panhandling, commonly known as begging, is a form of speech protected by the United States Constitution. But Washington’s cities are increasingly enacting laws that criminalize begging, despite courts finding these laws unconstitutional under both the First Amendment and the Due Process Clause. This brief surveys begging restrictions, assessing their scope and legality. This report offers the first statewide analysis of laws that restrict begging.Among the brief's key findings is that the vast majority (86%) of Washington cities criminalize begging; the majority (83%) of these laws result in a criminal charge if violated, leading to serious collateral consequences that impact one’s eligibility for housing and employment. Many of these laws would not survive constitutional scrutiny.
05/29/2018 - 10:00
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Promising Practices for Serving Philadelphia’s Students Who Experience Homelessness
FPSN originally developed Promising for Providers Serving Homeless Students in 2010 as a resource for building strong partnerships between family service providers and schools, and this is version II. Promising Practices offers a framework to help providers develop and maintain relationships with key personnel in their children’s schools, provide academic support, lower truancy, and improve parental involvement. Key terms are in bold and defined in the glossary at the rear of this booklet. Some Promising Practices might work differently in congregate emergency (EH) and transitional housing (TH) sites than in scattered housing or Rapid Rehousing sites. Scattered site locations may need to adapt the practices based on feasibility and what best suits the needs of the residents.
05/29/2018 - 09:39
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City of Richmond Housing Affordability Profile: Affordable Housing Strategy 2017–2027 Companion Document
Housing affordability continues to be a critical issue both regionally and at the local level. Richmond’s Affordable Housing Strategy 2017–2027 has been updated to reflect current and future needs of the community and to align with City and regional planning goals. Central to this update is an understanding of the housing affordability context in Richmond and the needs of existing and future residents so that anticipated policy recommendations can effectively address identified gaps and priorities. The Housing Affordability profile helps to identify current and emerging trends relative to Richmond’s housing market and highlights affordability needs through an analysis of available current demographic and housing data. The document combines quantitative analysis with feedback from a broad range of stakeholders including the public, senior government and the private and non-profit housing sectors, to determine housing gaps and needs in Richmond. The Housing Affordability Profile is one of two companion documents to the Affordable Housing Strategy 2017–2027.
05/28/2018 - 15:53
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Chronic Homelessness
As our understanding of homelessness has evolved, we have come to recognize chronic homelessness as a relatively small and “solvable” problem that affects, on average, about 10 to 15 percent of people who experience homelessness. This vulnerable population of people with disabilities is composed primarily of adults living on their own, who either experience homelessness for prolonged periods of time or have repeat episodes of homelessness. Chronic homelessness, in addition to being extremely debilitating to those who experience it, can be very expensive to homeless systems and public systems, including health care and criminal justice. Between 2007 and 2017, the number of people experiencing chronic homelessness on a single night fell by 27.4 percent, compared with a 14.5 percent reduction in homelessness overall. This decline coincided with a national, bipartisan commitment to increase investment and capacity to serve people experiencing chronic homelessness. Since 2007, the number of permanent supportive housing (PSH) beds dedicated to people experiencing chronic homelessness nearly quadrupled, from 37,807 to 149,005. Efforts to target PSH to the most vulnerable people and to prioritize chronic homelessness in programmatic and policy responses also intensified, and randomized-controlled trials have demonstrated that PSH keeps people with behavioral health issues from returning to homelessness. Providing permanent affordable housing to individuals with chronic patterns of homelessness has alsoproven to significantly reduce use of expensive acute care services such as emergency shelters, hospital emergency rooms, and detoxification and sobering centers. As a result, PSH can lead to substantial savingsand, among the heaviest service users, may even be a cost-neutral investment, with the cost of housing subsidies and services offset by reductions in other spending for public services. What are the implications for policymakers and practitioners? From the available evidence, we can draw some clear lessons for policy and practice: Coordinated entry and assessment can be used to differentiate the majority of people experiencing an acute housing crisis from the minority experiencing chronic homelessness, and to refer each group to the appropriate interventions. Accurate identification of those who are most likely to develop chronic patterns of homelessness in the future, in order to provide services to preempt this shift, is not feasible at this time. Treatment and care for people experiencing chronic homelessness should be the primary motivators for any intervention. However, communities that are also hoping to realize cost savings by addressing chronic homelessness will limit savings potential if they only focus on those who are already high-cost users of crisis response systems. Practitioners should consider referring all adults who are homeless with disabilities to rapid re-housing, with the option to transition to PSH as continuing need is revealed, consistent with a Progressive Engagement approach (i.e., initially providing a small amount of assistance to resolve a housing crisis, and then additional assistance as needed after individual assessment). Among the current population of people experiencing chronic homelessness, PSH is still the best fit, possibly with rapid re-housing as a bridge. As individuals with chronic patterns age, they will need more medical services and assistance with activities of daily living rather than behavioral health services. Symptoms of severe mental illness or substance abuse may become less acute, but people develop other severe chronic health conditions. Scalable interventions should be part of the solution, including aggressive enrollment in SSI and shallow rent subsidies when PSH is not available.
05/14/2018 - 14:20
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Housing in Canada's big cities
Background  In March 2017, The City of Calgary published Housing in Calgary: An Inventory of Housing Supply, 2015/2016, providing comprehensive information on Calgary’s housing supply, covering the entire spectrum of housing in Calgary, from emergency shelter spaces to market homeownership. Through this report, a more complete picture of the entire housing system in Calgary became visible, enabling a broader understanding of housing supply trends, gaps and implications and specifically, the current state of the affordable housing segment. This report is intended to compliment the 2017 Housing in Calgary report by helping to understand in what ways Calgary’s housing supply and affordability compare to other big cities, the possible reasons why it is different, and what municipal tools are currently being used to impact supply and affordability in Canada’s largest cities. In 2016, Calgary City Council unanimously adopted Foundations for Home: Calgary’s Corporate Affordable Housing Strategy 2016 – 2025, along with an Implementation Plan for the period 2016-2022. This research may inform several initiatives in the Implementation Plan, as well as the prioritization of tactics by Calgary’s Community Housing Affordability Collective (CHAC), and could be used to strategically plan future development in the city. Additionally, this research could be used to inform discussions and advocacy with other orders of government. Key Findings  Housing in Calgary is very different from housing in Canada’s other big cities, with the:  second-highest rate of homeownership at 71%, compared to the average of 59%,  second-lowest proportion of households living in rental housing at 29%, compared to the average of 41%,  lowest proportion of households living in subsidized housing, at 2.9%1 , compared to the average of 5.3%,  second-highest per cent of households living in single-family housing, at 56.3%, compared to the average 36.5%,  lowest per cent of households living in high-rise apartment buildings, at 7%, compared to the average 20%,  lowest supply of purpose-built rental apartments, representing 7% of housing supply, compared to the average 16%, and the  lowest supply of co-operative housing, at 0.3%, compared to the average of 1%.
05/14/2018 - 13:41
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Missed Opportunities: Pregnant and Parenting Youth Experiencing Homelessness in America
Missed Opportunities: Pregnant and Parenting Youth Experiencing Homelessness in America details the unique challenges faced by young people experiencing homelessness who are pregnant or parenting. Our findings suggest that many of the nearly 4.2 million adolescents and young adults in America who experience some type of homelessness during a 12-month period are pregnant or young parents. Many of those young parents are homeless with their children, and pregnant and parenting youth experiencing homelessness are a particularly vulnerable population. Supporting these young people and their families is critical to ending homelessness among youth in the U.S.
05/14/2018 - 13:31
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Bridging Hospital and Community Care for Homeless Adults with Mental Health Needs: Outcomes of a Brief Interdisciplinary Intervention
Abstract Objective: This study examines health and service use outcomes and associated factors among homeless adults participating in a brief interdisciplinary intervention following discharge from hospital. Method: Using a pre-post cohort design, 223 homeless adults with mental health needs were enrolled in the Coordinated Access to Care for the Homeless (CATCH) program, a 4- to 6-month interdisciplinary intervention offering case management, peer support, access to primary psychiatric care, and supplementary community services. Study participants were interviewed at program entry and at 3- and 6-month follow-up visits and assessed for health status, acute care service use, housing outcomes, mental health, substance use, quality of life, and their working alliance with service providers. Linear mixed models and generalized estimating equations were performed to examine outcomes longitudinally. Additional post hoc analyses evaluated differences between CATCH participants and a comparison group of homeless adults experiencing mental illness who received usual services over the same period. Results: In the pre-post analyses, CATCH participants had statistically significant improvements in mental and physical health status and reductions in mental health symptoms, substance misuse, and the number of hospital admissions. The strength of the working alliance between participants and their case manager was associated with reduced health care use and mental health symptoms. Post hoc analyses suggest that CATCH may be associated with statistically significant improvements in mental health symptoms in the study population. Conclusions: A brief interdisciplinary intervention may be a promising approach to improving health outcomes among homeless adults with unmet health needs. Further rigorous research is needed into the effectiveness of brief interventions following discharge from hospital.
05/14/2018 - 13:25
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What do homeless transition-age youth want from housing interventions?
Abstract Housing-led interventions have become recognized as a best practice for addressing homelessness among adults, yet whether and how they apply to transition-age youth (TAY) is less clear. The purpose of the present study is to expand on a burgeoning literature that has provided marginalized TAY an opportunity to voice their perspectives on housing-led program design. The goal of the study it to build on the existing literature that has predominantly used individual qualitative interviewing by using a focus group methodology in which group interaction can generate data and insights that may not emerge in individual interviews. Focus groups (n = 4) were conducted with 18 youth. Thematic analysis of focus group transcripts was conducted using independent and co-coding procedures. Three overarching and interrelated themes emerged from the focus groups: (a) personal responsibility and deservedness, (b) rising and falling together, and (c) needing individualized support. These findings suggest that TAY preferences for housing and services are not necessarily consistent with the homeless adult population and that youth may be looking for a more supportive housing environment.
05/14/2018 - 12:56
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Conditional Families and Lesbian, Gay, Bisexual, Transgender, and Queer Youth Homelessness: Gender, Sexuality, Family Instability, and Rejection
Abstract Existing research on lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth homelessness identifies family rejection as a main pathway into homelessness for the youth. This finding, however, can depict people of color or poor people as more prejudiced than White, middle‐class families. In this 18‐month ethnographic study, the author complicates this rejection paradigm through documenting the narratives of 40 LGBTQ youth experiencing homelessness. The author examines how poverty and family instability shaped the conditions that the youth perceived as their being rejected because of their gender and sexuality. This rejection generated strained familial ties within families wherein the ties were already fragile. Likewise, the author shows how being gender expansive marked many youth's experiences of familial abuse and strain. This study proposes the concept of conditional families to capture the social processes of how poverty and family instability shape experiences of gender, sexuality, and rejection for some LGBTQ youth.
05/14/2018 - 12:45
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2018 Canadian Rental Housing Index
Nearly half of Canadian renter households are spending more than the recommended 30 per cent of their income on housing while nearly one in five are spending more than 50 per cent of their income on housing, putting a growing number of families and individuals at a crisis level of spending and at risk of homelessness. The information comes from the 2018 Canadian Rental Housing Index, a comprehensive database of rental housing statistics released today by a national partnership of housing associations, credit unions, and municipal associations, developed using the latest census data from Statistics Canada. The Index tracks everything from average rental costs, to how rental housing spending compares with income, to overcrowding for over 800 cities and regions through an easy to access web portal. The tool is designed for governments, local planners, housing organizations, and the general public to view an accurate picture of the rental housing market in communities across the country.
05/14/2018 - 12:35
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Missed Opportunities: LGBTQ Youth Homelessness in America
Missed Opportunities: LGBTQ Youth Homelessness in America highlights research related to the specific experiences of young people who identify as lesbian, gay, bisexual, transgender, and queer (LGBTQ) and face homelessness. We learned that, compared to heterosexual and nontransgender youth, LGBTQ youth are disproportionately represented among the nearly 4.2 million youth and young adults in America who experienced some form of homelessness during a 12-month period. They also face a higher risk of early death and other adversities. On the positive side, this research points to actionable opportunities to better meet the needs of LGBTQ young people in our collective efforts to end youth homelessness. Key Findings - Overview LGBTQ youth in America are highly diverse and experience homelessness* differently. Nevertheless, several key findings about their experiences point the way toward policies, systems, and services that LGBTQ youth need: • LGBTQ youth had over twice the rate of early death among youth experiencing homelessness. • LGBTQ youth are at more than double the risk of homelessness compared to non-LGBTQ peers. • Youth who identified as both LGBTQ and black or multiracial had some of the highest rates of homelessness. • Among youth experiencing homelessness, LGBTQ young people reported higher rates of trauma and adversity. • Transgender youth often face unique and more severe types of discrimination and trauma. The research also showed that most LGBTQ youth became homeless not in the immediate aftermath of “coming out” but in large part as the result of family instability and frayed relationships over time. Lastly, young people's sense of whether service agencies were safe and affirming spaces for LGBTQ youth often informed their decisions about whether to engage with them. These findings signal opportunities for preventing homelessness and underscore the importance of services that help young people re-establish positive and reliable connections in their lives. 
05/10/2018 - 14:46
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Human Trafficking Prevalence and Child Welfare Risk Factors Among Homeless Youth: A Multi-City Study
The Field Center completed a three-city study as part of a larger initiative by Covenant House International to research human trafficking among homeless youth encompassing nearly 1,000 young people across 13 cities. The Field Center interviewed a total of 270 homeless youth, 100 in Philadelphia, 100 in Phoenix, and 70 in Washington, DC, to learn about the prevalence of human trafficking, and the history of child maltreatment, out of home placement, and protective factors among those who were sex trafficked or engaged in the sex trade to survive. Of those interviewed, 20% were victims of human trafficking, including 17% who were victims of sex trafficking and 6% who were victims of labor trafficking. Fourteen percent engaged in “survival sex” to meet their basic needs. A total of 36% of those interviewed reported engaging in a commercial sex act at some point in their lives.
05/07/2018 - 16:02
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Homeless to Housed in a Hurry: Extending the Use of Diversion to Help Families Exit Homelessness
Since 2014, Building Changes has tested Diversion as an approach to help families exit homelessness. Our Diversion pilots in King and Pierce counties served a combined 1,898 families. Results drawn from our evaluation of those pilots are highlighted in two publications, titled Homeless to Housed in a Hurry. One publication is an overview of Diversion and the other is a case study of the Pierce County experience. Our data reveals Diversion costs less and takes less time to get families successfully housed, and that the vast majority of the families that obtained housing through Diversion did not return to homelessness within a year. We conclude that Diversion is an effective and efficient approach for resolving the homelessness of some families.
05/07/2018 - 15:55
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‘This Is the View When I Walk into My House’
This article argues for the utility of phenomenology in accounting for the manner in which spatial methods yield insights into the everyday lived experiences of young people that are not as easily accessible through more traditional qualitative methods such as interviewing. Spatial methods, defined as methods that focus on the everyday spatial experiences of young people and methods that ask youth to position themselves in space, have been used by the author in a variety of research projects, and also incorporate certain visual methods. Phenomenological concepts such as the spatial perspective, the web of relations and opaque subjectivity are helpful in understanding not only that these methods work well but why they are so effective. The article also addresses Pierre Bourdieu’s critique of phenomenology, responding to his concern that phenomenology might be susceptible to ignoring or overlooking the social and political contexts that shape experiences.
05/07/2018 - 15:43
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Sanitizing Public Space in Olympic Host Cities: The Spatial Experiences of Marginalized Youth in 2010 Vancouver and 2012 London
This article is based on a cross-national qualitative study of homeless and street-involved youth living within Olympic host cities. Synthesizing a Lefebvrian spatial analysis with Debord’s concept of ‘the spectacle’, the article analyses the spatial experiences of homeless young people in Vancouver (host to the 2010 Winter Olympics) and draws some comparisons to London (host to the 2012 Summer Olympics). Tracing encounters with police, gentrification and Olympic infrastructure, the article assesses the experiences of homeless youth in light of claims made by Olympic proponents that the Games will ‘benefit the young’. By contrast, the authors argue that positive Olympic legacies for homeless and street-involved young people living within host cities are questionable.
05/07/2018 - 15:27
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Envisioning Democracy: Participatory Filmmaking with Homeless Youth
This paper explores the democratic potential for participatory filmmaking with homeless youth, as well as the constraints and dilemmas associated with this visual method. Theorizing democracy through the work of Hannah Arendt and Pierre Bourdieu, the paper approaches democracy not as an end, but rather as a process that seeks to lessen social injustice. Bourdieu's work helps us appreciate, however, that this process is constrained by structures of inequality that shape access to the political dispositions that enable such engagement. Consistent with other research on low‐income and marginalized young people, this study found that homeless youth engage with democracy through forms of community participation and mutual support, and are disinclined to orient toward liberal democratic structures such as voting and political parties, which they see as harmful or problematic. With a focus on one particular dilemma faced by the research team—namely, the question of how to make sense of and represent the issue of legalizing marijuana, which had been signaled by the youth participants as of primary political importance to them—the paper uses Arendt and Bourdieu to discuss how participatory filmmaking can help to expand the space of appearances available to homeless youth in Canadian society, and create a space at a shared table of understanding with middle class power brokers.
05/07/2018 - 15:12
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Social Ties and the Incidence of Homelessness
Abstract Although almost all homeless people are poor, most poor people do not experience homelessness. We use a detailed national survey to explore the role of social ties—including connection to relatives, friends, and religious community—in explaining why only a subset of poor adults fall into homelessness. We find that lifetime incidence of homelessness is reduced by 60% for individuals with strong ties along each of these dimensions. Ties to relatives are most important, followed by ties to religious community, whereas ties to friends are not associated with reduced incidence of homelessness. We also find that among currently low-income individuals, social ties are not associated with income, providing evidence that our results are not explained by unobserved variation in historical depth of poverty that is potentially correlated with our measures of social ties.
05/02/2018 - 09:45
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Spring 2018: FEANTSA Homeless in Europe Magazine
The recent Overview of Housing Exclusion in Europe 2018 by FEANTSA and the Abbé Pierre Foundation finds that housing exclusion continues to be a growing problem in Europe, resulting in an increasing demand for support and increased pressure on emergency services. The numbers of people experiencing homelessness has continued to rise in almost all EU countries. A deterioration in the living conditions of extremely vulnerable families has led to children becoming the largest group of people in emergency shelters, with the numbers of women, young people, those with a migration background, and the working poor, becoming increasingly numerous among the homeless population. Housing affordability and liveability are emerging as the most challenging social policy issues in Europe, with the ability to access housing adversely affecting young people, those with dependent family members, and migrants. Shelters are the physical interface of the staircase approach for people experiencing homelessness, with a succession of preparatory interventions, from initial reception to social reintegration. Despite this key role, many shelters are often rundown and equipped with low quality and second-hand furniture, reflecting an image of exclusion and instability. They lack privacy and come with the expectation of cohabitation with strangers. Emergency accommodation is supposedly a temporary solution although, in reality, it prolongs precarious living situations and rarely leads to well-being, recovery and social integration. The following articles provide an insight into the relationship of those using sheltered accommodation, those providing and staffing the shelter and the very building itself, as well as an opportunity to better understand some of the national realities and challenges faced by the homelessness sector professionals in different European Member States.
05/02/2018 - 09:20
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Promising Practices: 12 Case Studies in Supportive Housing for People with Mental Health and Addiction Issues
To showcase the expertise in the sector, and to help support implementation of new supportive housing, Addictions and Mental Health Ontario (AMHO), Canadian Mental Health Association, Ontario (CMHA Ontario) and the Wellesley Institute (WI) partnered to develop this resource guide. The 12 case studies share replicable, scalable and adaptable examples of how providers have overcome implementation challenges to meet the needs of their clients and communities. Promising Practices shares 12 case studies we know to be representative of a sector that is committed to high quality, high value services – and is ready to expand to better meet the growing needs of Ontarians with mental health and addiction issues.
05/02/2018 - 09:02
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Addressing Veteran Homelessness to Prevent Veteran Suicides
Abstract The U.S. Department of Veterans Affairs (VA) is shifting its focus from ending veteran homelessness to preventing veteran suicides. With supporting data, this Open Forum argues that VA homelessness services also help address veteran suicides. Analysis of a nationally representative survey of U.S. veterans in 2015 shows that veterans with a history of homelessness attempted suicide in the previous two years at a rate >5.0 times higher compared with veterans without a history of homelessness (6.9% versus 1.2%), and their rates of two-week suicidal ideation were 2.5 times higher (19.8% versus 7.4%). Because the majority of veterans who die by suicide are not engaged in VA care, VA services for the homeless that include outreach efforts to engage new veterans may be reaching some of these veterans. Thus continued federal support for VA homelessness services not only may help address homelessness but also may help prevent suicide of veterans. In 2009, the U.S. Department of Veterans Affairs (VA) announced its goal to end veteran homelessness and subsequently spent over $10 billion over the next seven years on VA health care, housing, and social services for homeless veterans. Considerable progress has been made, with annual point-in-time counts indicating a 47% drop in veteran homelessness from 2009 to 2016 (1). Under the new federal administration, administrative support and funding for VA homelessness programs may change, but how is not clear. For example, in late 2017, VA Secretary David Shulkin initiated plans to redirect millions of dollars for VA homelessness services to other VA services (2) until a wave of protests from veteran advocates caused the secretary to retract these plans in December (3). Moreover, under the new administration, the VA secretary has made veteran suicide the top clinical priority in the VA, which may shift focus away from veteran homelessness and toward veteran suicide.
04/17/2018 - 13:46
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Still Hungry and Homeless in College
Basic Needs Insecurity in Higher Education: A Continuing Challenge Since 2008, the Wisconsin HOPE Lab has examined food and housing insecurity among the nation’s undergraduates. We initially focused on Wisconsin, assessing prevalence of basic needs challenges in two samples of students—a cohort of Pell Grant recipients entering the state’s 42 public colleges and universities in fall 2008, and a cohort of low- and moderate-income students entering 10 public and private colleges and universities in 2012.3 Then we expanded to consider these challenges at colleges around the nation. Since there is no nationally representative survey of undergraduates that measures food or housing insecurity, surveying samples of students at colleges is the only option.4 This has been a major challenge.5 Limited finances and legal restrictions make it difficult to collect data from multiple colleges while obtaining high response rates. We would prefer to offer students strong monetary incentives and draw representative subsamples of students to focus the surveys on, but lack both the money and the data required. Therefore, we field inexpensive e-surveys and send them to each college’s entire population of undergraduates. The low response rates (often south of 10%) trouble us, but the estimates are likely conservative—our surveys do not explicitly recruit hungry or homeless students, and we expect that they have far less time or energy to give up for surveys. However, we leave that assessment to our readers—simply publishing the results as they arrive with as much transparency as possible, and continuing year after year to provide each college and university with its own data. We also continue to call on the National Center for Education Statistics to assess basic needs security on their nationally representative studies of undergraduates, and ask that other surveys of students include these questions as well.6 This report is about our third national survey. In 2015 we worked with the Association of Community College Trustees (ACCT) and invited all 1,200 of their members to do the survey. In total, 10 community colleges in 7 states accepted, and just over 4,000 students completed the questions. In 2016, we again partnered with ACCT, and 70 of their members responded, coming from 24 states, with a few repeats from 2015. More than 33,000 students completed that survey. In 2017, we opened the invitation up to any college or university, 2-year or 4-year, public or private, offering to support their efforts to address students’ basic needs by collecting data to inform their practices. This year’s survey is a purely voluntary, non-random sample, and includes 66 colleges and universities, including 31 community colleges and 35 4-year colleges and universities from 20 states and Washington, D.C. In total, 43,000 students responded, including over 20,000 in the 4-year sector. This is, therefore, the largest national assessment of basic needs security among 4-year students.
04/12/2018 - 14:59
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Men’s experiences of early life trauma and pathways into long-term homelessness
Abstract Previous studies that have explored the association between childhood trauma and homelessness indicate that traumatic events can lead to survivor distrust of interpersonal relationships and institutions, prolonged homelessness and poor health and social outcomes. The majority of this literature relies on quantitative data and fails to investigate the personal experiences of childhood trauma that are found to impact housing status later in life. Semi-structured, qualitative interviews were conducted with 25 men living in an urban area in Ontario who had spent more than 30 consecutive nights in an emergency shelter over the course of their housing histories. During data analysis, it was observed that all of the men had experienced some form of trauma or neglect in childhood which contributed to their entries into homelessness. Using a case study approach, three entry pathways into long term homelessness are described: 1) youth; 2) emerging or early adulthood; and 3) middle adulthood. Participants are classified into the pathways by the developmental period at which they first entered homelessness. These findings have implications for policy makers and service providers, as key intervention points are identified. Establishing effective interventions that address crises experienced at these points could assist with homelessness prevention across the life course.
04/12/2018 - 13:44
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Transitions between Housing States among Urban Homeless Adults: a Bayesian Markov Model
Abstract The purpose of this study is to explore how marginalization, substance abuse, and service utilization influence the transitions between streets, shelters, and housed states over the course of 2 years in a population of urban homeless adults. Survey responses from three yearly interviews of 400 homeless adults were matched with administrative services data collected from regional health, mental health, and housing service providers. To estimate the rates of transition between housed, street, and shelter status, a multi-state Markov model was developed within a Bayesian framework. These transition rates were then regressed on a set of independent variables measuring demographics, marginalization, substance abuse, and service utilization. Transitions from housing to shelters or streets were associated with not being from the local area, not having friends or family to count on, and unemployment. Pending charges and a recent history of being robbed were associated with the shelters-to-streets transition. Remaining on the streets was uniquely associated with engagement in Bshadow work^ and, surprisingly, a high use of routine services. These findings paint a picture of unique and separate processes for different types of housing transitions. These results reinforce the importance of focusing interventions on the needs of these unique housing transitions, paying particular attention to prior housing patterns, substance abuse, and the different ways that homeless adults are marginalized in our society.
04/12/2018 - 13:37
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Unlocking Doors To Homelessness Prevention (2018)
Since launching in 2014, Your Way Home has seen much success in rapidly rehousing those in Montgomery County who are experiencing homelessness. Findings from the research will assist Your Way Home in building a new agenda to expand its work into prevention efforts. The following themes were identified: - The causes of eviction and homelessness are multi-dimensional. - Race plays a critical role in determining eviction rates and is also correlated with rates of homelessness. - The challenge of prevention is targeting services and resources toward those most likely to become homeless. - Accurately targeted and effective community-based prevention programs can be cheaper for communities where shelter stays are expensive.  Access the report above, which provides a national scan of eviction prevention and homelessness prevention programs in local communities. Specific programs in other areas of the country are profiled. Eight key lessons are offered, and a link is provided for how policy makers, grantmakers and providers can best implement these lesssons (pg. 8). HealthSpark is proud to have partnered with Your Way Home on this seminal report.
04/12/2018 - 13:31
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The Homelessness Monitor: England 2018
The homelessness monitor is a longitudinal study providing an independent analysis of the homelessness impacts of recent economic and policy developments in England. It considers both the consequences of the post-2007 economic and housing market recession, and the subsequent recovery, and also the impact of policy changes. This seventh annual report updates our account of how homelessness stands in England in 2018, or as close to 2018 as data availability allows. It also highlights emerging trends and forecasts some of the likely future changes, identifying the developments likely to have the most significant impacts on homelessness. While this report focuses on England, parallel Homelessness Monitors are being published for other parts of the UK. Key findings Homelessness has shot up the media and political agenda over the past year. All of the major party manifestos made mention of homelessness in the snap June 2017 election, and the Conservatives under Theresa May pledged to halve rough sleeping by 2022 and eliminate it altogether by 2027. The Prime Minister has also established a high-level Rough Sleeping and Homelessness Reduction Taskforce supported by an expert Rough Sleeping Advisory Panel. This political attention is in large part a response to the ongoing rise in officially estimated rough sleeper numbers, with the national total now up by 169 per cent since 2010. The more robust statistics routinely collected by the CHAIN system similarly show London rough sleeping having more than doubled since 2010. Latest figures show London rough sleeping involving UK nationals continuing to increase very slightly. However, thanks to a sharp contraction in street homelessness involving those of Central and Eastern European and other non-UK origin, overall London rough sleeping has marginally reduced since 2015. At just over 59,000, annual homelessness acceptances were some 19,000 higher across England in 2016/17 than in 2009/10. With a rise of 2 per cent over the past year, acceptances now stand 48 per cent above their 2009/10 low point. However, administrative changes mean that these official statistics understate the true increase in ‘homelessness expressed demand’ over recent years. Since bottoming out in 2010/11, homeless placements in temporary accommodation have risen sharply, at twice the rate of homelessness acceptances. Thus, the overall national total rose by 8 per cent in the year to 31 March 2017, up 61 per cent on the low point six years earlier. A continuation of this trend would see placements topping 100,000 by 2020. Though accounting for only 9 per cent of the national total, bed and breakfast placements have been rising particularly quickly, and now stand 250 per cent higher than in 2009. The National Audit Office has drawn attention to a 39 per cent real terms increase in local authority spending on temporary accommodation in the five years to 2015/16, a period when expenditure on homelessness prevention declined. All available evidence points to Local Housing Allowance reforms as a major driver of this association between loss of private tenancies and homelessness. These reforms have also demonstrably restricted lower-income households’ access to the private rented sector. The number of Housing Benefit/Universal Credit claimants who are private tenants is now some 5 per cent lower than when the Local Housing Allowance reforms began in 2011, despite the continuing strong growth of the private rented sector overall. This policy has also, as intended, had a particularly marked impact in inner London. Alongside the narrowing opportunities to access the private rented sector (see above), there is a growing evidence of a squeeze on homeless households’ access to social tenancies. This arises not only from the pressure on the highly diminished pool of available social rented properties, with an 11 per cent drop in new lettings in the past year alone, but also a reported increase in social landlord anxieties about letting to benefit-reliant households and those with complex needs. The Homelessness Reduction Act 2017, due to come into force in April 2018, seems to have garnered significant and growing cross-sectoral support. While there remain concerns regarding the adequacy of the ‘new burdens’ funding granted to local authorities to support the Act’s implementation, the more fundamental issues relate to the growing structural difficulties that many local authorities face in securing affordable housing for their homeless applicants.
04/12/2018 - 13:16
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Poverty Reduction Strategy (Annual Report 2017): Ontario
This report highlights our progress – and what we plan to do next – in our efforts to reduce child poverty, eliminate chronic homelessness, help people move towards employment, increase food security, develop an action plan for income security reform and invest in programs and community-designed solutions. Introduction Ontario’s Poverty Reduction Strategy is based on the vision that every Ontarian has the opportunity to achieve their full potential and to contribute to a prosperous and healthy province. This report shares information about progress, profiles local poverty reduction efforts, and highlights areas where we can better support people by creating fairness and opportunity for all Ontarians. Cumulative investments can reduce poverty and improve quality of life by providing meaningful supports to people at every age and life stage. In 2017, we took action to empower individuals and families to confidently navigate key milestones, whether they are having a child, exploring postsecondary education, entering the workforce, seeking retraining for a new career, or shifting into retirement. We integrated our supports and services to better meet user needs. This builds on our earlier actions and is making a difference in the lives of Ontarians. The Poverty ReductionStrategy Indicators (see Chapter 5) measure our progress. Helping Ontarians realize their potential in a changing economy requires a responsive and adaptable system of employment, income and social supports. We are making progress on reducing the gap between income and the cost of living through increases to the minimum wage, the introduction of OHIP+, housing supplements, child care fee subsidies, full-day kindergarten, and free average tuition. We are building on the findings of the Income Security Reform Working Group and parallel working groups with First Nation and Indigenous partners to reform income security. In addition, we are piloting a basic income that will help inform our longer-term plans to better support people living on low incomes. We will continue to collaborate with the Federal government on their poverty reduction strategy, and with Indigenous partners, municipalities and service partners, to achieve results and improve incomes for Ontarians. And as always, we are excited to continue to engage and learn from Ontarians on how best to reduce poverty and improve outcomes for all.
04/12/2018 - 13:11
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City of Kingston & County of Frontenac - 2017 Housing & Homelessness Report
The Street Outreach Pilot Program, the extension of the Portable Housing Benefit to help safely house survivors of domestic violence, the opening of the One Roof Kingston Youth Services Hub and the completion of energy-saving updates to social housing, are among the highlights outlined in the City of Kingston's 2017 Report on Housing and Homelessness. "At 0.7 per cent, Kingston has the lowest vacancy rate in Ontario, which is a major challenge for low-income residents in rural and urban areas. The housing and homelessness programs and services offered by the City and the County of Frontenac are there to help people find and maintain safe, accessible and affordable housing," says Sheldon Laidman, director of housing and social services. Also included in the report are summaries of affordable housing projects, current market housing data and information on affordable housing programs.
04/12/2018 - 12:58
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Seeking Supportive Housing: Characteristics, Needs and Outcomes of Applicants to The Access Point
Currently in Toronto over 13,000 people are on the waitlist for mental health and addictions supportive housing. Understanding this population and how to meet their needs addresses an often overlooked health equity gap. This report is an analysis of the waitlist for mental health and addictions supportive housing in Toronto. It examines the characteristics of applicants, their support needs and housing preferences, and the patterns of wait times and outcomes of applying. Understanding the unique needs of this population will enable policy-makers to coordinate investments to ensure better outcomes. Further, it will provide an opportunity to develop program standards, common definitions and criteria and identify options to better meet client needs.  Most of the data are extracted from the administrative database of The Access Point, the coordinated access system for this supportive housing. This report summarizes a more detailed technical report which is also available.  Highlights of the Research Findings Demand for supportive housing far outstrips supply. In a recent two-year period, over 4,000 new people applied while less than 600 were placed in supportive housing.  Most applicants have long wait times. Nearly 60 percent (4,431) of applicants on the waitlist had been waiting for housing for two or more years and those waiting longest (top 10% on the waitlist) had been waiting 4.5 years or longer. Support needs vary, e.g. looking after the home, meal preparation, managing medications, avoiding crises, and addressing drug or alcohol use. The vast majority of applicants needed support in more than one of these areas. Applicants have high levels of housing need as well as great need for supports. More than half of them (52%) self-identified as homeless or in temporary housing when they applied.  A large majority of applicants stated a preference for self-contained supportive housing units. Only six percent specifically requested shared accommodation.  Applicants were diverse in their living situation, health and clinical issues: Homeless applicants included 11 percent (of total applicants) residing in shelters, 7 percent in hospital, 3 percent in jail, and 16 percent with no fixed address. One-third of applicants had mood disorders and another third had psychotic disorders, with anxiety and various other diagnoses among the rest.  Over one-third of all applicants reported problematic substance use. One-quarter of applicants reported current or recent criminal justice system involvement. One in every eight applicants reported high hospital inpatient use for mental health reasons (50 or more inpatient days in the two years before they applied). Support needs varied across the above applicant characteristics. However, two broad groupings were evident: people with psychosis diagnoses, higher hospital inpatient use, and functional support needs; and people with problematic substance use, criminal justice involvement, and needs related to managing crises.  One-fifth of people who were placed in a supportive housing unit were selected by the housing provider rather than drawn from the wait list. These “partnership applicants” were less likely to report being homeless and reported fewer support needs on average. There is wide variation in how long people wait for supportive housing. This may be the result of direct access for some applicants through partnership arrangements; boarding homes which have higher turnover and therefore faster access; and the inherent complexity of matching people with specific needs and preferences to particular housing and supports. Applicants’ wait times from application to placement in housing did not vary substantially based on mental health diagnosis, homelessness, inpatient hospital use or partnership status. But people with problematic substance use, criminal justice involvement, or more support needs tended to wait longer. Applicants are not always placed in the support intensity they request when they apply. This is attributable both to the more numerous openings in boarding homes that provide daily support, and to the absence of clear system-wide definitions of support intensity. Diverse needs and limited openings make it challenging to match applicants to suitable housing. Half of applicants offered supportive housing refused the first offer made.  Applicants declined by housing providers because their support needs were too high were more likely to report problematic substance use, criminal justice involvement and homelessness. 
04/12/2018 - 11:08
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A transitional housing program for older foster youth: How do youth fare after exiting?
Abstract Purpose This study is an outcome evaluation of Bay Area Youth Center's Real Alternatives for Adolescents (RAFA) transitional housing program in Hayward, California. Methods This study examined a sample of 55 youth ages 16 to 21 who lived in the RAFA transitional program between 2007 and 2015. Results About 96% were in residing in stable housing at follow up, there were low rates of parenting before age 22 (41% of females and 16% of males) when compared with other similar studies, and 86% were employed earning, on average, $15.69 per hour at follow-up. Also, there were lower rates of receipt of SSI, food stamps and TANF income support when compared to foster youth in other studies. Conclusions In vivo housing experiences in transitional housing programs can lead to successful outcomes for foster youth as they move to adulthood.
04/09/2018 - 16:35
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Using Housing First in Integrated Homelessness Strategies
This report explores Housing First in relation to the evidence base on services designed to end homelessness among single people (i.e. lone adults) with support needs. Some attention is given to prevention and relief services, but this report is concerned with services for those single homeless people who require support as well as housing. The report does not encompass services for homeless families.  The report has four main objectives:  To critically assess the evidence base for Housing First and other homelessness services, considering the extent to which the case for different service models has been proven or disproven.  To consider the state of the evidence on the efficiency and cost-effectiveness of different service models.  To review the potential for different service models to contribute to an effective, integrated strategy to prevent homelessness and to minimise the risk of homelessness becoming prolonged or recurrent.  To consider how lessons from various service models might be employed to increase the efficiency and effectiveness of homelessness services as a whole.  Globally, the existing evidence shows that integrated homelessness strategies that encompass effective homelessness prevention, rapid re-housing systems for when homelessness first occurs and a range of housing related support services for homeless people with high and complex needs – which includes Housing First working in coordination with other services – can deliver a ‘functional zero’ in homelessness.  The Finnish, Danish and Norwegian strategies show what can be achieved with the use of Housing First within a coordinated, integrated homelessness strategy which includes a mix of service models.  Crucially, these strategies have shown success by using Housing First alongside a mix of other models of floating (mobile) support and fixed-site supported housing, including congregate and communal models. This review explores the ways in which Housing First and other services are best employed within integrated homelessness strategies.  The report begins by looking at how changes in the understanding of homelessness and its financial, as well as social, costs have led to the development of new service models and to the emergence of integrated strategic responses to homelessness. The following section then critically explores the evidence base for different service models, including Housing First.  Finally, the report considers the lessons from the evidence to discuss what the optimal mix of services within an effective homelessness strategy should look like, and how the key lessons and successes from different models of homelessness service might be used to enhance the prevention and ending of homelessness.
04/09/2018 - 16:03
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Europe's Youth: Between Hope and Despair
In this year’s edition of the “Caritas Cares!” series, we undertake a stocktaking of the conditions of young people in Europe, as Caritas organisations perceive them in our social services, programmes and grassroots projects. Caritas member organisations report about their practices in the countries, providing evidence of the needs and testimonies of the vulnerable populations they are serving and they come forward when rights are being violated or are becoming more difficult to realise. It is our aim, therefore, to draw policy makers nearer to the impacts of their social policies as they impact on the ground, affecting the lives of people. Young women and men, aged 16 to 29, face major challenges in their life course when they transition from childhood to adulthood. This includes their identity formation, moving out from their parents’ home, transitioning from school to work, including choosing a professional career, and establishing a family of one’s own. All these challenges have become even more difficult in the last decade due to the protracted economic crisis and the changes in labour markets that have hit youth the hardest, e.g. in terms of youth unemployment, wages, working conditions and access to social protection. Our findings indicate that the current situation of youth in Europe has wider and longer-term consequences for our societies, labour markets and social protection systems. We identified a phenomenon of what we would call SINKies - Single Income, No Kids: Sinkies are young couples both working but who, wages combined, still earn only the equivalent of one single “decent” income, because of the bad wage levels and precarious working conditions. Being a working poor also prevents people from having kids. As opposed to DINKIES, a term coined in the 1980s to describe the phenomenon of couples earning a double income choosing not to have kids because they wanted to enjoy life, Sinkies are young couples who might wish to have children but who simply can’t afford it. And the term also refers to the social consequences of having a first generation in decades that is worse off than their parents, with consequences for social cohesion, social models as well as social protection systems – we run the risk of a sinking society if no action is taken now.
04/09/2018 - 15:27
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Danger Zones and Stepping Stones: Phase Two - A quantitative exploration of young people’s experience of temporary living
Depaul UK has launched research, supported by LetterOne, into the experiences of young people affected by homelessness. The report, which was released on Thursday, 22 March 2018, is entitled Danger Zones and Stepping Stones: Phase Two, and makes recommendations based on a quantitative survey of 712 young people. It follows up on the first Danger Zones and Stepping Stones report which was launched in 2016. The original report proposed a new approach to assessing temporary living situations, following qualitative research done with young service users. The second phase of research has revealed the scale of harm that young people in temporary accommodation can be subject to. Around one in five young women responding to the survey had been sexually abused or exploited whilst out of stable accommodation, and around a quarter of respondents identifying as LGBT had engaged in sexual activity in return for a place to stay. The report was based on a survey of people aged from 16 to 25 using homelessness services across England. It found that over half of those surveyed had been harmed whilst in temporary living arrangements. This figure rose to two-thirds of the people identifying as LGBT, 66 percent of whom had experienced harm in temporary living arrangements. Harm done to the young people surveyed included mental, emotional, sexual and physical abuse, pressure to drink alcohol and take drugs and property being stolen or damaged. In response to these findings, Depaul UK called on the Government to reconsider planned changes to supported accommodation. Supported Accommodation refers to housing where accommodation and support are provided together; services which the report showed are safer for young people than informal arrangements.
04/09/2018 - 13:23
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LGBT Youth Homelessness: What are You Going to Do about It?
What is the solution to LGBT youth homelessness? If you’re reading this, then it is likely that you (like me) wish for a clear and actionable perhaps simple instructive answer to that question. I imagine that you (like me) know that we do not live in clear and simple times. And there is no single solution to the social problems that contribute to homelessness among LGBT youth— including heterosexism/homophobia, cisgenderism/transbias (the ideology that denies/ pathologizes one’s understanding of their gender and the interpersonal enactment of bias toward transgender and gender-expansive people), poverty, and racism.
04/06/2018 - 09:37
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Greater Sudbury Landlord Toolkit
The purpose of the Landlord Toolkit is to make available an easily accessible guide to provide local landlords, social service providers, and housing caseworkers with information about Housing First and how the approach can support people who have experienced homelessness transition to housing stability and prevent eviction.
04/05/2018 - 15:35
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Street WISE
Street Wise is a small handbook, created in partnership with the City of Sudbury, comprising of local info and addresses to help navigate the services and locations available in Sudbury and area.
04/05/2018 - 15:25
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Why We Need to Change the Way We Talk about Homelessness
Abstract This paper discusses findings from the first ever large-scale study on public attitudes to homelessness in the UK. While experts believe that ‘homelessness’ encompasses a wide range of insecure housing situations and some groups are at higher risk of homelessness than others, public attitudes and action towards the issue do not appear to follow suit. The research used four sources of data – 15 expert interviews; 20 in-depth cultural models interviews and 30 on-the-street interviews; and media content analysis of a sample of 333 organisational and media materials about homelessness – to examine how we can communicate in a way that deepens public understanding, attracts new supporters and builds demand for change. Findings reveal that public opinion tends to overlook the relationship between homelessness and poverty or other structural causes in favour of a more fatalistic view that blames individual circumstances and poor choices. Implications for communications are discussed and what the sector needs to do to convince people that homelessness is an issue that can be tackled. The paper’s overall conclusion is that organisations or campaigners need to adopt a more strategic approach to communications – too often we concentrate on raising awareness without translating that awareness into action.
04/05/2018 - 09:04
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Fitting Stories: Outreach Worker Strategies for Housing Homeless Clients
Abstract Social service outreach workers serving homeless populations exemplify Michael Lipsky’s concept of street-level bureaucrats who exert considerable discretionary power in performance of their roles. In their efforts to qualify their homeless clients for housing, outreach workers create “fitting stories” that present their clients as qualified for support within the social service contexts that provide housing services. We describe outreach workers’ creation and negotiation of fitting stories with two audiences: homeless clients and institutional gatekeepers. Outreach workers respond to barriers to qualifying their clients for housing by creatively finding ways to manipulate clients’ biographical narratives and evidence to support those narratives in ways that “fit” their clients to agency criteria for housing services. In the process, outreach workers at times play loosely with the letter of the law in attempts to meet the spirit of the law in the service of their clients and agency expectations for service delivery.
03/29/2018 - 13:23
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Housing people who are homeless in Glasgow: March 2018
Housing people who are homeless in Glasgow: Summary This report sets out the findings from our review of how effectively Glasgow City Council and Registered Social Landlords (RSLs) house people who are homeless. Main findings  The Council is not housing enough people who are homeless quickly enough. In 2016/17 it housed around half of those it had a duty to house. Some people are housed quickly; this works best when all partners have a clear focus on moving people who are homeless into a home quickly.  The Council’s target of securing 3,000 homes for people who are homeless each year is too low for the number of people it assesses that it has a duty to house. It is not referring enough people to RSLs to meet the level of need from people who are homeless. Many people who are homeless have to wait a long time in temporary accommodation.  The Council and its partners have made some important improvements to the process they use to find homes for people, and they are working together more effectively.  The Council aims for a person-centred, needs-led approach to identifying solutions for people who are homeless. This is positive, particularly for people with multiple and complex needs. However, a full and detailed assessment is not necessary for everyone; many people who approach the Council need little help other than getting a home.  The Council’s phased approach to assessing the housing needs of people who are homeless results in duplication of work and unnecessary delay in referring people who are homeless to RSLs.  The Council loses contact with around a quarter of people who are homeless while they wait for a home. The length and complexity of the process in Glasgow is a significant factor in this.  Some RSLs in Glasgow are making a good contribution to housing people who are homeless; some could do more. The proportion of available homes let to people who are homeless by RSLs operating in Glasgow ranged from 8% to 47 %.  Some RSLs in Glasgow refused referrals because the person had former tenant arrears. This is not a good reason to refuse to house a person referred by the Council under section 5 of the Housing (Scotland) Act 2001 and the Council does not always challenge this.
03/29/2018 - 12:55
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Crisis: 2017 CCAP Hotel Survey & Housing Report
Introduction 2017 was the worst year for homeless Downtown Eastside (DTES) residents since the Carnegie Community Action Project (CCAP) began doing these annual reports in 2008. With an estimated 1,200 homeless people living in the DTES, with over 500 DTES residents evicted from their homes through no fault of their own, with only 21 new units of housing at welfare rate, with average rents in privately owned and run hotels ramping up to $687 a month, and with the fentanyl overdose tragedies killing people weekly, the community is in deep crisis. Governments need to act immediately to save lives lost to homelessness and drug overdoses. This report will focus on what the housing and homelessness situation is and what the government needs to do to ensure everyone is housed. While there have been some token housing announcements, the new Federal Housing Strategy only commits to ending half of chronic homelessness in Canada (2-20% of all homelessness) in one decade. The City’s new housing strategy doesn’t mention attempting to end homelessness. The Province has provided funds for 600 units of modular housing, which is good, but we need modular housing for all homeless people (2,138 counted in Vancouver in March 2017). In January 2018 the Province announced that it would fund about 300 welfare rate units in the DTES but they won’t be built, probably, for at least 3 to 7 years. These 300 units will only partially make up for the over 500 that we lost in 2017 alone. While the number of affordable units in the DTES and everywhere diminished, the number of low income people in the DTES who are on welfare and disability has increased by almost a hundred people in the last year. Low income people may not be displaced from the neighbourhood, but they are displaced from their homes to the street.
03/29/2018 - 12:37
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Third Overview of Housing Exclusion in Europe 2018
Since 2015, FEANTSA and the Fondation Abbé Pierre have released a yearly Overview of Housing Exclusion in Europe. These annual reports look at the latest Eurostat data (EU-SILC) and assess EU countries' capacity to adequately house their populations. The 2018 version reveals how millions of Europeans face housing exclusion on a daily basis as well as a dramatic picture of increasing homelessness across most of the EU – in particular amongst children, women and migrants.
03/27/2018 - 12:38
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Perceptions of Housing and Shelter among People with Histories of Unstable Housing in three Cities in Canada: A Qualitative Study
Abstract Housing is a key social determinant of health that contributes to the well-documented relationship between socioeconomic status and health. This study explored how individuals with histories of unstable and precarious housing perceive their housing or shelter situations, and the impact of these settings on their health and well-being. Participants were recruited from the Health and Housing in Transition study (HHiT), a longitudinal, multi-city study that tracked the health and housing status of people with unstable housing histories over a 5-year period. For the current study, one-time semi-structured interviews were conducted with a subset of HHiT study participants (n = 64), living in three cities across Canada: Ottawa, Toronto, and Vancouver. The findings from an analysis of the interview transcripts suggested that for many individuals changes in housing status are not associated with significant changes in health due to the poor quality and precarious nature of the housing that was obtained. Whether housed or living in shelters, participants continued to face barriers of poverty, social marginalization, inadequate and unaffordable housing, violence, and lack of access to services to meet their personal needs.
03/27/2018 - 12:21
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Impact of a New York City Supportive Housing Program on Housing Stability and Preventable Health Care among Homeless Families
Abstract Objective To assess the impact of a New York City supportive housing program on housing stability and preventable emergency department (ED) visits/hospitalizations among heads of homeless families with mental and physical health conditions or substance use disorders. Data Sources Multiple administrative data from New York City and New York State for 966 heads of families eligible for the program during 2007–12. Study Design We captured housing events and health care service utilization during 2 years prior to the first program eligibility date (baseline) and 2 years postbaseline. We performed sequence analysis to measure housing stability and compared housing stability and preventable ED visits and hospitalizations between program participants (treatment group) and eligible applicants not placed in the program (comparison group) via marginal structural modeling. Data Collection/Extraction Methods We matched electronically collected data. Principal Findings Eighty‐seven percent of supportive housing tenants experienced housing stability in 2 years postbaseline. Compared with unstably housed heads of families in the comparison group, those in the treatment group were 0.60 times as likely to make preventable ED visits postbaseline (95% CI = 0.38, 0.96). Conclusions Supportive housing placement was associated with improved housing stability and reduced preventable health care visits among homeless families.
03/19/2018 - 15:18
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Daybreak in Dayton: Assessing characteristics and outcomes of previously homeless youth living in transitional housing
Abstract Each year, >1 million American children and youth experience homelessness (Hammer, Finkelhor, & Sedlak, 2002Office of Applied Studies, 2004). The transient nature of this population makes it difficult to study, but youth homelessness has been identified with a number of problematic outcomes as well as a pathway to chronic adult homelessness (Baker Collins, 2013Chamberlain & Johnson, 2011). Yet, few empirical studies evaluate the effectiveness of a common intervention for homeless youth—transitional housing. In this paper, we describe the outcomes of homeless youth who participated in a youth-only transitional housing program. We analyze administrative data on 174 youth who entered and exited the Daybreak Transitional Housing program (Daybreak TH) between 2011 and 2014. We find that the majority of Daybreak TH participants were employed at least 20 h a week at program exit. Youth exited Daybreak TH with higher wages on average, while nearly half achieved educational gains from program entry to exit. Youth who resided in Daybreak TH for 12 months or longer were more likely to achieve positive program outcomes than youth who entered and exited the program in fewer than 12 months. Finally, youth who used drugs and alcohol were less likely than their peers to achieve desired program outcomes, as were those who suffered from chronic illnesses or attention deficit, conduct, or disruptive behavior disorders. We conclude with a discussion of policy implications and areas for future research.
03/19/2018 - 15:12
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The Challenge of Pregnancy among Homeless Youth: Reclaiming a Lost Opportunity
Abstract Young, homeless women often become pregnant, but little is known about how street youth experience their pregnancies. We documented 26 pregnancy outcomes among 13 homeless women (ages 18–26) and eight homeless men through interviews and participant-observation. Eight pregnancies were voluntarily terminated, three were miscarried, and fifteen were carried to term. Regardless of pregnancy outcome, street youths’ narratives focused on ambivalence about parenting, traumatic childhood experiences, and current challenges. Despite significant obstacles, almost all were convinced of their personal capacity to change their lives. While most wanted to be parents, the majority lost custody of their newborns and consequently associated contact with medical and social services with punitive outcomes. Most of the youth who chose to terminate successfully sought safe medical care. We offer recommendations for changing the approach of services to take full advantage of pregnancy as a potential catalyst event for change in this highly vulnerable and underserved population.
03/07/2018 - 12:49
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High prevalence of exposure to the child welfare system among street-involved youth in a Canadian setting: implications for policy and practice
Abstract Background Street-involved youth are more likely to experience trauma and adverse events in childhood; however, little is known about exposure to the child welfare system among this vulnerable population. This study sought to examine the prevalence and correlates of being in government care among street-involved youth in Vancouver, Canada. Methods From September 2005 to November 2012, data were collected from the At-Risk Youth Study, a prospective cohort of street-involved youth aged 14–26 who use illicit drugs. Logistic regression analysis was employed to identify factors associated with a history of being in government care. Results Among our sample of 937 street-involved youth, 455 (49%) reported being in government care at some point in their childhood. In a multivariate analysis, Aboriginal ancestry (adjusted odds ratio [AOR] = 2.07; 95% confidence interval [CI]: 1.50 – 2.85), younger age at first “hard” substance use (AOR = 1.10; 95% CI: 1.05 – 1.16), high school incompletion (AOR = 1.40; 95% CI: 1.00 – 1.95), having a parent that drank heavily or used illicit drugs (AOR = 1.48; 95% CI: 1.09 – 2.01), and experiencing physical abuse (AOR = 1.90; 95% CI: 1.22 – 2.96) were independently associated with exposure to the child welfare system. Conclusions Youth with a history of being in government care appear to be at high-risk of adverse illicit substance-related behaviours. Evidence-based interventions are required to better support vulnerable children and youth with histories of being in the child welfare system, and prevent problematic substance use and street-involvement among this population.
03/06/2018 - 09:38
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Building Bridges: Perspectives on youth homelessness from First Nations, Inuit, and Métis, Newcomer, and LGBTQ2S+ youth in Ottawa
In the capital city of one of the wealthiest countries in the world, young people ought not to be living on the streets, engaging in sex work to survive, and becoming enmeshed in drug cultures and illegal activities that put them at even greater risk of harm and violence. This report details Ottawa's remitting reality where youth are being exposed to these risks and more, through a process that creates their homelessness. Youth homelessness is not inevitable. One can see how the youth are 'created' as homeless simply by looking at the most haunting and recurring theme, that which is echoled throughout the first-hand accounts from youth documented in this report: points of failure. In each of the young lives described are numerous points at which a school, agency, detention facility, household, adult etc. had one or more opportunities to positively impact the young person's life. At a quick glace, it may seem that these young people are an anomaly, a minority that flew under the radar, but this is false. They have many points of contact with people and organizations that had the power and knowledge to help them; and yet they were not helped. These points of contact became points of failure, which were then repeated through encounters youth had with adult systems. This is why we use the language of "creating" and "recreating" young people to be homeless. This report advoctes for a wake-up call, not a meandering diffusion of awareness. There is no time for that. This is a call to action: to stop allowing and encouraging youth homelessness within our cities; to prevent young girls from contentious living where they are created as easy targets for sexual abuse; to stop putting transgender youth in places where they are subjected to bullying segregation, abuse and without even the medical assistance they may require; to stop typecasting First Nations, Inuit and Métis youth as lost causes and sticking them in shelters where their cultures are unknown, unrecognized and inaccessible to them; to stop ignoring the increased risks specific to identifying as a newcomer to Canada; to stop ignoring the need for safe spaces, for greater availability and visibility of programs and supports for LGBTQ2S+, newcomer, First Nations, Inuit, Métis, and all homeless youth.
03/05/2018 - 20:33
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Aboriginal Health Counts Toronto: Housing and Mobility Factsheet
Project Summary The Our Health Counts, Toronto research project will contribute to the priority area of Applying the “Two-Eyed Seeing“ Model in Aboriginal Health, specifically utilizing “Two-Eyed Seeing” in assessing and improving the health of urban Aboriginal people. The study design provides an opportunity to address the broad gaps in urban Aboriginal health assessment across health domains and lifecycle stages with a focus on a key health care utilization indicator (ER use). Our Aboriginal community partners (Seven Generation Midwives Toronto) and collaborators have made it clear that a comprehensive health assessment that balances wellness and illness measures and looks across the lifecycle and physical, mental, emotional and spiritual health domains is desired, and at the same time the study recognizes the scientific merit and policy relevance of our proposed longitudinal tracking and analytic study of the key drivers of emergency room admissions. This broad approach to the health research is necessary in order to ensure our research meets the dual criteria of Aboriginal community relevance and scientific excellence, and in doing so embodies and puts into action the “Two-Eyed Seeing“ model in Aboriginal health. This project is being led by Dr. Janet Smylie, Director of Well Living House, St. Michael’s Hospital and Sara Wolfe, Community Knowledge User at Seven Generation Midwives Toronto. The Our Health Counts Toronto research project is a 4 year long study that officially began January 2014 and will concluded March 2018 and is funded by the Canadian Institute of Health Research (CIHR). Summary: The Housing & Mobility chapter Housing is a key determinant of health and wellbeing. Unstable housing has been associated with poorer overall health, unmet health care needs, and higher emergency department use. High levels of mobility often coincide with unstable, crowded housing and can impact participation in the labour force and education system. Indigenous people living in urban areas experience higher levels of mobility and precarious housing conditions than non-Indigenous people. The Truth and Reconciliation Commission highlights the connection between loss of traditional territories, unemployment, and attendance at residential schools to the high levels of unstable housing among Indigenous people in Canada.
03/01/2018 - 13:11
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LGBT in Britain - Trans Report
THE STUDY  Stonewall commissioned YouGov to carry out a survey asking more than 5,000 lesbian, gay, bi and trans (LGBT) people across England, Scotland and Wales about their life in Britain today. This report, part of a series based on the research, investigates the specific experiences of the 871 trans and non-binary people who took part, across a range of areas of life in Britain. The study looks at the discrimination trans people face in their daily lives. It also looks at their home life and access to medical support for transition.  Key findings Two in five trans people (42 per cent) who would like to undergo medical intervention as part of their transition, haven’t done so yet, because they fear the consequences it might have on their family life. Almost half (48 per cent) of trans people don’t feel comfortable using public toilets through fear of discrimination or harassment. A third of trans people (34 per cent) have been discriminated against because of their gender identity when visiting a café, restaurant, bar or nightclub in the last year. More than a quarter (28 per cent) of trans people in a relationship in the last year have faced domestic abuse from a partner. More than two in five trans people (44 per cent) avoid certain streets because they don’t feel safe there as an LGBT person. One in four (25 per cent) were discriminated against when looking for a house or flat to rent or buy in the last year. One in five non-binary people (20 per cent) have experienced discrimination while looking for a new home. When accessing general healthcare services in the last year, two in five trans people (41 per cent) said healthcare staff lacked understanding of trans health needs. More than a third of trans students (36 per cent) in higher education have experienced negative comments or behaviour from staff in the last year.
03/01/2018 - 13:04
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No Place like Home?: Exploring the concerns, preferences and experiences of LGBT*Q social housing residents
About this study Despite changes in equality laws in recent years, Lesbian, Gay, Bisexual, Trans*, Queer and Questioning (LGBT*Q) people still face discrimination across a range of public services, including social housing. However, little is really known about the needs and views of LGBT*Q residents who live in housing provided by a housing association or local authority. We conducted this study to find out. The study was commissioned by HouseProud and funded by six housing associations (Clarion, Genesis, Hanover, L&Q, Optivo and Riverside). The study was conducted as HomeSAFE (secure, accessible, friendly, equal) by researchers from the University of Surrey and Goldsmiths, University of London. Over 260 people participated, through a survey, focus groups and interviews. More details about what was involved and who participated can be found at the back of this brochure. 
03/01/2018 - 12:53
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FALLING THROUGH THE CRACKS: HOW THE COMMUNITY-BASED APPROACH HAS FAILED CALGARY’S CHRONICALLY HOMELESS
Summary The seeds of chronic homelessness, with the addictions and mental illness that often accompany it, are sown frequently in traumatic childhoods. A survey of 300 people experiencing chronic homelessness and those sleeping rough in Calgary reveals that these individuals have suffered childhood trauma at a rate five times higher than the general population. Those traumas include neglect, parents with addiction issues, domestic violence and abuse. Unfortunately for those seeking help, community-based services in Calgary have been unable to keep up since the prevailing philosophy became one of releasing these people from institutions into the community. A 62 per cent reduction in psychiatric beds some 30 years ago was accompanied by levels of funding that simply weren’t enough to provide all the resulting community services needed. People without families to turn to, and with no social supports, tended to end up homeless. It has become a vicious circle – while mental health issues can lead to homelessness, homelessness also puts people at greater risk for mental illness. Because childhood trauma plays such a key role in chronic homelessness, it needs to be figured into the kinds of housing and support programs that are put in place for people who are homeless. Psychiatric supports should be among the programs that homeless shelters offer and should also be provided on a priority basis for people using the intervention program called Housing First.
03/01/2018 - 09:56
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CAEH Presentation Styles
02/28/2018 - 11:50
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Getting There: Alternative Federal Budget 2018 (Housing and Neighbourhoods Chapter)
The 2018 Alternative Federal Budget (AFB) delivers a roadmap to where the country could be on the eve of the next federal election, if the government moves forward with bold action to deliver a progressive economic plan that leaves no one behind. If implemented, the 2018 Alternative Federal Budget: Getting There will reduce income inequality, lift close to a million people out of poverty, close unfair and expensive tax loopholes, and create 600,000 jobs while locking in the unemployment rate in the five per cent range. The AFB plan:   Boosts direct transfers to low-income families in ways that would lift 600,000 children and adults out of poverty and reduce child poverty by roughly a third; Eliminates all fossil fuel subsidies and creates a Just Transition Fund to help ease energy sector workers into new roles in a fully green economy; Tackles historic under-investment faced by First Nations communities through a $9-billion investment this year in urgently needed infrastructure, clean water, education and health care on reserves; Acts immediately to implement pay equity legislation and invests heavily in child care so women’s labour is no longer discounted as a result of discrimination; Slashes senior poverty rates by 30% by increasing the Canada Pension Plan income exemption for the Guaranteed Income Supplement by $3,000 and boosting the top-up amount by $1,000; Accelerates the national carbon price to reach $50 per tonne by 2020, while investing in training, apprenticeships and green infrastructure. Background  All orders of government in Canada, along with the non-profit sector, must play an active role in creating affordable housing. Co-ordination is fundamental for several reasons.  First, low-income households, especially those relying on social assistance, simply cannot afford monthly rents on most private-market housing. A government subsidy is therefore vital. Second, Canadian cities, especially in high-growth areas, cannot rely on private developers to create the affordable apartment units needed by low-wage workers.  A third reason for co-ordinated action is that non-profit ownership of affordable housing stock keeps rent levels down over the long term and creates public assets in the process. Finally, when it comes to vulnerable subpopulations (e.g., persons with mental health problems, those living with HIV/AIDS, and frail seniors), non-profit entities are effective at creating buildings that can foster community development.  Beginning in the 1960s, the federal government very actively created housing for both low-income and middle-income households, often by sharing the costs of development with provincial and territorial governments. Tenants, in turn, were charged rents they could afford, typically in the range of 30% of their gross monthly income.  As many as 25,000 new subsidized housing units were being created annually across Canada under this system. Low-income households who sought subsidized housing received it more quickly than they would today, and very few individuals stayed in emergency shelters or outside on the street relative to today’s numbers. Today, wait lists for subsidized housing are growing and many people become homeless while they wait. The federal government stopped subsidizing new units of social housing in the early 1990s (with the exception of on-reserve housing). The government gradually and incrementally started to get back into the housing game, so to speak, after 2001. But fewer units are created annually today than in the 1970s and ‘80s, and these units tend to provide only modest affordability.  The 2017 federal budget was Canada’s most important for housing since 1993. It proposed investments of $11.2 billion over 11 years, including $2.1 billion to expand and extend funding for the Homelessness Partnering Strategy (HPS) beyond 2018-19. The budget also announced that the Investment in Affordable Housing (IAH) initiative, set to expire at the end of 2018- 19, will be replaced by a new framework.  The recently unveiled National Housing Strategy (NHS), which made history by adopting housing as a human right, includes plans to create a Canada Housing Benefit consisting of financial assistance to help low-income households afford their rents. However, this will not begin until 2020, and the average beneficiary will receive a mere $200 per month in benefits. This new federal benefit is expected to be cost-shared with the provinces and territories.  The federal housing strategy also includes the creation of a new National Housing Co- Investment Fund, which over 10 years will create up to 60,000 units of new housing and repair up to 240,000 units of existing housing. This is a unilateral federal program, though some assistance from provincial and territorial governments may be required.  Furthermore, the government’s strategy includes a new Canada Community Housing Initiative that will focus on preserving existing units of social housing. This will require cost-matching from provinces and territories. Canada’s approximately 500,000 social housing units — those that are both administered by provincial or territorial authorities and have rent-geared-to-income (RGI) subsidies — will be eligible. The fund will assist with repairs, help keep rents affordable and provide mortgage assistance for the operators.  Once funding starts to flow from this initiative, the challenge of expiring operating agreements will be addressed for a 10-year period, provided the provinces and territories agree to match costs. The Federal Community Housing Initiative will do essentially the same thing for social housing units that are federally administered, including co-op units, at a cost of $500 million to the federal government over 10 years.  It’s important to note that the National Housing Strategy’s targets — about 6,000 new builds annually over the next decade — represent just one-third of the total volume of Canada’s new annual builds from the 1970s and 1980s, keeping in mind that Canada’s population has grown since that time. 
02/27/2018 - 10:28
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Home is Where the Community Is: An Environmental Scan and Literature Review on Indigenous Homelessness in Halton
HCLS has undertaken this project, funded in part by the Government of Canada’s Homelessness Partnering Strategy Program and Legal Aid Ontario, to address knowledge gaps and define service priorities for Indigenous people who experience homelessness in Halton. The shared knowledge that results will be used to foster strategic partnerships and create an action plan that can be funded through coordination between levels of government or departments within the same level of government. This is crucial, since there is a particular need to build community capacity and partnerships to meet the needs of Indigenous Peoples in Halton. Project funding has already been used to hire an Indigenous community worker to gather knowledge and carry out qualitative research. A project advisory committee was also formed, consisting of Indigenous service providers from Peel and Hamilton, non-Indigenous service providers from Halton, and Indigenous Peoples with lived experience of homelessness. A project statement of principles was developed to guide the project and to ensure intercultural safety. The project seeks to answer the following questions: 1. What is the community profile of Indigenous peoples who are at risk of homelessness or are homeless in Halton? 2. What is the experience of Indigenous peoples who are at risk of homelessness or are homeless in Halton? 3. Are there particular elements, issues, types of trauma or other factors that create homelessness in the Indig- enous population? 4. What are their movement and mobility patterns in seeking supports for housing stability? Where do they go for help? 5. What are the relationships between Indigenous peo- ples and the agencies, services and individuals that give them support and/or shelter? 6. What services, processes, approaches and changes would benefit their lives by reducing or preventing homelessness? The project will proceed in three stages, using a range of methodologies. Stage 1 includes the completion of an environmental scan and literature review. This will be followed by qualitative research including interviews, focus groups and listening circles in Stage 2, leading to the development of a community action plan in Stage 3.
02/22/2018 - 10:39
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What we heard about poverty reduction
Executive summary As a whole, Canada remains among the best places in the world in which to live. However, too many Canadians live in poverty. This is why the Government made a commitment to develop a Canadian Poverty Reduction Strategy that would set targets to reduce poverty in Canada and measure and publicly report on progress. In February 2017, Employment and Social Development Canada launched a consultation process to inform the development of a Canadian Poverty Reduction Strategy. Although Canada’s economy continues to show signs of strength, job creation and growth, we heard that many Canadians are still struggling to make ends meet and satisfy basic needs. Essential things, such as providing for the needs of one’s children or taking care of one’s health, are simply out of reach for some people. Many participants told us that stable and quality jobs can be hard to find in some communities and regions, whether they are entering the labour market for the first time or re-entering. Canadians also made it clear that poverty is about more than simply not having enough income—it can also be about discrimination in all its forms, the challenges of physical or mental illness and working hard to reach and stay in the middle class. We also heard some Canadians find paying for a place to live challenging, and that Canada needs better and more affordable housing. We reached out to individuals for whom we knew there were existing challenges, namely vulnerable seniors, youth, women, the LGBTQ2 community, visible minorities, newcomers, persons with disabilities, single parents and unattached individuals aged 45 to 64. We heard that the Poverty Reduction Strategy should acknowledge the challenges faced by these groups and contain policies and/or supports specifically targeted for them. Many First Nations, Inuit and Métis participants told us that colonialism, racism and inter-generational trauma have made poverty worse in their communities and for their people in towns and cities across Canada. We heard that we need to rebuild or restore nation-to-nation relationships to help ensure a better future, through reconciliation and greater recognition of First Nations, Inuit and Métis governments, and by working together in practical ways to help overcome challenges and barriers. We heard that many Canadians are not accessing the government programs and services that are available to them, either due to lack of awareness of their eligibility or obstacles encountered during application processes. Consultation participants also shared with us their vision for the Canadian Poverty Reduction Strategy, indicating that the Government should set ambitious and measurable targets. The analysis conducted for the drafting of this report has informed the initial stages of the development of the Canadian Poverty Reduction Strategy and will continue to do so as we work towards the release of the Strategy.
02/21/2018 - 09:21
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I am a person without a home
After Bell Let’s Talk Day #bellletstalk, I want to continue the conversation. PLEASE WATCH, LIKE and SHARE my VIDEO. Let’s ERADICATE the word HOMELESSNESS from all current discourse, literature, and titling. We all know the stigma and labels behind this socially constructed concept. This is my attempt to share my vision and help our nation - to not only start thinking differently - but, to begin to create a community where all humans can live with dignity and humanity. Removing this word from our vocabulary will simply increase our existing community-based supports, political advocacy, and social change efforts!
02/09/2018 - 09:23
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A Home of Your Own: Housing First and ending homelessness in Finland
The handbook A Home of Your Own is a publication by the Y-Foundation. The Y-Foundation, one of the key national developers of the Housing First principle in Finland, has published a handbook A Home of Your Own – Housing First and ending Homelessness in Finland to answer the many questions we have received from professionals and policy-makers over the years. This book describes in detail why Finland has become the only European country where homelessness is on the decline. It also gives voice to the people who now have homes in supported housing units or scattered housing. The handbook is free of charge and available for anyone interested in the matter. We trust you will do good things with the information and share our story.
02/08/2018 - 10:25
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WHAT WOULD IT TAKE? Youth Across Canada Speak Out on Youth Homelessness Prevention
Are we making significant headway on youth homelessness in Canada? Are we stopping young people from becoming homeless? Are we ensuring that young people transition out of homelessness quickly, and that they do not become homeless again?  It is time that we started taking a good, hard look at these questions. In our efforts to end homelessness, we have primarily focused on providing emergency services and supports to young people while they are homeless. Unfortunately, this hasn’t gotten us the results we want. Youth homelessness in Canada is an ongoing problem for which we seem to be making slow but insufficient progress. It is time to consider a new approach – the prevention of youth homelessness.  The What Would it Take? study asked young people with lived experience of homelessness: what would it take to prevent youth homelessness in Canada? Between July 2017 and January 2018, A Way Home Canada and the Canadian Observatory on Homelessness consulted with youth across Canada to ask: What would have prevented your homelessness? What programs, policies, services, and supports are needed to prevent youth homelessness? What do you want to tell the Canadian government about preventing youth homelessness? How do you want to be involved in making change on this issue? The purpose of this report is to amplify the voices, insights, and wisdom of these young people in order to drive policy and practice change. In our efforts to end homelessness, we have primarily focused on providing emergency services and supports to young people while they are homeless. While this is important and generally well-meaning, we need to question whether this is enough; whether waiting for young people to become homeless before we help them is both sufficient and the right thing to do. In considering how we might reform our response to youth homelessness, young people with lived experience of homelessness need to have their voices heard. Their valuable insights drawn from their experiences can challenge our current thinking and point to a new approach that more effectively helps young people before they end up on the streets. Read the report for youth insights on how we can prevent youth homelessness in Canada.
02/07/2018 - 11:47
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The Landlord Engagement Toolkit: A Guide to Working with Landlords in Housing First Programs
HOW THIS TOOLKIT WAS MADE This toolkit was developed in collaboration with a diverse group of stakeholders from communities across Canada. Over 60 individuals from 24 different organizations were consulted by phone and in person. We heard from: -  Case managers in Housing First programs -  Housing specialists -  Housing First program managers -  Community entity representatives -  Municipal staff working on the issue of homelessness -  Landlords and property managers -  Tenants -  Other experts who have knowledge of Housing First, including Housing First with Indigenous populations. Site visits were conducted in ve Canadian communities: -  St. John’s, Newfoundland -  Ottawa, Ontario -  Kingston, Ontario -  Lethbridge, Alberta -  Victoria, British Columbia The toolkit contains the experiences, recommendations and advice that were shared during consultations and site visits, as well as findings from existing research and reports.  WHO THIS TOOLKIT IS FOR This toolkit is meant to be a practical “how to” guide to working with landlords in the context of a Housing First program. It will help program providers build effective, lasting relationships with landlords. Although many aspects of the toolkit will apply to a wide range of programs, the toolkit will focus on programs that offer participants a rent supplement in scattered site housing in the private rental market. This toolkit presents a set of ideas, approaches and resources that program providers may choose from and adapt to their own practice. ÉLABORATION DE LA TROUSSE À OUTILS Cette trousse à outils a été créée en collaboration avec un groupe diversi é d’intervenants provenant de collectivités de l’ensemble du Canada. Nous avons mené des consultations par téléphone et en personne auprès de plus de 60 personnes provenant de 24 organisations différentes, notamment : -  de gestionnaires de cas travaillant au sein des programmes de l’approche Logement d’abord; -  de spécialistes du logement; -  de gestionnaires de programmes dans le cadre de l’approche Logement d’abord; -  de représentants d’entités communautaires; -  d’employés municipaux responsables de la question de l’itinérance; -  de propriétaires et de gestionnaires immobiliers; -  de locataires; -  d’autres experts connaissant l’approche Logement d’abord, y compris l’approche visant les populations autochtones. Des visites sur place ont été effectuées dans cinq collectivités canadiennes : -  St. John’s (Terre-Neuve-et-Labrador) -  Ottawa (Ontario) -  Kingston (Ontario) -  Lethbridge (Alberta) -  Victoria (Colombie-Britannique) La trousse à outils fait état des expériences, des recommandations et des conseils transmis pendant les consultations et les visites ainsi que des constatations provenant de recherches et de rapports existants. DESTINATAIRES DE LA TROUSSE À OUTILS Cette trousse à outils est en fait un guide pratique décrivant la façon de collaborer avec les propriétaires dans le cadre d’un programme de l’approche Logement d’abord. Elle vise à aider les fournisseurs de programmes à forger des relations ef caces et durables avec les propriétaires. Bien que de nombreux aspects de la trousse à outils s’appliquent à une vaste gamme de programmes, la trousse vise particulièrement les programmes qui offrent aux participants un supplément au loyer pour des logements situés dans des endroits dispersés dans le marché locatif privé. Cette trousse à outils présente un ensemble d’idées, d’approches et de ressources parmi lesquelles les fournisseurs de programmes peuvent choisir, et lesquelles ils peuvent adapter à leurs propres pratiques. 
01/25/2018 - 14:22
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Afterword
A YOUTH PERSPECTIVE Being homeless is stressful. It’s 24 hours a day. Even if you experience a good week or month, there is always an underlying and pervasive feeling of instability, that everything around you is temporary. Despite the positive things you experience, there is still a strong fear that you will lose everything you have gained or relapse into homelessness. As a young person who has experienced homelessness and a transition back to housing, I have found that homelessness had a large impact on my mental health. I have learned, from myself and others, that the experience of homelessness can easily trigger previous or new mental health symptoms. For example, feelings of loneliness, isolation, and a general lack of family and community support often lead to an overall sense of hopelessness or depression. This depression can then translate into substance use or risky behaviours as youth seek comfort through harmful coping strategies because they lack healthier or more adaptive options. These risky coping measures can then lead to even greater or longer lasting mental health challenges and harm. This is why support for young people who are homeless is essential. In my own experience, the most helpful services have come from dependable and flexible outreach workers, as well as highly trained and accessible mental health professionals. Outreach workers have been a lifeline for me. They created the feeling that somebody was actively helping me because they would come to wherever it was I needed them to be. Trustworthy, dependable and flexible service was key. However, access to these services is not very easy; wait lists are often over a year long or require specific referrals from physicians to which youth may not have access. These are barriers for youth who live on the street and who are forced to remain homeless longer because services are lacking or because they don’t know how to get connected to a professional. Unfortunately, many youth who are homeless experience serious mental health challenges and require intervention, but cannot easily access highly qualified and trained mental health professionals such as psychologists and psychiatrists. I feel that this access is an investment in the well-being of youth that helps prevent further escalation of already stressful experiences. I had the opportunity to enroll in an integrated program called HOP-C that linked me with a supportive team that stayed connected with me and with each other. I had access to high-quality mental health care, an outreach worker, and peer mentorship in the community. This included the opportunity to attend fun community events. These events helped me and others in the program see past our current circumstances and have fun and let loose. They reminded me that there is more to life than my current situation and that I had the capacity to be happy. My own improved mental health has increased my capacity for life and my ability to work toward a better future. It enables me to put actions to my words. This change started with attending appointments and making efforts to maintain a healthy balance, and then led to working toward education and employment goals. Improved mental health has shifted my perspective on life: I feel hope, that I can achieve things. The focus of my life is no longer on mere survival, but on seeing and experiencing what life has to offer. I support resources that assist workers and systems in better addressing the mental health and addiction challenges of youth. These supports help youth who need extra assistance, due to their histories and difficult experiences, to realize their potential and see a better future for themselves. Service providers who have solid training in mental health and addiction make us feel more secure and supported, and help ease the burden of homelessness. For me, they made getting through life just a little bit easier. They instilled hope and reminded me that there is life after homelessness. The best workers were constant sources of motivation, encouraging me to not give up on my life goals. All youth deserve this. M.H. - ABOUT THE EDITORS Sean Kidd, PhD, CPRP, is a senior scientist and division chief of psychology at the Centre for Addiction and Mental Health in Toronto. He is also an associate professor in the Department of Psychiatry at the University of Toronto. His career has focused on marginality and service enhancement, specifically among youth experiencing homelessness and people with severe mental illness. He has published landmark papers in qualitative methods in psychology, and is internationally recognized for his research on youth homelessness, including being one of the most published scholars in that area. He has done extensive work in developing and testing psychiatric rehabilitation interventions and in examining social inclusion among marginalized populations. Natasha Slesnick, PhD, is a licensed clinical psychologist. At Ohio State University, she is associate dean of Research and Administration in the College of Education and Human Ecology, and a professor of couple and family therapy, human development, and family science. Her research focuses on youth and families experiencing homelessness, specifically on developing and evaluating interventions for substance use, HIV risk, mental health, and housing. She has evaluated and refined an ecologically based family systems intervention for shelter-recruited adolescents who have run from home, and for their families. She has also modified and tested individually focused interventions for street-recruited youth and young mothers with children in their care. Dr. Slesnick launched two drop-in centres for youth who are homeless: one in Albuquerque, New Mexico, and another in Columbus, Ohio. Tyler Frederick, PhD, is a sociologist and an assistant professor at the University of Ontario Institute of Technology in Oshawa. He is a community-based researcher with a focus on marginalized young people. His research focuses on how young people navigate homelessness and how this process shapes their mental health, identity, and well-being. Jeff Karabanow, PhD, RSW, is a professor of social work at Dalhousie University in Halifax, Nova Scotia. His research focuses on housing stability, service delivery systems, street health, and homeless youth culture. He has completed a documentary about the plight of street youth in Guatemala City and several animated shorts on Canadian street youth culture. Dr. Karabanow is one of the founding members of Halifax’s Out of the Cold Emergency Shelter and is co-director of the Dalhousie School of Social Work Community Clinic.334  Stephen Gaetz, CM, is a professor in the Faculty of Education at York University in Toronto, and director of the Canadian Observatory on Homelessness/Homeless Hub. His program of research has been defined by his desire to “make research matter” by conducting rigorous scholarly research that contributes to our knowledge base on homelessness, and that at the same time can be mobilized to have a bigger impact on policy, practice, and public opinion. Dr. Gaetz has pioneered efforts to bring together researchers, practitioners, policy makers, and people with lived experience of homelessness to participate in community-engaged scholarship and knowledge creation designed to contribute to solutions to homelessness. As director of the Canadian Observatory on Homelessness, one of his key projects is the Homeless Hub, an innovative web-based research library internationally recognized as a leading example of innovation in knowledge mobilization.
01/17/2018 - 11:52
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4.2 Pragmatic strategies & considerations for evaluating mental health programs
Evaluation research involves gathering a wide variety of indicators in order to better understand how a program is operating, its impact, and what can be done to improve it. The performance indicators that many organizations collect routinely as part of their daily operations can provide important information for a program evaluation (e.g., attendance, client demographics), but are not themselves considered evaluation research. Evaluation involves systematically and intentionally collecting and reviewing information in order to understand and strengthen a program.  This chapter offers service providers guidance around evaluating programming within their organizations, with a particular focus on mental health initiatives. It discusses developing evaluation questions and choosing sources and methods for obtaining information. It also examines ethical considerations in conducting evaluation research. 
01/17/2018 - 11:44
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4.1 Assessment tools for prioritizing housing resources for youth who are homeless
In almost all communities in North America, the number of youth experiencing homelessness exceeds the capacity of the housing resources available to them. This situation leaves communities with the predicament of trying to decide who to prioritize for the precious few spots available in housing programs. For adults, this same dynamic exists and many communities have turned to vulnerability assessment tools to help them make these difficult decisions. Most communities have moved to a coordinated entry system. In such systems, most agencies within a community pool their housing resources in a centralized system. People seeking housing are first assessed for eligibility. Criteria usually include being chronically homeless, in addition to veteran status and vulnerability (U.S. Department of Housing and Urban Development, 2015, 2016). Based on these assessments, individuals are prioritized for housing and placed on waiting lists until appropriate housing becomes available in the community.  In the context of adult homelessness, tools for assessing vulnerability have focused on assessing factors associated with premature mortality (Hwang, Lebow, Bierer et al., 1998; Juneau Economic Development Council, 2009; Swanborough, 2011) or with greatest system costs (Economic Roundtable, 2011). However, since youth under age 24 are unlikely to experience health-related premature mortality or to have created enormous system costs, new assessment tools have been developed in recent years that reflect the needs and realities of youth who are homeless. Most widely used are the TAY Triage Tool (Rice, 2013), developed by the Corporation for Supportive Housing (CSH) and myself, and the Next Step Tool for Homeless Youth,1 which was developed by Orgcode Consulting (2015) with CSH and myself. 
01/17/2018 - 11:31
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4. ASSESSMENT & EVALUATION
01/17/2018 - 11:27
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3.9 Resilience-based mental health intervention for street children in developing countries
“Street children” are an underprivileged group that is visible in public places of urban areas in developing countries. These children engage in informal economic activities to make a living for themselves and their families. They are found in every corner of the globe, but are more visible in developing countries in Africa, South Asia, and parts of Latin America (Thomas de Benítez, 2011). There is debate about the size of this population, with estimates ranging anywhere between several million and 100 million. Part of the difficulty in determining the exact number is the lack of a universally accepted definition of street children1 (Thomas de Benítez, 2011).  These challenges aside, the question remains: Why do these children leave their homes for the complex hardships of street life? Research from developing countries tends to view children’s movement to the street through two lenses: poverty and family dysfunction. Chronic poverty often creates unbearable conditions at home for young children and exerts pressure on family members to find economic means for survival (Ballet, Bhukuth, & Radja, 2013). In this situation, children migrate to the streets voluntarily or involuntarily to support their families. From the family dysfunction perspective, family environments that feature conflict, violence, abandonment, and authoritarian behaviour weaken or disintegrate ties among family members, prompting the child’s eventual departure from the home (Ballet et al., 2013). Moreover, population growth, urbanization, war, and HIV epidemics affect the stability of economic and social institutions in developing countries; when these institutions are unstable, families and individuals migrate to urban centres that are themselves economically depressed and thus offer limited opportunities. Some families disintegrate under these conditions and children are forced to take to the streets for survival (Kombarakaran, 2004). 
01/17/2018 - 11:22
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3.8 Partnerships that support mental health intervention for street-involved youth
After decades of fragmentation within the community-based child and youth mental health sector, there is an emerging trend and understanding of how cross-sectoral partnerships and integration between organizations can improve mental health outcomes for children, youth, and young adults. This chapter describes the benefits of these partnerships and key considerations in developing them. It also presents a case study of a successful partnership that is helping to address mental health issues among youth in the shelter system. 
01/17/2018 - 11:18
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3.7 The digital lives of youth who are homeless: Implications for intervention, policy, and services
Each year, 1.5 million to 3 million youth in the United States experience homelessness1 (Toro, Lesperance, & Braciszewski, 2011). They are considered to be one of the most marginalized groups in the country. Among the many challenges they face are acquiring health care, employment, and stable housing. It is becoming increasingly important to consider how to use information and communication technologies (ICT) to increase service engagement and outreach and improve health outcomes and quality of life among youth who are homeless.  ICT encompasses a range of interactive tools and platforms; these include social networking sites such as Facebook and Twitter, where people create profiles and share them with network contacts; content-sharing sites such as YouTube and Flickr, which are used to share, rate, and discuss videos and photographs (Adewuyi & Adefemi, 2016); and mobile phones and mobile phone–based applications, which have become a popular alternative to traditional websites for delivering information.  This chapter discusses recent research on ICT use among youth who are homeless. It also describes interventions in the United States that have used these technologies to engage this population, and explains how what we have learned can be translated into service and policy initiatives that reduce disparities in accessing information and other resources in this vulnerable group. 
01/17/2018 - 11:14
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3.6 Peer support work to enhance services for youth experiencing homelessness
Across contexts, peer workers and peer mentors are becoming an increasingly important resource in delivering youth-focused programming for young people who are homeless or street involved. Peer work has been established across a number of practice areas, including public health, addictions, education, and community-based research. The most considerable development in the role has been within the mental health sector, where peer work is gaining increasing visibility and legitimacy as a central component of a recovery-based approach that is demonstrating positive outcomes (Nesta, 2015). While the incorporation of adult peers is relatively well established in many service sectors, youth and young adult involvement is still developing.  Peer work can encompass a number of activities, and although the role lacks a clear definition, a defining feature is the use of lived experience as a support to individuals in similar circumstances (Vandewalle et al., 2016). Within this broad conceptualization, various authors (Ansell & Insley, 2013; Ontario Centre of Excellence for Child and Youth Mental Health, 2016; Paradis, Bardy, Cummings, Athumani, & Pereira, 2012) have identified the common peer worker roles. These roles include:  Peer mentor: partners with a client or participant and offers support and encouragement regarding program-specific goals and broader life goals;  Peer educator: helps develop educational materials and leads educational presentations and workshops;  Peer navigator: provides help with systems navigation (e.g., accompanying people to appointments, connecting to services, helping to fill out paperwork);  Peer specialist: a broader role that encompasses some of the above activities and might include some case management, advocacy, and group facilitation; and  Self-help and mutual aid group: this includes peer support groups and peer knowledge exchanges.
01/17/2018 - 11:10
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3.5 Beautiful trouble: Possibilities in the arts with street-involved youth
 Beautiful trouble makers who remember, resist and reimagine.  —Min Sook Lee, OCAD University, Art and Social Change  Offering Crys a ride “home” after a jewelry-making workshop led me to a makeshift “shanty town” under the Bathurst Street bridge in Toronto. I was struck by the vivid colour and detail in this woven compilation of blankets, boxes, and condo sales sandwich boards, used to create multi-storey structures, walls, doors, beds, tables, and chairs. It looked like a theatre set. Crys told me that over 20 youth lived there, and it had taken months to construct. Everyone had a role in this “under-the-bridge” community. Someone fed the dogs and another created the schedule for their walks; someone held the alarm clock to wake people for jobs, school, or appointments; others led study and support groups for those in school, and those wanting to “stay clean.” And of course, many of them were musicians, poets, and artists who made things to sell instead of panhandling and who entertained each other in the evenings. They shared their earnings and combined costs, especially for meal-making that happened over their custom-made Bunsen burners. They met weekly to make decisions and talk through problems. Crys was pretty proud of that place and it evoked a kind of envy in me for creative, cooperative, and alternative community. 
01/17/2018 - 11:07
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3.4 The individual placement & support model of supported employment for street-involved youth with mental illness
More than two million youth in the United States are homeless at some time each year (Whitbeck, 2009). They often have histories of depression, complex trauma, substance abuse, and physical and sexual abuse—all of which make obtaining and maintaining competitive employment difficult. Epidemiologic data indicate that 26% meet the clinical criteria for major depression, 35% have attempted suicide, and 72% use illegal substances to cope (Rotheram-Borus & Milburn, 2004). Their connection to school is also irregular or non-existent, which contributes to low educational levels and limited employment skills. Several studies suggest that over one-third of youth who are homeless have dropped out of school, do not attend school regularly, or fail to earn a high-school diploma by age 18 (Thompson, Pollio, & Constantine, 2002; Whitbeck, 2009). These mental health and behavioural health challenges, combined with low educational and employment skills, contribute to high unemployment rates among youth who are homeless compared with their housed peers. Housed youth in the general population (aged 16–24) have unemployment rates ranging between 8% and 17% (U.S. Department of Labor, Bureau of Labor Statistics, 2016), whereas unemployment rates for youth who are homeless range from 39% to 71% across various samples of youth living on the street or in shelters (Courtney, Piliavin, Grogan-Kaylor, & Nesmith, 2001; Ferguson & Xie, 2008; Lenz- Rashid, 2006; Whitbeck, 2009). 
01/17/2018 - 11:02
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3.3 Strengths-based outreach & advocacy for non-service-connected youth experiencing homelessness
Much of what is known about youth who are homeless is obtained from those engaged through service programs, such as drop-in centres or shelters. This means that much less is known about youth experiencing homelessness who are not engaged in services as they are excluded from most studies. This is a significant concern because some reports indicate that youth who are not connected to services represent the majority of youth who are homeless: less than 10% access community resources meant to serve them (Kelly & Caputo, 2007). Furthermore, service-disconnected youth are different from those who already access services; they have more unmet needs and more severe substance use and mental health problems (Kryda & Compton, 2009). Efforts to connect youth to services are essential to prevent a range of public health consequences associated with homelessness, including premature death. 
01/17/2018 - 10:56
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3.2 Responding to mental health concerns on the front line: Building capacity at a crisis shelter for youth experiencing homelessness
It is well established that youth experiencing homelessness face many challenges with their mental health. For example, a literature review of the topic found that 30%–40% of youth who are homeless experience major depression, bipolar disorder, posttraumatic stress disorder, and substance use (Kidd, 2013). A small number also experience psychotic disorders such as schizophrenia, although this incidence is believed to be larger than that found in the general population (Kidd, 2013). Moreover, an alarming number of youth face some form of emotional distress regardless of whether they have a formal diagnosis. Our administrative data at Covenant House Toronto, Canada’s largest youth-serving agency, show that about 30% of the young people we serve in our emergency shelter have a serious mental health concern, and of a sample of 164 youth using our drop-in, shelter, and transitional housing programs, over 70% reported experiencing at least one symptom of depression, anxiety, hearing or seeing things that others could not, distress from past trauma, sleep disturbances, and/or suicidal ideation in the past three months. 
01/17/2018 - 10:32
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Report on Youth Homelessness 2018
A Vision for Tomorrow On any given night, more than 6,000 Canadian youths are homeless. Young people account for one in five of the people living in Canada’s homeless shelters. In Kingston the figure was more acute in 2013. One in three shelter residents here were between the ages of 15 and 24.* To help these vulnerable young people put their homelessness behind them and live safe, productive lives, the United Way Kingston, Frontenac, Lennox & Addington embarked on a mission to prevent and end youth homelessness in our region. This mission began with the vision of reducing the number of young people using the shelter system. However as the consultation process gained momentum, it became clear that the root causes of homelessness are complex and require intervention on multiple fronts. Instead of reducing homelessness, then, the United Way opted to focus on prevention, providing timely intervention, and building a sustainable network of supportive resources. While this approach may not have the intended effect of reducing the number of homeless youth, it will ensure that youth homelessness in our community becomes a treatable condition, rather than a chronic one. And so a new vision emerged: “By 2020, 80 per cent of youths who enter the homelessness system in KFL&A will be housed within 30 days.” By pursuing this vision, we can focus our attention and our efforts on identifying and removing the barriers that keep young people from accessing safe, suitable, and sustainable housing, and ensure that every young person in KFL&A has a place to call home. * In 2017, as a result of community wide efforts, one in five shelter residents were between the ages of 15 and 24.
01/17/2018 - 09:43
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Rent Assist Rates for Persons Renting in the Private Market
Outline of rent assistance available in Manitoba. 
01/08/2018 - 14:49
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