Conducting Research on Homelessness in Canada from a Community Psychology Perspective: Reflections on Lessons Learned

Homelessness has emerged as a significant and enduring social problem globally in developing and developed countries. With is aim of promoting social justice and influencing public policy, community psychology has much to offer in terms of addressing this problem. The presentation will focus on research and on research and knowledge mobilization efforts on homelessness in Canada of the keynote speaker that now spans over a decade. Specifically, findings from intervention and observational studies as well as knowledge dissemination products including a short video and report card on homelessness will be presented. Lessons learned from this work as a community psychologist will be discussed

Conducting Research on Homelessness in Canada from a Community Psychology Perspective: Reflections on Lessons Learned

Homelessness has emerged as a significant and enduring social problem globally in developing and developed countries. With is aim of promoting social justice and influencing public policy, community psychology has much to offer in terms of addressing this problem. The presentation will focus on research and on research and knowledge mobilization efforts on homelessness in Canada of the keynote speaker that now spans over a decade. Specifically, findings from intervention and observational studies as well as knowledge dissemination products including a short video and report card on homelessness will be presented. Lessons learned from this work as a community psychologist will be discussed

Strengthening Ontario\u27s System of Housing for People with Serious Mental Illness

This article describes recent work to support recommendations for improving Ontario’s system of housing for people with serious mental illness. This multifaceted project engaged stakeholders in discussions concerning strategies for improving the system based on (a) values that underlie housing programs, (b) evidence of effective housing practices, (c) the current status of the system, and (d) international practices for monitoring community mental health systems. Stakeholders reviewed summaries of the work and discussed implications for improving the provincial system of housing and supports. Recommendations are made for improving the system, focusing on both regional and provincial level actions

A Profile of Families in the Emergency Family Homeless Shelter System in Ottawa, Ontario, Canada

Compared to the wealth of research on single homeless adults, there is little known about homeless families. This paper describes a study of 75 homeless families in Ottawa, Ontario, conducted in 2012-2013. This sample of homeless families includes a large number of newcomer families, including immigrants and refugees. Participants are poor and unemployed, but many are educated, and there is little evidence of alcohol or substance abuse. Nonetheless, participants report poor mental health and high levels of family stress. Whereas newcomer families tended to be larger and include more two-parent families than did Canadian-born families, there were no differences in the physical and mental health of the participants. These findings add to our growing understanding of homeless families and point to notable similarities and differences in homeless families in this city in Canada, and in the United States

Examining the prevalence of chronic homelessness among single adults according to national definitions in Canada

This article examines the prevalence of chronic homelessness when applying definitions used in Canada to a sample of homeless and vulnerably housed single adults enrolled in a multi-city longitudinal study. The federal government’s current definition, Reaching Home, identified the highest proportion of homeless single adults (31 percent; 95% CI = 27.2 – 34.1) as “chronically homeless.” Our findings suggest that the federal definitions of chronic homelessness, which are based on both shelter stays and periods of homelessness outside the shelter system, are double the size of this sub-population when compared to definitions based on shelter stays alone. Participants who were male, identified as Indigenous, and reported problematic drug use, were more likely to be chronically homeless for definitions based on any-kind of homelessness. The findings highlight the importance of counting unsheltered and hidden homelessness to estimate the number of single adults who are chronically homeless.Cet article examine la prévalence de l’itinérance chronique lors de l’application de définitions utilisées au Canada à un échantillon d’adultes célibataires sans abri et logés de façon vulnérable, inscrits dans une étude longitudinale multi-villes. La définition actuelle du gouvernement fédéral, Reaching Home, a identifié la plus grande proportion d’adultes célibataires sans abri (31 pour cent ; 95 % CI = 27,2 - 34,1) comme «sans abri chronique». Nos résultats suggèrent que les définitions de l’itinérance chronique, qui sont basées à la fois sur les séjours en refuge et les périodes d’itinérance en dehors du système de refuge, représentent le double de la taille de cette sous-population par rapport aux définitions basées uniquement sur les séjours en refuge. Les participants qui étaient de sexe masculin, s’identifiaient comme indigènes et déclaraient avoir fait un usage problématique de drogues, étaient plus susceptibles d’être associés à l’itinérance chronique pour les définitions basées sur tout type d’itinérance. Les résultats soulignent l’importance de compter l’itinérance non abritée et cachée pour estimer le nombre d’adultes célibataires qui sont chroniquement sans abri

The At Home/Chez Soi trial protocol: a pragmatic, multi-site, randomised controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities

This article was published in BMJ Open following peer review and can also be viewed on the journal’s website at http://bmjopen.bmj.comIntroduction: Housing First is a complex housing and support intervention for homeless individuals with mental health problems. It has a sufficient knowledge base and interest to warrant a test of wide-scale implementation in various settings. This protocol describes the quantitative design of a Canadian five city, $110 million demonstration project and provides the rationale for key scientific decisions. Methods: A pragmatic, mixed methods, multi-site field trial of the effectiveness of Housing First in Vancouver, Winnipeg, Toronto, Montreal and Moncton, is randomising approximately 2500 participants, stratified by high and moderate need levels, into intervention and treatment as usual groups. Quantitative outcome measures are being collected over a 2-year period and a qualitative process evaluation is being completed. Primary outcomes are housing stability, social functioning and, for the economic analyses, quality of life. Hierarchical linear modelling is the primary data analytic strategy. Ethics and dissemination: Research ethics board approval has been obtained from 11 institutions and a safety and adverse events committee is in place. The results of the multi-site analyses of outcomes at 12 months and 2 years will be reported in a series of core scientific journal papers. Extensive knowledge exchange activities with non-academic audiences will occur throughout the duration of the project.This work was supported by a contract from Health Canada administrated by the Mental Health Commission of Canada

Characterisation of age and polarity at onset in bipolar disorder

Background Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools. Aims To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics. Method Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts. Results Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO. Conclusions AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.publishedVersio

The health and housing in transition study: A longitudinal study of the health of homeless and vulnerably housed adults in three Canadian cities

Objectives: While substantial research has demonstrated the poor health status of homeless populations, the health status of vulnerably housed individuals is largely unknown. Furthermore, few longitudinal studies have assessed the impact of housing transitions on health. The health and housing in transition (HHiT) study is a prospective cohort study that aims to track the health and housing status of a representative sample of homeless and vulnerably housed single adults in three Canadian cities (Toronto, Ottawa, and Vancouver). This paper discusses the HHiT study methodological recruitment strategies and follow-up procedures, including a discussion of the limitations and challenges experienced to date. Methods: Participants (n = 1,192) were randomly selected at shelters, meal programmes, community health centres, drop-in centres, rooming houses, and single-room occupancy hotels from January to December 2009 and are being re-interviewed every 12 months for a 2-year period. Results: At baseline, over 85% of participants reported having at least one chronic health condition, and over 50% reported being diagnosed with a mental health problem. Conclusions: Our findings suggest that, regardless of housing status, participants had extremely poor overall health