In recent years the field of vocational programming for people with serious mental health problems has been undergoing major changes. This paper examines one of the new approaches which has emerged: consumer/survivor-run businesses. These models typically feature as key players people who have used the mental health system themselves. Cooperative businesses are set up in which those involved are employees rather than clients. There is little or no input from professional staff. Consumer/survivor-run businesses represent a challenge to the idea that vocational programs should be based on professional rehabilitation service models. Early results indicate that involvement in these programs substantially reduces the use of mental health services such as inpatient hospitalization.

Housing programs are complex social interventions. Research on housing for people with mental illness has proceeded without a framework for integrating emerging findings and guiding new research directions. This paper describes a definition and model of housing stability developed with stakeholders in 3 local housing systems for people with mental illness. The model describes housing stability as a dynamic relationship among 3 factors (person, housing, and support) that are influenced by broader system influences. The model is discussed in terms of its usefulness for integrating existing research, guiding new research, and integrating research with practice to improve housing practices.Over the past two decades there has been some progress in research on housing programs for people with serious mental illness. Despite the methodological limitations of much of this research, including the absence of more rigorous experimental designs (Newman, 2001), there is emerging evidence that a variety of attributes of housing are associated with better outcomes for consumers of mental health services. These attributes include housing that is well-maintained, that supports individual choice and control, that is managed in an empowering and democratic fashion, and that provides consumer-centred, rehabilitation-oriented support ( Newman, 2001;Parkinson, Nelson, & Horgan, 1999).

This paper outlines the development of the Supportive Housing Coalition of Metropolitan Toronto, an organization which co-ordinates the efforts of housing agencies, consumers, and treatment facilities in the provision of psychiatric residential programs. An assessment of the organization's impact to date on housing policy, municipal by-laws, program types, and housing stock is described. The organizational model utilized by the coalition is also examined in light of literature on the subject.

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. Housing is an essential component of an effective community mental health system for people with serious mental illness. Without accessible, good quality housing and support, successful community living and recovery are not possible. Ontario has provided housing dedicated to people with serious mental illness since the onset of deinstitutionalization. Since the 1960s, the system has grown substantially to encompass a variety of forms of housing and to become a cornerstone of the community mental health system. Despite its growth and importance, this housing system faces a number of significant challenges. It remains inadequate for meeting consumer demand, with very long waiting lists reported by most programs in the province. There is a lack of good data on the system, documenting who is being served and how they are being served, as well as on the needs of those who cannot access the system. This lack of information makes it difficult to effectively manage the system and to plan for its future.In 2003, the Ontario Ministry of Health and Long-Term Care funded a research project to examine the province's dedicated housing system and to make recommendations for improving it. This paper describes the multifaceted project that was conducted to develop a foundation for planning system improvements. The project developed three foundations for system planning: (a) a vision for the system by identifying values that should guide the delivery of services, (b) research evidence about the status of the system and effective practices, and (c) consultations with stakeholders from across the province about directions for system improvement.

This study explored mental health consumers’ preferences regarding the support services needed to find, access, and maintain housing, and compared their views with the preferences of family members of consumers. A total of 354 consumers and 187 family members from across Canada completed questionnaires assessing their past and present experiences with housing and supports. Income supports and nutritional supports were described by both consumers and family members as the most important support services. Opinions diverged in other areas; consumers desired supports that fostered independent living, while family members emphasized services offering higher levels of support.