Costs of services for homeless people with mental illness in 5 Canadian cities: a large prospective follow-up study

Abstract

A n estimated 35 000 Canadians are homeless on any given night, and over 235 000 experience homelessness over the course of a year. 1 In some jurisdictions, the discussion has shifted toward how homelessness can be ended rather than on how to manage it.1,2 Ending homelessness will require resources in the form of targeted prevention interventions, 2 development of affordable housing and a variety of housing and support programs such as Housing First, in which homeless people are offered immediate access to permanent housing together with long-term, individualized support.3 Arguments for additional government expenditures on programs to end homelessness can be better framed if the costs of maintaining the status quo are well understood. To this end, estimates of the costs of homelessness are needed.Limited information is available on the economic costs that homeless people engender in Canada. Based on a sample of 10 people, in 1998-1999, service and shelter costs of Background: Limited evidence on the costs of homelessness in Canada is available. We estimated the average annual costs, in total and by cost category, that homeless people with mental illness engender from the perspective of society. We also identified individual characteristics associated with higher costs.

Bread and Shoulders: Reversing the Downward Spiral, a Qualitative Analyses of the Effects of a Housing First-Type Program in France

“…Housing First programs include intensive supports and follow-up similar to those of Assertive Community Treatment (ACT) teams and have been evaluated with randomized control trials (RCT) designs. RCT studies found the Housing First model to be more effective and efficient compared to other housing programs, in the United States [ 3 ] and Canada [ 4 ]. In fact, better effectiveness has been shown through housing stability as well as reduction in hospitalization, juridical system contact and symptoms [ 3 , 5 , 6 ].…”

Clinical and functional characteristics of young adults living in single room occupancy housing: preliminary findings from a 10-year longitudinal study

“…The success of these programs has been well documented (Stergiopoulos et al 2014;Corbiere et al 2010). However, at the same time, increasing numbers of people who are homeless or marginally housed are presenting to emergency departments (Latimer et al 2017). As well, in Vancouver, British Columbia, the number of people who are at risk of homelessness continues to escalate: the highest numbers to date were reported in 2017, with a 30% increase compared to 2014 (BC Non-Profit Housing Association and M. Thomson Consulting 2017).…”

Predictive modeling of housing instability and homelessness in the Veterans Health Administration

“…Housing instability and especially homelessness, which is an acute form of housing instability, are associated with a range of adverse health outcomes and increased costs for health care systems . This knowledge has led to growing recognition of housing as an important social determinant of health and a corresponding increase in efforts of health care systems to address housing instability and homelessness, ranging from interventions in clinical settings, to new care delivery, and financing mechanisms …”

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| INTRODUC TI ONHousing instability and especially homelessness, which is an acute form of housing instability, are associated with a range of adverse health outcomes 1,2 and increased costs for health care systems. [3][4][5] This knowledge has led to growing recognition of housing as an important social determinant of health 6 and a corresponding increase in efforts of health care systems to address housing instability and homelessness, ranging from interventions in clinical settings, 7 to new care delivery, 8 and financing mechanisms. 9From a practical standpoint, efforts to address housing instability within the health care system rely on the accurate identification of those who are, or are at risk of, experiencing housing instability.Accurate identification can lead to more efficient targeting of interventions to prevent housing instability or to mitigate the potential ill effects of continued housing instability.

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