Research Profile – Street Smart, Health Wise

Researchers are partnering with the City of London, Ontario, to develop a smart approach to youth homelessness.

[ Back to main article ]

Helping homeless people get off the streets is a complex challenge. People may be homeless for a complicated mix of reasons such as disability, mental health issues or addiction.

"The homeless population is an extremely heterogeneous group," says Dr. Cheryl Forchuk of the Lawson Health Research Institute and Western University. "We have to really understand some of the subpopulations within that group to come up with good strategies."

Many researchers and policy makers support the view that people need the stability of a home before they can begin to tackle problems related to mental health and addiction. So the first goal is to get people who are homeless into housing and then begin to treat any underlying issues. This highly successful approach, known as "housing first," began in the US and has been replicated through the Mental Health Commission of Canada's "At Home" pilot project.

But there are several reasons why "housing first" might not work for homeless youth. First, many street youth are too young to legally sign a lease. Also, while older homeless people might be eligible for disability benefits and therefore have more money for housing, youth are typically only eligible for general welfare. And from a developmental perspective, youth are just in a different place and may have different priorities.

"There were enough questions that we felt youth needed to be studied as a separate group to find out whether these same very positive results that had been found with an older population also applied to this population," says Dr. Forchuk.

Her research team partnered with the city of London and an outreach organization called Youth Opportunities Unlimited to study these questions. With the help of street youth in the community, they were able to recruit 187 participants for a three-year study.

They began by asking each participant what approach they would prefer: housing first, treatment first, a combination of the two, or something different. Each youth was then enrolled in the program of their choice.

Throughout the project, which is co-funded by the Mental Health Commission of Canada and the Canadian Institutes of Health Research, the researchers and their partners have worked closely with homeless youth for advice. These advisers provided valuable suggestions for recruiting and keeping track of all the participants in the study. For example, they recommended handing out lanyards with the researchers' email address written on them, so that the study participants could wear them under their clothing and check in with the researchers from the road.

The youth were also highly involved in creating and maintaining a peer support group. This group allows young people struggling with housing issues to get together to strategize and even connect with potential roommates.

The preliminary results from the study reinforce the idea that there is no single solution to homelessness. About 40% of the youth, mostly women and young parents, opted for the "housing first" approach; 30% of the participants, particularly young men battling addictions, chose "treatment first"; and about 20% of the youth wanted a combined approach.

For the remaining months of the project, the researchers will continue to check in with the youth at regular intervals and assess the success of each strategy.

According to Jan Richardson, Manager of Homelessness, Hostels and Special Populations for the City of London, collaborating with Dr. Forchuk on this research project has created the opportunity to make informed decisions about both public policy and funding for programs and services.

"Being active in the research process, versus just reading results, helps us to pilot and test changes to local rules that can support immediate change," says Ms. Richardson.

"Although there is really no one-size-fits-all solution to support individuals experiencing homelessness, it is fair to say that housing and housing with support is a more permanent solution."
– Dr. Cheryl Forchuk, Lawson Health Research Institute, Western University

Mental Health Commission of Canada (MHCC): At Home