No Fixed Address version 2 Expansion (NFA v.2x)

Very little work has been done to reduce discharge from hospital medical wards to homelessness. While our earlier work (Forchuk et al., 2006) was successful in reducing similar discharges from psychiatric units our local shelter data found an increase in the medical discharges. This project seeks to evaluate the effectiveness of reducing homelessness by preventing hospital discharge from medical wards to “no-fixed address” by establishing housing and income supports, as well as access to the Ontario Works and housing databases, within hospital medical programs.

The project will use a program-evaluation design to test the effectiveness of a homeless prevention strategy that makes housing and income supports available on-site at hospitals. This strategy has been previously validated in hospital psychiatric departments (i.e., “No Fixed Address v.1”; see Forchuk et al., 2006, 2008 & 2013). Individual and system-level quantitative and qualitative data will be collected from study participants. Data will also come from local hospitals, community supports, and social service providers. A mixed-method program evaluation will allow individual, client and staff to give feedback as well as provide administrative data to look at the impact of the system as a whole.

The “No Fixed Address” (NFA) strategy focuses on supporting housing first initiatives. Canada lacks a coordinated and evidence-based approach to discharge for individuals who are experiencing, or are at-risk of, homelessness. The NFA strategy is an innovative intervention that redesigns and streamlines the delivery of services, with the ultimate aim of breaking the cycle of homelessness by providing individuals with stable housing and financial supports as they leave the hospital.

Final Report - English Version (PDF: 5,951 KB) | Final Report - French Version (PDF: 1,695 KB

 

This project is funded by the Government of Canada's Homelessness Partnering Strategy.

References

Forchuk, C., Godin, M., Hoch, J. S., Kingston-MacClure, S., Jeng, M. S., Puddy, L., Vann, R., & Jensen, E. (2013). Preventing psychiatric discharge to homelessness. Canadian Journal of Community Mental Health, 32(3), 17-28. doi:10.7870/cjcmh-2013-028

Forchuk, C., MacClure, S. K., Van Beers, M., Smith, c., Csiernik, R., Hoch, J., & Jensen, E. (2008). Developing and testing an intervention to prevent homelessness among individuals discharged from psychiatric wards to shelters and ‘no fixed address’. Journal of Psychiatric and Mental Health Nursing, 15(7), 569-575. doi:10.1111/j.1365-2850.2008.01266.x

Forchuk, C., Russel, G., Kingston-MacClure, S., Turner, K., & Dill, S. (2006). From psychiatric ward to the streets and shelters. Journal of Psychiatric and Mental Health Nursing, 13, 301–308. doi:10.1111/j.1365-2850.2006.00954.x

Press

Program that finds housing for homeless patients in hospital gets $223K in federal funding (Global News Radio, September 2018)
‘Brilliant approach’ to homelessness gets federal grant (London Free Press, September 2018)
Western prof’s homelessness prevention project receives federal grant (Western Gazette, September 2018)

Team

Investigators
Cheryl Forchuk Western University & Lawson Health Research Institute
Jeffrey Reiss London Health Sciences Centre
Sandra Northcott St. Joseph's Health Care London, Parkwood Institute Mental Health
Rebecca Vann St. Joseph's Health Care London, Parkwood Institute Mental Health
Christine Babcock Canadian Mental Health Association Middlesex
Charlotte Dingwall The Salvation Army - Centre of Hope
Dan Catunto City of London, Ontario Works
Richard Booth Institute for Clinical Evaluative Sciences
Salimah Shariff Institute for Clinical Evaluative Sciences

Community Partners
Canadian Mental Health Association - Middlesex
City of London, Ontario Works
The Salvation Army - Centre of Hope, Housing Stability Bank

Principal Investigator

Cheryl Forchuk, RN, PhD

The Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery, Parkwood Institute Research;
Distinguished University Professor, Arthur Labatt School of Nursing, Faculty of Health Sciences, Western University;
Assistant Director and Scientist, Lawson Health Research Institute

Mental Health Nursing Research Alliance
Lawson Health Research Institute
Parkwood Institute – Main Building
550 Wellington Road, B3-110C
P.O. Box 5777, STN B
N6A 4V2

Tel: (519) 685-8500, ext. 77034
Email: cforchuk@uwo.ca

Research Coordinator

Anne Peters
Mental Health Nursing Research Alliance
Lawson Health Research Institute
Parkwood Institute – Main Building
550 Wellington Road, B3-110
P.O. Box 5777, STN B
N6A 4V2

Tel: (519) 685-8500, ext. 77096
Email: anne.peters@lhsc.on.ca