Introduction

In the time since NFA v.1 was established and became part of usual care, several system-level changes occurred. All of the hospital psychiatric units in the city were geographically re-located, the Ontario Works (OW) and the Ontraio Disablity Program (ODSP) community start-up intervention was cancelled and replaced by a local housing-stability intervention administered through the Salvation Army Centre of Hope, the software used by OW changed, and Canadian Mental Health Association (CMHA) amalgamated with other services and underwent significant organizational changes.

Due to these changes in context, a second version of the program, NFA v.2, was designed.

This revised intervention re-established Housing Stability Workers (HSW) from CMHA, caseworkers from OW, and Housing Stability Bank workers from the Salvation Army Centre of Hope within hospital psychiatric units in London.

Later on the project expanded to the medical wards and the improved version of the program, NFA v.2x, came out.

In order to access the other studies done by Forchuk and colleagues related to this topic please use the links below:

General Page
NFAv2
NFA-Y
H2I

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

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.

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

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