Finding solutions to end homelessness
CAMH Physician-in-Chief Dr. Vicky Stergiopoulos is also aiming to heighten the role of people with lived experience as CAMH research partners
CAMH’s Dr. Vicky Stergiopoulos is developing and assessing approaches to improve the well-being of some of Canada’s most vulnerable individuals – including people who experience both homelessness and mental health and addictions challenges. She’s leading the evaluation of several interventions aiming to end homelessness or improve access to mental health care and outcomes for disadvantaged groups.
As CAMH Physician-in-Chief, she’s also championing wide-reaching research directions across the hospital, particularly expanding opportunities for people with lived experience to contribute as research partners, and augmenting clinical research by the hospital’s team of health-care professionals. (See below, “Strengthening CAMH research.”)
Dr. Vicky Stergiopoulos
A driving goal in her research is finding solutions – creating and identifying the interventions or models of care that succeed at improving outcomes for people who are homeless or experience complex mental health needs and social disadvantage. In Toronto alone, roughly 5,000 people are homeless on any night, and an estimated 27,000 people use shelters each year.
“My focus has been: How can we design and test solutions together with affected individuals and communities? We know about the problems – we are seeing the problems on the ground in our frontline work as care providers,” says Dr. Stergiopoulos, who is Clinician Scientist at CAMH and at the Centre for Urban Health Solutions in the Li Ka Shing Knowledge Institute at St. Michael’s Hospital. “Although it’s necessary to further define and understand the problems through research, it’s not sufficient – we need to move to what’s next, to finding effective solutions and models of care and support. Once we identify what works, how and for whom, we can maximize the reach and impact of our interventions.”
Investigating models of care
To achieve this, she’s leading the evaluation of Canada’s first Recovery Education Centre for people who are or recently have been homeless, funded by the Canadian Institutes of Health Research. The community-based program, Supporting Transitions and Recovery (STAR), uses principles of adult education and co-production with service users and people with lived experience to support housing stability, social inclusion and recovery outcomes among this population.
She is also co-leading the study of the long-term outcomes of an evidence-based model called Housing First, which provides a place to live as the first step to support people who are homeless and have a mental illness. The model is a departure from the traditional approach of caring for mental health, addiction and other issues first to prepare a person for living in housing.
The current study builds on the Mental Health Commission of Canada-sponsored At Home/Chez Soi research demonstration project that took place in five cities across Canada, with funding from the federal government. Two-year findings of the At Home/Chez Soi study found that “Housing First can rapidly reduce homelessness” and “can improve community functioning and quality of life” for homeless adults with mental illness. The Toronto team, led by Drs. Hwang, O’Campo and Stergiopoulos, is now investigating four-year outcomes of this intervention in Toronto.
In another project, Dr. Stergiopoulos is working with the City of Toronto to evaluate Bridges to Housing, a pilot program offering housing, health and other supports to homeless individuals with intellectual and developmental disabilities. “An eyeopener has been that many people have more severe developmental disabilities than we’d anticipated,” says Dr. Stergiopoulos. “This speaks to how we miss children and youth by not identifying issues and intervening at early stages, while in school, or by not providing continuity of care at every step in their trajectory.”
She is also working with Covenant House, a homeless youth agency, evaluating a peer-focused group intervention for homeless young women who are victims of sexual exploitation or intimate-partner violence. The project is funded by the Public Health Agency of Canada.