We all have stories. Many of our stories are deeply personal. Some of our stories are painful, traumatic, hilarious, heroic, bold, banal. Our stories connect usthey reflect who we are and how we relate to one another. Stories are extremely powerful and have the potential to bring us together, to shed light on the injustice committed against us and they lead us to understand that not one of us is alone in this world. But our stories are also a commodity-they help others sell their products, their programs, their services-and sometimes they mine our stories for the details that serve their interests best-and in doing so present us as less than whole. -Becky McFarlane, Recovering Our Stories event,

This qualitative study examined how homeless individuals with mental illness experience pathways into homelessness. Study participants were enrolled in the At Home/Chez Soi project, a Pan-Canadian Randomized Controlled Trial comparing the Housing First approach with Treatment as Usual for homeless individuals. This inquiry is grounded in social ecological perspective, which considers interactions between individual and structural factors. Findings from consumer narrative interviews ( n = 219) revealed that individual factors, such as substance abuse, relationship conflicts and mental health issues significantly contributed to homelessness, in addition to structural transitions from foster care and institutional settings into the community. Additional structural factors entrenched participants in unsafe communities, created obstacles to exiting homelessness and amplified individual risk factors. The study findings confirm the role of individual risk factors in pathways into homelessness, but underscore the need for policies and interventions to address structural factors that worsen individual risks and create barriers to exiting homelessness.

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Housing quality (HQ) is associated with mental health, and may mediate outcomes in housing interventions. However, studies of housing interventions rarely report HQ. The purpose of this study was to describe HQ in a multi-site randomized controlled trial of Housing First (HF) in five Canadian cities and to examine possible differences by treatment group (HF recipients and treatment-as-usual (TAU) participants who were able to find housing through other programs or on their own). We also examined the association between HQ and the primary trial outcome: housing stability. The performance of a new multi-dimensional standardized observer-rated housing quality scale (the OHQS) in a relatively large cross-site sample was also of interest. HQ was rated by trained research assistants for 204 HF participants and 228 TAU participants using the OHQS. General linear regression models were used to examine unit/building quality scores by group and site adjusting for other group differences, and as a predictor of housing stability outcomes after 24 months of follow-up. The OHQS was found to have good reliability and validity, but because most of the neighborhood subscale items were negatively correlated with the overall scale, only unit and building items were included in the total HQ score (possible scores ranging from 13.5 to 135). Unit/building HQ was significantly better for the HF group overall (91.2 (95 % CI = 89.6-92.9) vs. 88.3 (95 % CI = 86.1-90.5); p = .036), and in one site. HQ in the TAU group was much more variable than the HF group overall (W (mean) = 24.7; p G .001) and in four of five sites. Unit/building HQ scores were positively associated with housing stability: 682CI 91.4-94.9)) for those housed all of the time (F = 43.9 p G .001). This association held after adjusting for site, housing characteristics, participant ethnocultural status, community functioning, and social support. This study demonstrates that HQ can be as good or better, and less variable, in HF programs in Canada that systematically and predominantly source housing stock from the private sector compared to housing procured outside of an HF program. HQ is also an important predictor of housing stability outcomes.

Mental health lived experience narratives are first-person accounts of people with experience of mental health problems. They have been published in journals, books and online, and used in healthcare interventions and anti-stigma campaigns. There are concerns about their potential misuse. A four-language systematic review was conducted of published literature characterizing uses and misuses of mental health lived experience narratives within healthcare and community settings. 6531 documents in four languages (English, Danish, Swedish, Norwegian) were screened and 78 documents from 11 countries were included. Twenty-seven uses were identified in five categories: political, societal, community, service level and individual. Eleven misuses were found, categorized as relating to the narrative (narratives may be co-opted, narratives may be used against the author, narratives may be used for different purpose than authorial intent, narratives may be reinterpreted by others, narratives may become patient porn, narratives may lack diversity), relating to the narrator (narrator may be subject to unethical editing practises, narrator may be subject to coercion, narrator may be harmed) and relating to the audience (audience may be triggered, audience may misunderstand). Four open questions were identified: does including a researcher’s personal mental health narrative reduce the credibility of their research?: should the confidentiality of narrators be protected?; who should profit from narratives?; how reliable are narratives as evidence?)

Medical discourse currently dominates as the defining framework for madness in educational praxis. Consequently, ideas rooted in a mental health/illness binary abound in higher learning, both as curriculum content and through institutional procedures that reinforce structures of normalcy. While madness then, is included in university spaces, this inclusion proceeds in ways that continue to pathologize madness and disenfranchise mad people. This paper offers Mad Studies as an alternative entry point for engaging with madness in higher education, arguing centring madness in pedagogical praxis has the potential to interrupt hegemonic ways of knowing, being, and learning. We illustrate how this disruption is facilitated by examining particular aspects of pedagogical praxis mobilized in Mad Studies, including building curriculum alongside mad community, centring madness in course design and student assessment, and the deployment of mad positivity. Ultimately, this approach provides a metacurriculum of unlearning, challenging students to consider how their engagement with madness in the classroom, and beyond, has the potential to disrupt sanist systems of oppression and the normalcy they reconstitute. Mental health/illness discourse currently runs rampant in higher education. Universities are declaring a 'mental health crisis' on campus (Hawkes, 2019; Reid, 2013) and policy, access, and accommodation strategies rest on tactics that respond with notions of risk and liability. At the same time, critical scholars continue to build on a long line of inquiry refuting the mental health/illness binary, and the responses it develops and valourizes (Fernando, 2017; Foucault, 2006; Mills, 2014; Parker, 2014). Yet scholarship resistant to biomedical epistemes is rarely engaged in undergraduate curriculum, and university administrations remain reticent to engage disability justice approaches to distress. Indeed, through this cumulative collective disengagement, students easily pass through programs of study without encountering alternative ways of knowing. Enter Mad Studies.