Strengthening Ontario's System of Housing for People with Serious Mental Illness

Abstract

This article describes recent work to support recommendations for improving Ontario's system of housing for people with serious mental illness. This multifaceted project engaged stakeholders in discussions concerning strategies for improving the system based on (a) values that underlie housing programs, (b) evidence of effective housing practices, (c) the current status of the system, and (d) international practices for monitoring community mental health systems. Stakeholders reviewed summaries of the work and discussed implications for improving the provincial system of housing and supports. Recommendations are made for improving the system, focusing on both regional and provincial level actions. Housing is an essential component of an effective community mental health system for people with serious mental illness. Without accessible, good quality housing and support, successful community living and recovery are not possible. Ontario has provided housing dedicated to people with serious mental illness since the onset of deinstitutionalization. Since the 1960s, the system has grown substantially to encompass a variety of forms of housing and to become a cornerstone of the community mental health system. Despite its growth and importance, this housing system faces a number of significant challenges. It remains inadequate for meeting consumer demand, with very long waiting lists reported by most programs in the province. There is a lack of good data on the system, documenting who is being served and how they are being served, as well as on the needs of those who cannot access the system. This lack of information makes it difficult to effectively manage the system and to plan for its future.In 2003, the Ontario Ministry of Health and Long-Term Care funded a research project to examine the province's dedicated housing system and to make recommendations for improving it. This paper describes the multifaceted project that was conducted to develop a foundation for planning system improvements. The project developed three foundations for system planning: (a) a vision for the system by identifying values that should guide the delivery of services, (b) research evidence about the status of the system and effective practices, and (c) consultations with stakeholders from across the province about directions for system improvement.

Canadian community mental health workers’ perceived priorities for supportive housing services in northern and rural contexts

“…For the last half century, in Canada, consistent calls for strategic investments in community‐based supports for people with mental health problems have met with minimal tangible response (Sylvestre et al . , Mental Health Commission of Canada ). Responsibility for social housing, in particular, has been downloaded to the provinces; and provinces have increasingly delegated administration and maintenance of existing housing stock to municipalities (Nelson ).…”

“…Sylvestre et al . () advocate for local planning that involves the creation of distributed housing and support teams to meet the overall health needs of a local population, consistent with a broader regional plan.…”

Poverty and Serious Mental Illness: Toward Action on a Seemingly Intractable Problem

“…It can lead to access to services and supports that other marginalized people may not have access to. In the Canadian province of Ontario, the location of housing programs within the Ontario Ministry of Housing and Long‐Term Care has led to the implicit identification of housing as a health intervention, and has led this stock of housing to be one of the few social housing stocks that has seen consistent, if still inadequate, growth since the late 1990s (Sylvestre et al., ). The mental illness focus may, however, limit the potential for CMH to address issues such as poverty and basic needs, as it leads to a preponderance of narrow efforts, rather than a broader set of cross‐sectoral efforts to emancipate people from marginalization and poverty.…”

Forging Political Will from a Shared Vision: A Critical Social Justice Agenda Against Neoliberalism and Other Systems of Domination

“…Working together, CP advocates could encourage community members to express their political will as electoral constituents, at social institutions, in community organizations, through neighbourhood grassroots movements, and even as engaged individual citizens, against neoliberal influences and other systems of domination. Some CP advocates have conducted research that has decidedly influenced public policy and provincial legislation concerning social justice issues (Pomeroy, Trainor, & Pape 2002;Sylvestre et al 2007), and this is an option that other advocates and community members could pursue.…”