Homelessness in London is a complex issue, often impacted by addiction, mental health and poverty. Since 2008, the London Community Addiction Response Strategy (London CAReS) has been striving to serve individuals facing these multifaceted needs. And now, as that five-year strategy draws to a close, Western professor Cheryl Forchuk will take a closer look at what impact CAReS has had on the homeless and what changes need to be made.
To fund the study, associate director of Nursing Research at Western’s Arthur Labatt Family School of Nursing received $70,000 from Human Resources and Skills Development Canada. The funding was announced last week at the London CAReS downtown office.
“It is very important that when communities develop innovative approaches to address homelessness, that these approaches are rigorously evaluated,” said Forchuk, assistant director at Lawson Health Research Institute and lead researcher on the project.
Her team will compare outcomes for 200 homeless people before and after they accessed services, including quality of life, health status, health and social service usage and housing stability. Those findings will fuel change.
“Every time we do an evaluation, such as this, there are always ways to come up with further refinement and improvement,” she said.
And these changes often come from the client themselves, she added.
“We have to be prepared to be surprised. We can’t go in and say we have the absolute perfect program and we’re going to be closed to what people will say to improve it,” Forchuk said. “We know we’ve got a strong program, but we’re going to be open to hear from the people who have experienced it. What is their perception of what we can do to make the program even better, and, at the same time, have these quantitative measurable things, so that it’s not just do we think it really works, but we have some hard measures as to what some of these outcomes are.”
London CAReS, which is funded by the City of London, is based on the standard four-pillar approach to addiction response: treatment, prevention, justice response and harm reduction. It also includes a new fifth pillar – collaboration and integration – which was designed by engaging clients, service providers and other members of the community. The goal is to provide better outcomes for the individuals participating in London CAReS, and to relieve unnecessary strain on the health, social and criminal justice systems.
Forchuk’s goal is to improve clients’ health outcomes – physical and mental – and establish a set of best practices, so they can create a standard of service that can be implemented in London and beyond.
“Because it is such a broad issue, you want to have a broad evaluation as well,” Forchuk said. “While one outcome we’re looking at is homelessness, we’re also looking at other social services that are being accessed before and after – such as housing services, mental health services, the legal system – so we can really have an understanding what the impact of the strategy actually makes.”
For example, emergency room use among the homeless is four times that of the general public. They are also admitted to hospital more often, and stays are much longer.
“So even small changes in those areas have huge cost implications to our society,” Forchuk said.