Abstract
BackgroundThe literature on interventions addressing the intersection of homelessness, mental illness and race is scant. The At Home/Chez Soi research demonstration project is a pragmatic field trial investigating a Housing First intervention for homeless individuals with mental illness in five cities across Canada. A unique focus at the Toronto site has been the development and implementation of a Housing First Ethno-Racial Intensive Case Management (HF ER-ICM) arm of the trial serving 100 homeless individuals with mental illness from ethno-racial groups. The HF ER-ICM program combines the Housing First approach with an anti-racism/anti-oppression framework of practice. This paper presents the findings of an early implementation and fidelity evaluation of the HF ER-ICM program, supplemented by participant narrative interviews to inform our understanding of the HF ER-ICM program theory.MethodsDescriptive statistics are used to describe HF ER-ICM participant characteristics. Focus group interviews, key informant interviews and fidelity assessments were conducted between November 2010 and January 2011, as part of the program implementation evaluation. In-depth qualitative interviews with HF ER-ICM participants and control group members were conducted between March 2010 and June 2011. All qualitative data were analysed using grounded theory methodology.ResultsThe target population had complex health and social service needs. The HF ER-ICM program enjoyed a high degree of fidelity to principles of both anti-racism/anti-oppression practice and Housing First and comprehensively addressed the housing, health and sociocultural needs of participants. Program providers reported congruence of these philosophies of practice, and program participants valued the program and its components.ConclusionsAdapting Housing First with anti-racism/anti-oppression principles offers a promising approach to serving the diverse needs of homeless people from ethno-racial groups and strengthening the service systems developed to support them. The use of fidelity and implementation evaluations can be helpful in supporting successful adaptations of programs and services.Trial registrationCurrent Controlled Trials ISRCTN42520374
Highlights
The literature on interventions addressing the intersection of homelessness, mental illness and race is scant
This paper presents the findings of an early implementation and fidelity evaluation of a novel Housing First Ethno-Racial Intensive Case Management (HF ER-ICM) model, designed to meet the needs of homeless people with mental illness from ethno-racial groups
204 participants were eligible for the HF ER-ICM program, of which 102 were randomized to the intervention, while the remaining 102 were randomized to the control group
Summary
The literature on interventions addressing the intersection of homelessness, mental illness and race is scant. The At Home/Chez Soi research demonstration project is a pragmatic field trial investigating a Housing First intervention for homeless individuals with mental illness in five cities across Canada. A unique focus at the Toronto site has been the development and implementation of a Housing First Ethno-Racial Intensive Case Management (HF ER-ICM) arm of the trial serving 100 homeless individuals with mental illness from ethno-racial groups. The 2006 Canada census reports that half (47%) of Toronto residents are ethno-racial (see definition in Table 1 [3,4]) and the population is comprised of more than 200 distinct ethnic ancestries [5]. Among the Toronto homeless population, a recent study of shelter or meal program users reported that almost half (45%) identified as belonging to a non-White ethnic group, most commonly Black (22%), and Aboriginal (9%) [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
