Making Supportive Housing Work for Those with Highest Needs

The Challenge

Canada is facing related housing affordability and homelessness crises. Having created the crises through the cessation of new social housing development in the 1980s, more recently through the National Housing Strategy there is a renewed focus on increasing affordable housing stock. While affordability is a key factor, it isn’t the only one. For many exiting homelessness or leaving other public services (hospital, incarceration, child welfare) supports are required to sustain successful tenancies.

Unfortunately, while dedicated streams exist for new affordable housing, to attach supports to this housing is far less straight-forward. Instead, an over-stretched mish-mash of health and social services are leveraged to either provide supports outside the home environment, or more rarely within the housing environment. Because of this, exits into successful housing for Canada’s most vulnerable persons remain a significant challenge.

The idea of the need for supports in-home is not novel. Indeed, this is a core element of successful Housing First and mental health services over the last several years (for Housing First) and decades (for mental health care). However, beyond metrics of how supports improve health and social outcomes, several questions remain:

  1. How are organizations making supportive housing work when dedicated funding streams for this model are absent?
  2. What do in-home supports mean for those exiting homelessness and living in supportive facilities?
  3. How do supportive housing services fit within the broader network of services?
  4. How do supportive housing buildings and their residents integrate (or not) in their local community.

The Partnership

This project represents a partnership between the housing provider, Indwell, and researchers from the Centre for Research in Health Equity and Social Inclusion (CRHESI) at the Faculty of Health Sciences, Western University. Indwell represents a ‘positive deviant’ in the supportive housing space. That is, they are making new supportive housing happen in a funding environment where this is particularly rare. This partnership allows for the research team to look beneath the service to understand both how these services are being delivered as well as their impact at the individual, service sector, and community level.

The Funding

This Project entitled “Making Permanent Supportive Housing Work for Vulnerable Populations” received funding from the National Housing Strategy under the NHS Research Grants stream, however, the views expressed are the personal views of the author and CMHC accept no responsibility for them.

Ce projet “Making Permanent Supportive Housing Work for Vulnerable Populations” a reçu du financement de la Stratégie nationale sur le logement. Cependant, les opinions exprimées sont les opinions personnelles de l’auteur et la SCHL n’accepte aucune responsabilité à l’égard de telles opinions.

The Process

The project is being delivered in 3 phases. The first phase, completed through mid-2020 to May 2021 was to understand the experiences of residents in accessing supportive housing through Indwell’s Woodfield Gate site in London, Ontario. Interviews with 20 residents were analyzed to understand what is making supportive housing work, or not, for them? We also used the opportunity to explore how the COVID-19 pandemic was impacting residents.

The report from this phase is available here:

https://www.abeoudshoorn.com/wp-content/uploads/2021/05/Indwell-Interim-Report-NHS-Research-May-12-2021.pdf

A presentation of preliminary findings is available here:

https://www.abeoudshoorn.com/wp-content/uploads/2021/05/Indwell-Project-Mar-9-2021-preliminary-findings.pdf

At this point, we are preparing for phase 2 and phase 3 when pandemic restrictions ease. Phase 2 will explore how the supportive housing service integrates in the broader community, and how residents integrate in the community. Phase 3 will use videographer to develop narratives of accessing and living in supportive housing among interested residents.

What We Have Learned so Far

In our analysis of interviews with residents, findings coalesce around three interrelated themes:

  1. Available and timely supports;
  2. Affordability; and
  3. Community, but with independence as desired.

In terms of available and timely supports, having on-site staff and services was a vital element to making housing work for those with high support needs. Indwell’s services were distinguished by residents from other past housing experiences where supports were only available from external agencies, usually only during business hours, and led to frequent use of emergency services instead.

In terms of affordability, there is a noted difference between what is deemed by the federal and provincial governments as new affordable units (such as 80% of average market rents), and the true affordability needs of those on social assistance incomes. While still consuming the majority of tenant’s social assistance incomes, rents were at least within reach and residents did not have to fear raises to rents that would go beyond their ability to pay. Residents appreciated that this affordability did not come at the cost of quality of housing.

In terms of community, residents were pleased with the opportunity to build relationships both with staff and with neighbours and to do so to the extent they personally wished. While the pandemic limited opportunities for socialization and recreation, residents still noted the value of having someone to talk to when they needed, whether it be staff or neighbours. The intentionality around building community that is core to Indwell’s model was clearly paying dividends even within the restricted pandemic context.

In spite of these benefits, residents at indwell also faced some struggles. Challenges faced by residents relate to: 1) a lack of conflict resolution skills, 2) residual effects of institutionalization coupled with the inability of staff to be readily available for less urgent issues, and 3) rent-that while subsidized- still consumes more than 50% of income. The pandemic served as a sort of “pressure cooker”, accentuating each of these challenges.

Recommendations to Date

From phase 1, we have the following recommendations:

Contact Us:

We would be grateful for your feedback on this project or to provide further information. Please contact us at:

Abe Oudshoorn – Principal Investigator – Assistant Professor, Arthur Labatt Family School of Nursing, Western University, aoudshoo@gmail.com, 519-854-2085

Our full project team:

Steven Rolfe, Carrie Anne Marshall, Miranda Crockett, Susana Caxaj, Natasha Thuemler, Jason Gilliland, Sarah McLean, Vanisa Ezukuse, Amy Van Berkum, Yinka Ariba, Deanna Befus