What Is The Issue?
The smallest of the five At Home/Chez Soi sites, Moncton presented a unique opportunity to study the issue of mental health and homelessness within the context of a smaller urban centre and its surrounding rural population.
Compared to Canada’s larger cities, Moncton suffers from a lack of mental health services as well as extended waiting lists for people seeking support. Because they have no reliable way to be contacted by health care professionals, staying on these lists can be challenging for people experiencing homelessness, causing them to fall through the cracks of the mental health system. In Moncton’s nearby rural areas, the situation is more problematic: some smaller communities have no available mental health services and many people with mental illness are unable or unwilling to travel into the city to receive the help they need. As a result, many end up in special care homes that are designed primarily for the elderly and not equipped to support those with chronic mental health issues, simply because it’s the only option available.
What Are We Doing?
Working from waiting lists for housing and mental health services, as well as referrals from friends and family, Moncton’s At Home/Chez Soi project recruited nearly 250 participants, all of whom were living with some degree of mental illness. Of these participants, approximately 50 were recruited from the rural communities surrounding Moncton.
Building community partnerships
Implementing a Housing First approach to small-city and rural homelessness required extensive collaboration with government departments, regional health authorities, non-governmental organizations and community partners. These partnerships were essential to connecting At Home/Chez Soi staff to the expertise necessary to navigate the complex and interconnected mental health, housing and social services systems.
For example, by partnering with rural pharmacies, the team could ensure medication was delivered to participants without access to transportation. Another key collaborator was the United Way of Greater Moncton and Southeastern New Brunswick, which provided assistance with the program’s finances, liaised with private-market landlords, supported the Assertive Community Treatment Teams from Horizon Health Network and Réseau de Santé Vitalité and even facilitated the purchase of an apartment building to house participants with complex needs. To better understand homelessness in a small-city and rural area, a team of researchers from the University of Moncton and the University of Ottawa worked with the 250 participants over two years to learn about the participants’ experiences and service use.
Creating a sustainable solution to homelessness
Unique to the Moncton study was its use of a home economist, who taught participants the basic cooking, cleaning and personal care skills needed to live on their own. In the city, participants also actively maintained a vegetable garden—and led by one participant who turned out to be a trained chef, they won a citywide soup competition and cooked Christmas dinner for project participants and staff. Rural participants were paired with local farms, where they learned how to work the land and prepare meals using the food they grew.
Helping people who experienced homelessness find employment
The Moncton At Home/Chez Soi project also focused on supporting participants’ vocational goals, providing access to a full-time vocational support specialist to help them identify and develop employment opportunities. With funding from the Vitalité Health Network, program staff established At Home Services, which hired project participants to provide cleaning, packing and moving services. While the initiative was originally intended to help participants get settled into their new apartments, community partnerships led to additional work for At Home Services employees, including clean-up and maintenance in downtown Moncton.
Learn more about one participant’s work experience.
What We’ve Learned
Providing housing to people living with mental health issues who are homeless can positively affect their recovery and quality of life. Final findings from the Moncton At Home/Chez Soi project show that participants receiving housing supports are more stably housed, require fewer visits to emergency rooms, are less frequently incarcerated and spend less time in shelters than participants who do not receive such supports.
The Moncton At Home/Chez Soi project has also proven that smaller cities and rural communities can create the capacity necessary to adequately serve people who are homeless living with mental illness. As a part of its mental health strategy, New Brunswick is now actively pursuing wider implementation of the Housing First approach based on the At Home/Chez Soi experience.