1. Homelessness Prevention Initiative – Mainstay Housing Presented by Parvin Merchant and Math Radfar Addictions and Mental Health Ontario Conference – May 2016

2. Homeless and vulnerably housed people have much higher rates of mortality than the general population. Hwang SW, et al. BMJ. 2009;339:b4036.

3. “ ” Homeless and vulnerably housed people are far less likely to survive to age 75 than the general population Hwang SW, et al. BMJ. 2009;339:b4036.

4. VISION STATEMENT “With stable housing as a foundation, everyone belongs – and has a bridge to a better life ”. Since 1982, developer of “housing plus supports” approaches to meet the needs of consumers of mental health and/or addiction system who are homeless.

5. MISSION STATEMENT Mainstay Housing works with people living with mental health and addiction issues who are deeply affected by poverty and provides them with housing, ongoing support and greater opportunity to be part of a community.

6. ABOUT MAINSTAY HOUSING  Developed 19 properties for others 41 properties for ourselves – 867 units: 1,000 tenants – singles, couples and families Built form: 21 apartment buildings, 18 houses (shared), 2 boarding homes, 5 condos; from bedroom to bachelor to 4 bedroom unit types.  We provide mental health housing and support through a landlord role.  Partnership Agreement 22 Support Service Agreement agencies (clinical support services)

7. Responding to the Needs of ‘Homelessness’ 2008- 2009: Program -10 units, First Tenant moved in May 1 st 2008. 2009- 2010 Program -20 units, 100% increase in funding 2014- 2015 Program – 30 units  Increased funding The purpose of the initiative is to address gaps across the continuum of care for homeless people living with mental health and complex addiction issues, high users of emergency services. Since 2008, Mainstay Housing have worked with City of Toronto in partnership to provide permanent housing and support homeless population in the program.

8. Chronically Homeless People Bring Extraordinary Complexity Substance Use Chronic Health Issues Homeless Justice Social Isolation Trauma Mental Health Stigma Poverty Tenant Race Race Sexual Orientation Gender Ethnicity The interplay of challenges, internalized stigma, experiences of discrimination, affects the new tenant’s ability and confidence to succeed as a tenant.

9. No Fixed Address4 Street/Shelter64 Psychiatric Hospital2 Rooming/Boarding House2 Supportive Housing1 Couch Surfing2 Private Market3 Total78

10. Our Housing and Support Strategies Approach This model, which includes Housing First, Trauma informed, Harm Reduction, and creates strengths based approaches, has proven to be successful in the following  Increase housing stability  Improve quality of life and outcomes  Reduce reliance in high cost medical services Staff Involved in our sites: 3 Full time Supportive Housing Workers 1 Peer Support Worker Choice Recovery Harm Reduction Rights Based Trauma Informed

11. Flexible, Client/Tenant Centered Service Delivery Approach  Permanent housing  Flexible place based support  Step up: intense support  step down: connected to Mainstay /SHW and external case worker This program is based on a modified Housing First approach and offers housing for people living on streets. Our approach increases successful tenancies by fostering self, direction, personal responsibility and community capacity as it relates to housing individuals living with complex health issues.

13. Community Development Activities

14. What is “Eviction and Prevention Recovery”? Leveraging the ability of tenants to make choices about their housing by providing them with tools and skills to meaningfully participate in all aspects of their tenancy as they move through their journey of recovery.

15. 2015 -2016 Total 37 tenants in the program  13 tenants received eviction notice  1 abandonment  2 files are in process  3 Voluntary move out ( restraining order )  None of them were evicted Eviction Prevention

16. Measurable Outcomes Improved Housing Stability and Healthy Community 78total of tenants are housed (since 2008)  83% are housed for more than one year.  82% Currently housed tenant within the last year  85% reduction in social isolation  77% participation in our programs and activities  13% have volunteered /leadership role in the community

17. A tenant member experience  L had a long history of homelessness 13+ years moving  L moved in 2009  Involved in the justice system –drug abuse, trafficking, panhandling and sex trade  L is part of a community, connected and has primary care  L made friendship in the building, attends all programs and activities in the building

18. Unique Individual S2HProgramme and SROI

19.  Mainstay Housing 550 Queen Street East, Suite 150 Toronto, ON M5A 1V2 info@mainstayhousing.ca info@mainstayhousing.ca  hash #AMHO2016 @AMHOnt Contact Information