The Centre for Research on Inner City Health is a scientific pillar of St. Michael’s Hospital.
Scientists in Centre for Research on Inner City Health identify which problems are most pressing for vulnerable, urban populations—such as those who are homeless or under-housed, are suffering from mental illness, or are HIV-positive—and then conduct high-impact, evidence-based research studies, seeking solutions that will advance systems of health care for these disadvantaged patients.
A prime example of Centre for Research on Inner City Health’s impact for some of Canada’s most vulnerable citizens is the At Home/Chez Soi project, led by Drs. Stephen Hwang and Vicky Stergiopoulos.
In 2008, the Government of Canada allocated $110 million to the Mental Health Commission of Canada to undertake a research demonstration project on mental health and homelessness. The result was At Home/Chez Soi, a four-year project in five cities that aimed to provide practical, meaningful support to Canadians experiencing homelessness and mental health problems.
At Home/Chez Soi was a massive Canadian study spanning Vancouver, Winnipeg, Toronto, Montreal and Moncton. Researchers followed more than 2,200 Canadians who were homeless and living with mental health issues.
Safe, quality housing was provided to about half the participants in the randomized trial. These individuals also received specialized support services to help better focus on recovery. This combination of housing and intensive support is known as Housing First.
Dr. Vicky Stergiopoulos and Dr. Stephen Hwang co-lead the At Home/Chez Soi study which determined the best way to treat homelessness and mental health issues for Canadians.
The remaining half of participants used the pre-existing services available in their cities and was not given additional support for housing.
“Housing First is an idea based on common sense,” said Dr. Stergiopoulos, who is a Centre for Research on Inner City Health scientist and the Psychiatrist-in-Chief of St. Michael’s Hospital. “It’s much easier to manage a mental health problem when you have a stable place to live.”
On April 8, 2014, five years after the study began, the Mental Health Commission of Canada released its final report.
The largest study of its kind, At Home/Chez Soi provided strong evidence that Housing First is an effective way to reduce homelessness and treat mental health issues. The project also showed that Housing First is a sound financial investment that can lead to significant cost savings.
“We showed that every $10 spent, led to an average government savings of $21.72 when it was invested in the participants who were the highest users of emergency and social services,” said Dr. Hwang, director of Centre for Research on Inner City Health and a St. Michael’s internist.
“Through this research project, Centre for Research on Inner City Health showed Canada that the right thing to do can also be the best thing to do.”
Because of this Centre for Research on Inner City Health-led research, the Canadian government’s $600-million Homelessness Partnering Strategy shifted to a Housing First approach. The project has also been extended and funded for another five years.
At Home/Chez Soi is but one example of the impact made by Centre for Research on Inner City Health scientists. The Centre develops and tests solutions to address the needs of urban populations in Canada and beyond our borders.
The Sisters of St. Joseph established St. Michael’s in 1982 to care for the sick and poor. With a focus on vulnerable, the Centre for Research on Inner City Health embodies values of St. Michael’s and reflects the hospital’s continued commitment to its 123-year-old mission of serving the disadvantaged.
Learn more about the Centre for Research on Inner City Health program