People experiencing homelessness and using mental health services describe what helps (and what doesn’t)

Unhelpful Help and Its Discontents: Peer Researchers Paying Attention to Street Life Narratives to Inform Social Work Policy and Practice. Voronka J, Wise Harris D, Grant J, Komaroff J, Boyle D and Kennedy A. Social Work in Mental Health, 12:3, 248-279. 2014.

Issue: People experiencing homelessness and using mental health services often experience a disconnect between the programs, supports and approaches on offer and their self-identified needs.

What we did: Researchers with lived experience of homelessness and/or mental health problems from organizations including the Mental Health Commission of Canada and the Centre for Research on Inner City Health analyzed 30 interviews with people experiencing both homelessness and mental health problems in Moncton, Montreal, Toronto, Winnipeg and Vancouver.

Findings: While people were often obliged to claim an identity related to mental illness in order to receive certain types of service, they did not always identify mental health problems as their primary challenge. Instead, people talked about facing ‘an assemblage of discrimination, trauma and oppression.’ They also talked about the challenges of living in poverty. People described frequent disconnects between what they were looking for (housing, money, work, a phone, someone to talk to) and what they received (a psychiatric label, experiences of stigma, professional distance). Recommendations for service provision include offering:

Practical assistance like housing, financial assistance, phone, internet access, help finding employment and connections to social supports.

Flexible, individualized services with a balance of medical, social, practical and cultural supports.

Services that respond to people’s realities including evening/night hours, TTC tokens and/or mobile services.

Access to talk therapy and peer groups including ongoing supports. ‘I wish that group was still there because then, you don’t have to be like, “Oh – I should be over this by now.”’

Providers who relate to people as human beings, are compassionate and are able to ‘throw out the textbook’ when appropriate.

Providers who ‘really get it’ due to personal experience with mental health problems, homelessness and/or ‘interlocking oppressions: such as those of race, class, gender, sexual, national and/or cultural identity.’

* The interviews were conducted in 2010 as part of “At Home/Chez Soi” a randomized controlled trial of ‘Housing First,’ a program offering housing and supports to people experiencing homelessness and mental health problems. The interviews were conducted at the beginning of the trial, and do not reflect people’s experiences with the Housing First intervention.

Contact: Jijian Voronka, OISE/University of Toronto,