| 1 |
Facilitating access to housing |
It is important to situate housing as a basic human right [20], irrespective of health and social service uptake [21]. |
| Initiatives that prioritize access to housing have demonstrated success among those with substance use disorders, veterans [22–24], and PLE from rural settings [25]. |
| 2 |
Providing mental health and addiction care |
A number of interventions have been developed for PLEs with mental illness and addictions [26] in Canada and internationally, including intensive case management [27], assertive community treatment [28], supportive and supported housing [29], housing first [30], critical time interventions [31], and harm reduction services such as managed alcohol programs [32], supervised injection sites and wet shelters [33]. |
| Such interventions are either not widely available or implemented with various degrees of fidelity to the evidence-based models [34]. Screening for mental health, addictions, and associated neurocognitive impairment and other disabilities among PLEs and building greater awareness of the range of supports available is essential to supporting PLEs in finding and keeping housing, addressing their mental health and substance use needs, and achieving community integration [35]. |
| 3 |
Delivering care coordination and case management |
Effective care coordination can bridge various care settings (i.e. inpatient or long-term care), potential participants (i.e. informal caregivers, health specialists), and other resources (i.e. education, community services) to create a unique care pathway tailored for the patient. Facilitating care coordination makes navigating complex health systems manageable for PLEs. |
| 4 |
Facilitating access to adequate income |
Case management programs for PLEs have included the need for obtaining adequate income at the centre of their support plans [36]. It is assumed that adequate income is a prerequisite for improving the health and increasing the likelihood of obtaining housing for PLEs. |
| The role of health providers in addressing income insecurity is increasingly recognized. Both the Canadian Medical Association and the College of Family Physicians of Canada have produced guidance documents for physicians on addressing income and other social determinants of health [37,38]. |
| Income intervention programs have been co-located with health care programs in the United Kingdom [39] and the United States [40] |
| Population |
Importance |
| 1 |
Indigenous people |
Indigenous people experience multiple risk factors for becoming homeless or vulnerably housed, such as low education level, insecure employment, and poor health [41]. Their distinct experience of being indigenous within a colonized country puts them at a structural and systematic disadvantage and at a significantly higher risk of homelessness or vulnerable housing [42]. |
| 2 |
Youth |
Youth who are PLEs have unique health needs as they experience high rates of substance use [43,44], frequent histories of exposure to domestic violence [45], and often resort to sex work to meet their basic needs once removed from the family setting [46]. |
| 3 |
Women, families, children |
Women, families, and children tend to be underrepresented among official homeless counts as they are more likely to be experiencing hidden homelessness and precarious housing compared to single men [47]. Women also have different paths into homelessness or vulnerable housing and suffer different sequelae than men [48]. |
| 4 |
People with acquired brain injury, intellectual, or physical disabilities |
Disability can lead to homelessness or vulnerable housing, as it is often accompanied by loss of income, social supports, and adequate housing [49]. |
