This feasibility study suggests that a Social Impact Bond (SIB) could be used to fund a Housing First (HF) intervention that aims to improve the lives of homeless individuals with mental illness.
Homelessness is a major issue in Canada, affecting 200,000 people every year and costing $7 billion to the economy. The prevalence of mental illness within the homeless population is higher than in the general population: 50% of homeless individuals have some form of mental illness, compared to 20% of Canadians. Homelessness and mental illness are closely linked and around 120,000 Canadians are simultaneously affected by both conditions. If we include people who are vulnerably housed (unstable, poor quality housing, couch surfing) as many as 520,000 Canadians lack safe, affordable and supportive housing.
Encouraging developments in addressing the homeless population have taken place in Canada over recent years. Nevertheless, many of the available responses to homelessness remain focused on emergency services and crisis management, which lack attention to preventative measures and breaking the negative cycle. HF is a model that has demonstrated positive housing stability outcomes by providing immediate access to housing coupled with wraparound support services.
The At Home/Chez Soi (AHCS) pilot is an evidenced-based HF intervention holding promise to significantly improve the lives of homeless individuals with mental illness. Backed by the largest randomized controlled trial for an HF intervention, the rich data and related research from the AHCS pilot has allowed us to confidently assess the costs
and projected outcomes for the program.
AHCS data reveals that HF results in public sector cost offsets, specifically from a reduction in public sector usage across the shelter, health and justice systems. For members of the population who are high users of public services, HF results in substantial net cost savings.
Funding broader implementation of HF using a SIB would share the implementation risk associated with replication, scaling and modification from governments with investors, and would establish a rigorous performance measurement framework focused on outcomes.