Qualitative findings from a Housing First evaluation project for homeless Veterans in Canada

Introduction: This study sought to improve access to safe and affordable housing through a Housing First approach, provide a successful transition from homelessness, and enhance coordination between housing and support services with Veterans experiencing homelessness. Methods: This two-year evaluation project was conducted from May 2012 to June 2014 in four Canadian cities: Toronto, London, Calgary, and Victoria. Housing First principles implemented for this study were peer support and in-home harm reduction to improve housing stability within a range of different housing types. Focus groups with Veterans, housing staff, and stakeholders were completed in July-September 2012 (n = 24), May-June 2013 (n = 24), and January 2014 (n = 39) across all sites. Responses were transcribed and analyzed using an ethnographic thematic approach. Results: The Veterans, housing staff, and stakeholders discussed the project's strengths, including peer support and harm reduction services, as positive and advantageous. Permanent housing, rather than temporary or transitional housing, is preferable to assist with personal stabilization. Areas to be addressed included greater mental health support, peer supporters with military experience, and issues with roommates. Other considerations included having a mental health peer support worker and the addition of an Operational Stress Injury Clinic clinician. Discussion: The housing program implemented provided stable housing and improved access to supports needed to maintain housing stability. Further qualitative research to establish the long-term experiences and needs of Veteran Housing First programs is required. Continued collaboration between Veteran-serving organizations and housing services is crucial for successful homelessness reduction. LAY SUMMARY This two-year study implemented a Housing First approach among homelessness services for Veterans in four cities across Canada (Victoria, Calgary, London, and Toronto). This approach included peer support and harm reduction resources for Veterans. To obtain a detailed evaluation of personal experiences and opinions, focus groups were held with Veterans, housing staff, and stakeholders at three time points during the study: July-September 2012, May-June 2013, and January 2014. Harm reduction and peer support were regarded as positive aspects of this new approach to housing and homelessness. It was suggested that greater mental health support, support from peers with military experience, and issues regarding roommates should be considered in future implementations of housing services for Veterans. It was also noted that to support personal stabilization, permanent housing is preferred over transitional or temporary housing. Future housing programs serving Veterans experiencing homelessness should consider the addition of harm reduction and peer support to further enhance services and help maintain housing stability.