NFB short web docs capture results of Canada’s At Home/Chez Soi study

TORONTO – Toronto nurse and case manager Bouchra Arbach visits the apartment of a frail and aging man who, after being homeless for some 30 years, is trying to adjust to his new life indoors.

He knows his health will further suffer if he returns to the streets, which he’s vowed never to do again, but he can’t help but long for a life where he felt in control.

“I’d rather be back on the street because I understand the street better than living indoors,” the man, identified only as James, tells Arbach after confessing he can’t figure out how to work the oven in his recently acquired place.

The poignant scene is from one of 50 compelling short documentaries the National Film Board of Canada is posting on its website between now and summer 2013 under its “Here at Home” bilingual series.

The docs chronicle the results of At Home/Chez Soi, a Canada-wide research project led by the Mental Health Commission of Canada, which aims to provide housing to those who are mentally ill and homeless before they begin treatment. The idea is that once participants have a place to live, they can then focus on other personal goals.

The study — taking place in Vancouver, Winnipeg, Toronto, Montreal and Moncton — contrasts the traditional treatment-first approach that some experts say doesn’t work. It’s based on the Housing First model that originated from the U.S.-based Pathways to Housing program and has had positive results in cities including New York, Philadelphia and Washington.

Participants hail from a wide range of backgrounds and are able to choose where they want to live and which goals they want to accomplish.

In Canada, more than 70 per cent of the people who have been housed through the project have stayed in the first apartment that they’ve selected, said Faye More, site co-ordinator on At Home/Chez Soi in Toronto.

“Often at the beginning, people just couldn’t believe when they went to look at an apartment that this really could be their home. It was very profound,” she says.

“In some cases people were anxious and very easy to find and wanted apartments right away, and everyone was off to the races right from Day 1. In other cases, because this has been the lifestyle, there’s fear and concern: ‘Is this really real?'”

The NFB’s recently launched “Here at Home” web series has commissioned one filmmaker in each study city to create 10 short docs (each three to four minutes in length) apiece for the website. Study participants featured in the films must not only give their consent to being captured on camera, they also must approve the final product before it’s published.

Manfred Becker, the filmmaker behind the Toronto “Here At Home” docs, says the NFB is “kind of skeptic’s eye in this.”

“This is not a project where you say, ‘Oh, we have to save the poor homeless and do everything we can do to make their lives better.’ This is also a hard look at, what’s the effect on society?” notes Becker, who is also scheduled to direct a feature-length doc on the project next year.

Becker says he joined the project last year because he’s passionate about social issues, had worked with the NFB before and has lost friends to suicide.

He also recently watched a family member struggle with mental health issues.

“I realized that we were able to get through it and we were able to go through it because of the strong family support … and the people I see on the street often don’t have anybody,” says the German-born director, who’s explored mental health issues with his 2003 film “Life of Me” and as aprogrammer of the Rendezvous with Madness film festival.

According to the MHCC, there is an estimated range of 150,000 to 300,000 homeless people across Canada, many of whom live with a mental illness. And the cost of looking after people who are homeless with mental health problems is $1.4 billion a year in Canada. That price tag includes shelter systems and emergency services.

In 2008, the Canadian government granted the Mental Health Commission $110 million to carry out the Housing First approach across the country. About 1,250 participants are currently in the project, which also includes a comparison “treatment as usual” control group of people who have mental health issues but live on the street.

Different types of homes are offered, including private and social-housing units. Those who leave the homes — either due to voluntary leave, eviction or other reasons — still receive support through the study.

“I’ve met remarkable people,” says Becker, who calls Arbach “a true heroine” and “an angel without wings.”

“I went to landlords, a woman who is an administrator for a big apartment block in the west end, and I said, ‘Why would you welcome potential trouble? You have 300 units, there are all kinds of people there,’ and she said, ‘You know what? I was homeless once, I know what it’s like.’

“And that line that we’ve all heard about: ‘You’re two paycheques away from hitting the street’? Well, that’s true for many people, and some of them come through and they say, ‘I’ve been there, I know what it’s like.’

“So what Chez Soi/At Home gives is an expression of compassion in a very concrete sense.”

The research initiative ends on March 31, 2013, with findings slated for release later that year.

Preliminary project results are “very, very positive around the outcomes for the participants,” says More, noting many who receive housing then express interest in achieving new goals such as reconnecting with family, getting education or volunteering.

“When you sit and listen to participants talk about the difference the project has made, there’s a great deal of emphasis on the safety that they’ve felt once they had a door —that they could lock a door and they could actually sleep in a sound sleep.”

“When you think about how profound it is to not have that ability, night after night, to never be rested and to be, for many of them, in chronic pain,” continues More. “We found the majority of people who came into the Toronto site project had an untreated medical condition, and the majority also were experiencing daily pain that was not being dealt with.

“So you hear at a very fundamental level the difference it made to have a door that they could close and they could be alone.”

Becker says everything he’s observed also suggests the study is working.

“One day we went out and tried to find people in the control group to interview for research interviews and we spent all day pounding the pavement and knocking this door and that and we couldn’t find a single person. We went to this shelter and that shelter and had lists of people and they said, ‘Yeah, no, we haven’t seen them, just disappeared, nobody knows.’

“And then we interviewed somebody who has been housed and it was an hour-long visit and the person has improved their condition very clearly. So that’s kind of living proof that the project is working.”

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