“The mental health of individuals is affected by many factors including where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family. It is widely recognized that positive mental health is a cornerstone of our overall well-being.”

-- Canadian Mental Health Association, Citizens for Mental Health Backgrounder, April 2003

• What we're doing

• Mental Health Framework Goals

• Mental Health and Homelessness

• Mental Health and Seniors
  

Toronto Community Housing is committed to social inclusion and building healthy and safe communities for everyone.  Promoting and addressing issues of mental health is a responsibility of not only all levels of government, but all levels of society as equal stakeholders with a shared vision of building healthy societies. As such, Toronto Community Housing is committed to ensuring that all levels of government continue to realize their role in funding and the delivery of mental health services.

What we’re doing…  

Toronto Community Housing is developing a Mental Health Framework, a key initiative outlined in the Community Management Plan (CMP) that involves reviewing our existing systems and then implementing improvements in a variety of areas.  It will also include a monitoring and evaluation system to ensure that we are meeting our goals as outlined in the framework.

The Mental Health Framework will support Toronto Community Housing’s mandate as a social housing landlord in:

1. accommodating people with chronic mental health illnesses and addictions
2. promoting successful tenancies
3. fostering an environment that supports recovery and health

This Framework will be used as a platform in developing community-based strategies that recognize Toronto Community Housing’s role as the largest housing provider in Canada whose communities include people living with mental illness or drug usage.  It will provide recommendations to assist in leveraging it’s many assets (such as tenants, units, common space); role clarity for staff in respect to assessment and interventions; and ensure both tenants and staff have a greater understanding and capacity to respond to critical issues that impact the health of tenants in our communities.

Mental Health Framework Goals:

• Pilot two mental health projects to test practical skills required to achieve the development of a successful Framework
• Complete an external scan that will provide recommendations on best practices
• Put into place a diverse Advisory Committee that will guide the development of an implementation plan for the Framework
• Identify training and skills building opportunities for staff and tenant leaders working or living with vulnerable populations
• Identify specific actions, initiatives, networks and linkages required to support tenants living with mental health concerns, including effective response to breaches of the lease related to mental health or substance use
• Create toolkits and protocols that will assist staff and tenants to connect residents in need to mental health service providers and supportive housing providers
• Identify linkages between mental health and other internal strategies and policies (e.g.: Eviction Prevention; Seniors Strategy)
• Identify gaps and linkages between mental health and other external strategies/policies
• Develop advocacy strategies to address gaps in mental health supports
• Create and integrate relevant and strategic partners to support Toronto Community Housing’s role in the area of mental health

Mental Health Pilot Projects

In order to develop protocols, training programs, partnerships, resources and a mental health policy, Toronto Community Housing has piloted two projects to explore the issues of mental health as they relate to tenants living in a variety of situations.

The areas of focus for the pilot projects were identified through a combination of CMP consultations that took place over the course of 2006, in addition to ongoing formal and informal information collected by staff members.

Two priority situations that significantly impact the health of communities were identified:

1. tenants who have experienced homelessness and have experienced either chronic mental health issues and/or substance usage.
2. seniors who experience mental health concerns (distinct from diminished capacity as a result of aging) who may also experience issues of isolation and are in need of supports.

In Toronto Community Housing’s experience, all of these situations directly compromise broader community health.

To increase our organization’s understanding of these issues, two pilot projects explored the following:

1. Mental health and homelessness;
2. Mental health and senior’s mental health and cognitive impairment (within mix-mandated buildings).

The pilot projects are being evaluated and are being used to identify successful practice, challenges and potential policy and resource implications for the organization.

Findings from these pilots are used to inform the content of all elements of Toronto Community Housing’s Mental Health Framework.

Mental Health and Homelessness Pilot Project

In 2007, Toronto Community Housing Operating Unit Central Sherbourne (formerly known as Operating Unit K, located in the downtown Dundas and Sherbourne neighbourhood), began their pilot by creating a diverse advisory committee that included tenants, front-line staff and agency partners.

In 2008, the advisory committee recommended the establishment of a learning partnership with Houselink Community Homes, a housing provider that only houses residents with chronic mental health issues.  Various workshops and sessions provided opportunities for TCHC managers, staff and tenants to learn about real strategies to better support its residents, many of whom came through local shelters or the City of Toronto’s Streets to Home program.

Houselink used this community-based input to develop recommendations that would advance the work for TCHC in supporting residents with special mental health and substance use needs, and inform the TCHC-wide Mental Health Framework.

THE RECOMMENDATIONS

1. Create an environment that supports recovery
2. Strengthen the community in each building
3. Create many opportunities for tenant involvement
4. Train (and pay) peer support workers
5. Organize joint staff-tenant training opportunities
6. Seek out new partners to provide support services
7. Create a healthy workplace
8. Review corporate policies and practices
9. Continue this pilot

Further resources created or used during this pilot project can be found through www.torontohousing.ca.

Mental Health and Seniors Pilot Project

COMPARITIVE ANALYSIS

Four buildings in Toronto Community Operating Unit Scarborough Southwest (known as Operating Unit I, located in the Danforth and Warden area) were involved in a comparative analysis in 2007, which included reviewing calls to the community safety unit, turn-over rates, and anecdotal stories by staff and residents. 

Three of these buildings are mix-mandated buildings with a large proportion of seniors (approximately 40 per cent) and one is a seniors-mandated building.  These buildings are comprised primarily of bachelor units, with some one-bedroom units.  

The result of this analysis was to host the seniors pilot project in a building that is currently mix-mandated.  Many mix mandated buildings were formerly seniors-only building that needed to expand the mandate to ensure low vacancy loss.

Hosting the pilot in these buildings provide the pilot project with two advantages:

• it compliments the existing seniors strategy, which focuses on the health of seniors in seniors-only buildings;
• It allows for TCH to review the impacts on seniors who live in buildings that, due to a large number of small bachelor units, have had an influx of residents experiencing a multitude of complex issues related to mental and physical health, substance use, heavy reliance on social assistance, and street acculturalization. 

THE PILOT

In November 2008, the pilot began by creating a diverse committee of agency staff, Toronto Community Housing staff and tenant leaders.   One of the key initiatives for this project is to establish an integrated support network that will promote the community and mental health needs of all residents, while ensuring the seniors population is fully supported to age-in-place.  The pilot is expected to continue until the summer.

The findings from this report will be documented and will be used to both inform the mental health framework, as well as test emerging themes from its development.