For homeless people struggling with mental illness, housing can make a world of difference: Canadian study
TORONTO - There are many roads to homelessness. For Marek Wroblewski, it was schizophrenia. But he didn't know that at first.
"I was manic depressive, they say, I was obsessive compulsive," he told CTV News. "But it was [actually] schizophrenia, and when [it] hit me, I wasn't prepared."
The 59-year-old immigrant arrived in Canada from Poland as a translator and occasional actor. He worked much of his life, but his undiagnosed mental illness plagued him, causing him to make poor decisions that led to his money disappearing as fast as he earned it.
Wroblewski said he ended up in shelters and wandering the streets of downtown Toronto at several points in his life.
"I tried to find stairways in a building when it was very cold," he said.
Wroblewski said he would hunch down and try to stay warm. He said being homeless "was humiliating."
Refuge for Wroblewski came in the form of Dr. Vicky Stergiopoulous, with the Centre for Addiction and Mental Health (CAMH), who was launching a study dubbed At Home/Chez Soi, which looked at the long term effects of a housing-first approach for adults struggling with both mental illness and homelessness.
Unlike programs that require recipients to be on medications or drug free before they can be assisted with housing, this approach provided the security of a home first in order to give the stability needed to tackle those issues. The program gives subsidies to cover rent, followed by support for mental and health problems that tenants may have.
Wroblewski was chosen to be part of the study -- and it was a good thing he was, Stergiopoulous said.
The doctor told CTV News that the state Wroblewski was in when she met him, "he probably would have died," without the intervention of this program.
Wroblewski received his own one bedroom apartment on a tree lined street in Toronto's west end. It's near public transit and grocery stores. He pays $475 -- or two thirds of the rent -- from his meagre pension. The housing program pays the other third.
Now, Wroblewski has called it home for the past eight years, being grateful for it every day.
"Eight years … and six months … it's the longest time that I'm not homeless, the longest time that I'm really peaceful," Wroblewski said.
He added that it made him feel "confidence that I'm good, that I'm not such a loser, that I deserve my life.
"Home is the most important," he concluded.
The Canadian study, published in the journal Lancet Psychiatry, recruited over 575 homeless people between 2009 and 2011, and tracked their progress for six years, on average. All genders were included, but almost 70 per cent of the participants were male. The study is the largest and longest study of its kind, and found that six years later, those with high support needs for mental health had 42 per cent greater housing stability on this program compared to the usual services available for housing support.
This means that researchers saw a drop off in people who returned to the streets while they were part of the program.
"It's really remarkable, six years later, to continue to see the benefits," Stergiopoulous said. "It helps those that do have mental illness reclaim their position in society, integrate into the community (and) pursue their recovery goals."
Patricia Mueller, society chief executive officer of Homes First in Toronto, said that she wasn't surprised to see the results of the study.
Her group delivers these housing programs in Toronto and she says that the cost of running them is only a fraction of the cost of homelessness.
Homelessness is expensive -- both for the person struggling to find a home and for society as a whole.
Studies estimate that it costs up to $161,000 per person per year when you take into account medical fees, hospital visits, police resources, jail time and shelter costs. One breakdown done by Homes First shows the relative costs per month for a place to sleep.
A hospital bed? Around $13,900. In provincial jail? Around $9,400. In a shelter? Even that clocks in at $2,129, according to the group.
By comparison, Homes First said that sleeping in one of their social housing units is $1,545 a month, or $51 a day.
The study from CAMH found that its program worked out to about $67 a day for a client with moderate needs. Researchers are now doing more cost benefit analysis in the hopes of improving the program.
"Studies like this … it influences decision makers," said Mueller, referring to the substantive proof the study offers that these programs work long term.
She hopes that this study will inspire governments to expand this type of programming.
Mueller said that housing was the "key to mental health.
"Isn't it key to yours?" she pointed out. "I would be anxious if I didn't know where I was going to sleep tonight." She added that these programs are not only "saving hospitals money," but are "saving people from being arrested for being on the street."
Ultimately, she said, "we are saving lives."
Wroblewski is one person who knows just how true that is. In his bright yellow apartment, with roses and cookies for guests, he was happy to show off his sanctuary.
"This is my home," he said. "This is where I hope I will be until I die."
He's on medication for his schizophrenia. His condition is stable, though he admits he still struggles at times. But living here has made him hopeful about his illness. He said he wants people to know that "somebody with schizophrenia can live reasonably well and be (a) good person."
Most important of all, he feels safe and warm in his home, and he has his dignity back.
"This is the place where I run," he said. "When I have panic attack I come here, I'm quiet, peaceful and pray. And I'm regaining back myself again. So home, it's the most important."