A small but growing group of Canadians experiencing homelessness are living with severe, permanent cognitive impairment, from compounded issues such as FASD, traumatic brain injuries, cognitive slowing from mental health concerns, and brain injury from repeat overdose. When a person with a home has similar cognitive disability because of conditions like dementia, they receive clinical assessment, and if needed, long-term care. But when a person experiencing homelessness has the same level of need, there is no place for them to go.
Without the housing, health care, and supports they need, people experiencing homelessness with severe cognitive impairment suffer in an endless cycle between the street, emergency rooms, shelters, and the criminal justice system. As this human suffering has grown and become more visible, so too have concerns about ripple effects on public safety and wellbeing.
In our work with communities, we’ve been hearing more and more about their challenges finding solutions that meet these complex needs. Working with Dr. Monty Ghosh, a physician and researcher, the CAEH has co-developed a model of supportive housing to address this need.
What is Intensive Housing?
Intensive Housing is a critical missing piece in Canada’s housing system, designed to meet the needs of a small group of people that we’ve let fall through the cracks. It’s the equivalent of long-term care for people experiencing homelessness who need round-the-clock clinical support that provides:
- 24/7 nursing care and medication management
- Structured daily support
- Integrated mental health and addiction services
- Safety, stability, and the basic dignity that every Canadian deserves
It is grounded in the same legal and clinical frameworks available to any other Canadian with the same level of needs: clinical assessment, access to a guardian or advocate where necessary, and permanent housing with individualized care, periodically reviewed to ensure it continues to meet their clinical needs.
Closing the Gap: What Comes Next
CAEH is calling on the federal government to invest $2 billion in capital funding to build a minimum of 6,000 Intensive Housing units, and to work with provinces and territories to establish a sustainable operating funding framework. The cost is significant, but it is less than continuing to leave people in a cycle of repeat emergency visits, lengthy hospital stays, and repeated interactions with the justice system: none of it improving their situation long-term.
Intensive Housing needs to be a core component of the next national housing strategy, so that every Canadian has access to the care they need, and a safe, stable place to call home.