Developing and testing an intervention to prevent homelessness among individuals discharged from psychiatric wards to shelters and ‘No Fixed Address’ C. FORCHUK 1,2 rn , p h d , S. K. MACCLURE 3 rsw , msw , M. VAN BEERS 4 dsw , C. SMITH 5 ba , R. CSIERNIK 6 rsw , p h d , J. HOCH 7 p h d & E. JENSEN 2,8 rn , p h d 1 Professor, Faculty of Health Sciences, University of Western Ontario, and 2 Scientist, Lawson Health Research Institute, and 3 Social Worker, London Health Sciences Centre, and 4 Housing Advocate, Canadian Mental Health Association, and 5 Manage, Ontario Works, and 6 Professor, School of Social Work King’s College, London, ON, Canada, and 7 Research Scientist, Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michaels Hospital, and 8 Assistant Professor, School of Nursing, York University, Toronto, ON, Canada FORCHUK C., MACCLURE S. K., VAN BEERS M., SMITH C., CSIERNIK R., HOCH J. & JENSEN E. (2008) Journal of Psychiatric and Mental Health Nursing 15, 569–575 Developing and testing an intervention to prevent homelessness among individuals discharged from psychiatric wards to shelters and ‘No Fixed Address’ Shelter data in a recent study revealed discharges from psychiatric facilities to shelters or the street occurred at least 194 times in 2002 in London, Ontario, Canada. This problem must be addressed to reduce the disastrous effects of such discharge, including re-hospitalization and prolonged homelessness. An intervention was developed and tested to prevent home- lessness associated with discharge directly to no fixed address. A total of 14 participants at-risk of being discharged without housing were enrolled, with half randomized into the intervention group. The intervention group was provided with immediate assistance in accessing housing and assistance in paying their first and last month’s rent. The control group received usual care. Data was collected from participants prior to discharge, at 31 and 6-months post-discharge. All the individuals in the intervention group maintained housing after 3 and 6 months. All but one individual in the control group remained homeless after 3 and 6 months. The exception joined the sex trade to avoid homelessness. The results of this pilot were so dramatic that randomizing to the control group was discontinued. Discussions are underway to routinely implement the intervention. Systemic improvements can prevent homelessness for individuals being discharged from psychiatric wards. Keywords: discharge, homelessness, housing, income, psychiatric Accepted for publication: 13 February 2008 Correspondence: C. Forchuk Faculty of Health Sciences University of Western Ontario London ON N6A 5B9 Canada E-mail: cforchuk@uwo.ca Introduction In recent decades, the trend in mental health has been towards ‘dehospitalization’ (Sussman 1998). During the last 30 years, mental health policy within the province of Ontario has led to hospital bed closures and poorly planned discharge of individuals into the community with support services that lack funding (Lightman 1997). It is well accepted that people with mental illness are over rep- resented in the homeless population (Eynan et al. 2002, Journal of Psychiatric and Mental Health Nursing, 2008, 15, 569–575 © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd 569