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In Canada, about 235,000 people experience homelessness each year. The number of homeless people, and the length of time they spend homeless, continues to rise. Homelessness is not a choice and anyone can become homeless. 

Although the root cause is poverty, some underlying issues are poor physical or mental health; violence or abuse in the home; lack of employment or income; and, a shortage of affordable housing. 

A group of researchers at Lawson Health Research Institute (Lawson), working at both London Health Sciences (LHSC) and St. Joseph’s Health Care London (St. Joseph’s), are committed to tackling the issue of homelessness from within hospital walls, where some patients face the risk of being discharged into homelessness. 

“Many of our patients with lived experience of homelessness were saying that their journey started with a hospital discharge,” says Lawson clinician researcher Dr. Cheryl Forchuk. “Often, they were experiencing major transitions in their lives and then experienced a hospital stay. Normally a relatively short visit, they aren’t able to gather the information and make a plan to be able to leave the hospital with somewhere to stay.”

On September 10, Adam Vaughan, Canadian MP and Parliamentary Secretary (Housing and Urban Affairs), on behalf of the Honourable Jean-Yves Duclos, Minister of Families, Children and Social Development, announced that Lawson will receive $223,572 from the Homelessness Partnering Strategy’s (HPS) Innovative Solutions to Homelessness funding stream to support the project “No Fixed Address Version 2 Expansion” research project. 

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“This is a brilliant approach. It supports an augmented duty of care where hospitals have the means to transfer people into stable settings where they can continue to heal and move towards self-sufficiency,” says Parliamentary Secretary Vaughan. 

Taking place at London Health Sciences Centre, this research will further refine the No Fixed Address strategy for reaching and supporting patients during the crucial transitional period when they are being discharged from the hospital and re-integrated into the community. 

“Lawson’s expanded No Fixed Address research project is the first evaluation anywhere of a strategy to reduce the number of patients being discharged into homelessness. There is almost no literature on any aspect of this troublesome issue,” explains Dr. Forchuk who is the study’s Principal Investigator. Dr. Forchuk is also the Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery and Assistant Director at Lawson.

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This project is an extension of three previous studies conducted by Dr. Forchuk’s research team, which developed and tested this novel approach. They demonstrated the efficacy, feasibility and cost-effectiveness of using the No Fixed Address strategy in acute and tertiary psychiatric care in the London region, at both LHSC and St. Joseph’s. In the first phase, they found that the interventions used prevented homelessness in 95 per cent of cases. 

The researchers are now taking a solution proven to have worked in the mental health units and applying it in selected medical departments at LHSC. Through the study, the services will be available to all patients in those units who are at risk of homelessness. There have already been 17 patients who have accessed this support since the project got underway this summer. 

Three community partners from London are supporting implementation of the strategy - Canadian Mental Health Association Middlesex, Ontario Works in the City of London and the Salvation Army’s Housing Stability Bank. They will provide assistance in areas like securing appropriate private-sector housing, provision of income and employment supports, and financial assistance. 

“In many ways London, Ontario is the high water mark of solving and tackling homelessness. This community has a lot of be proud of given the way that the municipality is stepping up to the plate and how many different organizations are working together towards a common goal,” says Parliamentary Secretary Vaughan. 

This kind of collaboration showcases the important partnership between the Canadian Government, research-intensive hospitals and community organizations to translate innovative solutions from the research stage to the front line of care. 

“The hope is that the findings will be even more robust, leading to the development of a best-practice model of hospital discharge that can be adopted throughout Canada. This will reinforce the need for a systemic change in the way hospital discharges occur and ensuring the person is transitioning to a secure housing arrangement,” says Dr. Forchuk. 

Learn more about the Government of Canada’s Homelessness Partnering Strategy. 

News Coverage

• CBC London - Helping medical patients in London avoid homelessness when they leave hospital 
• CTV London - Expanded research hopes to break the cycle of homelessness that psychiatric patients sometimes face when discharged
• Global News, AM 980 - Program that finds housing for homeless patients in hospital gets $223K in federal funding
• London Free Press - 'Brilliant approach' to homelessness gets federal grant
   

International Women’s Day, taking place on March 8, 2020, is a day to celebrate the various achievements of women around the world and is a call to action for gender parity. This year’s theme is “Each for Equal” to emphasize that each individual has a significant part in working towards a gender equal world. 

This year, Lawson is highlighting the different paths for women who are working towards a career in the health sciences. Below are the perspectives from students, physicians and researchers on their contributions to science and medicine. 

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High school student, Nimrit Aulakh, is completing her co-op placement with Lawson Scientist, Dr. Cheryl Forchuk. Her research focuses on improving mental health care for youth.  

“Science has always been of interest to me and has now become significant within my academic endeavours. Part of my desire to become involved in the sciences stemmed from my older sister, who exposed me initially to the research side of science. It is with the help of rationale and logic in science that I can enrich my academic experience. Specifically, I have been working as a co-op student alongside the Mental Health Nursing Research Alliance and learning what it means to be a researcher. During my time, I conducted preliminary analyses on one of their studies, which focuses on improving mental health care for youth through virtual models of care. I will be presenting my findings at the Thames Valley Science and Engineering Fair later this month and if successful, will advance to the Canada Wide Science Fair. This experience has shown me a new side of science, one that I hope that I can continue to be a part of. I realized that through science and research, I can contribute to advancing society. To continue my journey through post-secondary education, I have applied to get my Bachelor’s in Health Sciences. Both within and beyond my four years of undergraduate studies, I hope to continue my contributions in serving the public through scientific research, as well as create an image for girls with the same interests as me, everywhere.” 

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Romaisa Pervez is a Research Assistant working with Lawson Scientist, Dr. Arlene MacDougall. She recently completed her Master of Science in Epidemiology and Biostatistics at Western University. 

“I’m the student lead on a project that’s titled “Building a Sustainable Model and Evaluation for Psychological Rehabilitation in Kenya: An Implementation Study.” I’m working with the CREATE (Community Recovery Achieved Through Entrepreneurism) Kenya team to conduct a study to improve how we deliver, evaluate, and train persons with lived experience or community members to facilitate the Psychosocial Rehabilitation (PSR) Toolkit so it can be locally sustained in Kenya. I’ve travelled to Kenya twice during my Master’s to build relationships with stakeholders and conduct focus groups/interviews. My passion lies in understanding how we can implement upstream initiatives for mental health that are both sustainable and effective. Furthermore, I want to explore how we can find leverage points within the current mental health system in low to middle income countries and create innovative solutions. In the near future, I want to pursue medicine and further my knowledge and build stronger skills in this field.” 

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Dr. Kelly Anderson is an Associate Scientist at Children’s Health Research Institute, a program of Lawson. She is also Assistant Professor in the Department of Epidemiology & Biostatistics at the Schulich School of Medicine & Dentistry, Western University.

“I lead a research program in public mental health research, with a primary focus on young people experiencing a first onset of psychotic disorder. Together with my team, we are investigating the distribution and risk factors for psychotic disorders, prevention in early psychosis, and access to care and utilization of services in first-episode psychosis. My research program is centered around mentorship and training of students from all levels, and I work with trainees to foster high-level skills in the design and analysis of epidemiologic studies using large complex datasets. I am committed to fostering a culture of equity, diversity, and inclusion within my research team, and I advocate strongly for gender and early career representation for awards, scientific symposia, and other career opportunities. As a female scientist, I regularly mentor young women, both formally and informally, and due to the focus of my research, I also regularly work with trainees with lived experience of mental disorders. The diverse experiences and perspectives of these students both inspire and inform our work together.”

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Dr. Michelle Barton-Forbes is an Associate Scientist at Lawson and a Physician at London Health Sciences Centre (LHSC) specializing in paediatric infectious diseases. She is also an Assistant Professor at the Schulich School of Medicine & Dentistry, Western University.

“My research program is focused on the clinical epidemiology of infectious diseases in children, particularly in vulnerable paediatric populations such as neonates and young infants. A secondary area of interest is in bacterial resistance and antimicrobial stewardship. Through engagement in multicentre research and contribution to national guideline development, I am able to make a difference in the management and prevention of common childhood infections nationally.  The combination of intense passion for my subspecialty, inquisitive curiosity and a drive to better understand common childhood illnesses is infectious to my students. I motivate my students to excellence by inspiring them to believe in themselves and their ability to make a difference. My students are encouraged and challenged to find answers to unanswered questions and unexplained trends through research. As a proud Canadian and an immigrant from a nation that prides itself in its diversity, I believe that diversity is our strength. The Jamaican national motto “out of many one people” has framed my worldview and has influenced my practice.”

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Dr. Eileen Crowley is a Scientist at Lawson and a Pediatric Gastroenterologist at LHSC. She is also an Assistant Professor at the Schulich School of Medicine & Dentistry, Western University. 

“My research interests include pediatric inflammatory bowel disease (IBD), the genetics of IBD, big datasets, therapeutic drug monitoring clinical trial endpoints and precision medicine. My work has served to be better delineate the genetic phenotype of children with IBD as well as optimizing response to therapy in this age group. I engage students and motivate them to work with enthusiasm! My aim is to create learning opportunities that are active, collaborative and promote learning relationships. Once I have identified a student’s goal, it is easier to share and attain that goal. Within the research setting, I aim to maintain an environment where every student feels accepted, valued and safe. Sharing of ideas creates opportunities whilst also fostering a sense of personal belonging and achievement.”

To learn more about International Women’s Day, visit https://www.internationalwomensday.com/. 

Lawson Health Research Institute – the research institute of London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London – is ranked seventh in the country in Re$earch Infosource’s 2023 list of Canada’s Top 40 Research Hospitals. 

This is the 13th year in a row that Lawson has ranked top ten in the country, and the seventh-place ranking is up two spots from 2022 – highlighting continued dedication to hospital-based research at LHSC and St. Joseph’s.

Lawson also ranked second for research intensity among the large tier institutions with more than $776,000 of research spending per researcher.

“These rankings help LHSC and St. Joseph’s assess how we compare to similar hospitals across the country,” says Dr. David Hill, Scientific Director at Lawson and Integrated Vice President, Research at LHSC and St. Joseph’s. “Our continuous placement in the top 10 of all research hospitals shows we are doing important and relevant medical research that is making a difference to patient care.”

Lawson has been at the forefront of research in a wide range of specializations, making advances in areas from cancer care and mental health supports to molecular imaging and theranostics in recent years.

“Conducting research in hospitals means it can go from bench to bedside much more quickly,” says Dr. Hill. “Things move much faster now than they ever did. Our top 10 ranking shows we are leading the way, and that funders are confident in London’s hospital-based researchers.”

The top 40 list analyzes hospital-based research institutes from across the country on several metrics, including total research expenditure from the previous fiscal year. The ranking looks at funds from all sources, including both internal and external, to support research in hospitals.

The city of London, Ontario is home to a vibrant health research community. On Wednesday, May 9, researchers from across the city gathered to discuss the importance of equity, diversity and inclusivity (EDI) in the careers of health researchers. Through participation at Exchange: A London Health Research Day Forum on Diversity & Inclusivity, guests discussed the challenges associated with EDI and potential solutions for the future.

Exchange was held the evening before London Health Research Day, the region’s premier research showcase event which features nearly 400 trainee presentations. Trainees are the future of Canadian science and EDI is crucial to that future. This is a topic of national importance that has garnered attention and action from the federal government, funding agencies and scientists across the country.

Recognizing the importance of this topic, Canada’s Minister of Science, The Honorable Kirsty Duncan, and local Member of Parliament for London North Centre, MP Peter Fragiskatos, shared video greetings with Exchange guests.

“The Exchange event highlights a vital area of discussion. It is important to not only recognize but embrace the differences between scientists and the diverse perspectives they bring to research,” said Rebecca Sullivan, a third year PhD candidate at Western University’s Schulich School of Medicine & Dentistry, training in Savita Dhanvantari’s lab at Lawson Health Research Institute, and one of the organizers of the event. “Becoming aware of our own unconscious biases and trying to change these culturally ingrained implicit associations is the only way to make active change in science!”

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Above: Rebecca Sullivan, a third year PhD candidate, leading a scenario-based group activity at Exchange

The evening’s first presenter was Dr. Janet Smylie, Director of the Well Living House Applied Research Centre for Indigenous Infant, Child and Family Health at St. Michael’s Hospital and CIHR Applied Public Health Research Chair in Indigenous Health Knowledge and Information. Dr. Smylie, who also delivered the keynote presentation at London Health Research Day, spoke about the role of anti-Indigenous racism and discrimination within health care professions, including its impact on research. This included a discussion of Dr. Smylie’s own research in the field of Indigenous health.

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Above: Dr. Janet Smylie presenting on "Addressing anti-Indigenous racism and discrimination within health care professions"

Greta Bauer, PhD, a professor in the Department of Epidemiology and Biostatistics at Schulich Medicine & Dentistry, spoke about the role of epidemiology as a toolkit for building equity in health research. This included a discussion on incorporating intersectionality and multidimensionality into population health research methodology.

“The purpose of this work is to give researchers the measurement and statistical tools they need to shift the focus from studying broad population average effects to more heterogeneity within populations,” said Greta. “The whole point is to better study not only diversity in health outcomes, but in the processes that generate those outcomes.”

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Above: Greta Bauer, PhD, presenting on "Epidemiology as a toolkit for building equity"

This talk was followed by a presentation on Gender-Based Analysis Plus (GBA+). GBA+ is an analytical tool used to assess how diverse groups of women, men and gender-diverse people may experience policies, programs and initiatives. The “plus” in GBA+ acknowledges that GBA goes beyond biological (sex) and socio-cultural (gender) differences. We all have multiple identity factors that intersect to make us who we are; GBA+ also considers many other identity factors, like race, ethnicity, religion, age, and mental or physical disability. GBA+ is a method for collecting and reviewing data in an unbiased manner, one that leaves aside many of the assumptions that can mask the GBA+ impacts of a given initiative. Alysha Croker, PhD, Manager, Tri-Agency Institutional Program Secretariat, discussed how GBA+ is being used in research and grant funding, including at the federal funding agencies.

“Diverse research teams can lead to more innovation, greater collective intelligence and an increased capacity to tackle complex issues,” said Alysha, when discussing the importance of EDI in the careers of health researchers.

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Above: Alysha Croker, PhD, presenting on "Incorporating Gender-Based Analysis Plus (GBA+) in research and beyond"

The evening also included a presentation from Shantal Feltham, founder and CEO of Stiris Research, a North American clinical trials management company based in London. Shantal discussed the importance of ensuring that clinical trials are designed to recruit diverse research participants that represent real patient populations. She also discussed her own experiences and perspectives as a female entrepreneur.

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Above: Shantal Feltham delivering a presentation titled "That’s a great idea – It’ll never work"

A group of health research trainees concluded the night with a scenario-based presentation and activity. Audience members were divided into small groups and given a diversity scenario to discuss. Topics ranged from the experiences of LGBTQ+ researchers, racial diversity, physical ability barriers in research labs and more. Notes and ideas from these conversations were recorded and displayed the next day at London Health Research Day.

“Exchange highlighted EDI in health research in action. It featured talks by leading female researchers on issues in Indigenous health and LGBTQ health, implementation of equity in the Canada Research Chairs program, and female entrepreneurship in the field of health research,” said Savita Dhavantari, PhD, assistant director and scientist at Lawson and assistant professor at Schulich Medicine & Dentistry. Savita was also one of the Exchange organizers and the facilitator for the event. “Above all, I hope attendees were encouraged to be fearless in advocating for equity, diversity and inclusivity in health research.”

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Above: Guests at Exchange discussing a diversity scenario

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Above: Savita Dhanvantari, PhD, facilitating the Exchange event