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In London, Ont. more than 1,700 people are experiencing homelessness.

Recognizing the growing crisis, more than 200 individuals from 70 organizations across the city came together and developed the Health & Homelessness Whole of Community System Response – a strategic roadmap for supporting unhoused people who have the most complex health and social support challenges, and helping them access permanent housing that meets their needs. Now a team of researchers has been tasked with assessing how well the roadmap is working.

To understand if the program is meeting its ambitious goals and explore areas for improvement, the Centre for Research on Health Equity and Social Inclusion (CRHESI), a community-university partnership based at Western’s Faculty of Health Sciences, was asked by the Whole of Community Response leaders to support and coordinate research and evaluation of the program. 

CRHESI works with and reports to the System Foundation Table, a team of volunteer community partners from diverse sectors with a mandate to evaluate new activities and embed continuous improvement to ensure sustainability of the program.

“London’s Whole of Community Response is a novel approach to addressing the needs of the most vulnerable individuals experiencing complex housing and health challenges within our community,” said Mick Kunze, chair of the System Foundation Table. “While our approaches and interventions are rooted in evidence-based practices, we also understand that local context matters.”

This research and evaluation work is funded jointly by Western, London Health Sciences Centre and through a generous donation from local businessman Ryan Finch to St. Joseph’s Health Care Foundation. The three groups came together recognizing there is a need to create meaningful and measurable change in our community.

Their support has allowed CRHESI to recruit two research managers, Eleanor Gebrou and Kelly Barnes, who oversee the work of more than 100 researchers and community partners from organizations across the city participating in the evaluation project. 

"Community-led initiatives not only reflect the real needs of individuals facing homelessness, but they also empower frontline workers by fostering an environment of collaboration and understanding. Together, we can create solutions that prioritize well-being for all—those we serve and those who serve," said Gebrou.

This work is split into four main research areas: 

1. Exploring the outcomes and experiences of people who are precariously housed, unhoused or at risk of homelessness, as well as the perspectives of the broader residents of London, Ont. and especially the business community.
2. Evaluating the experiences and well-being of those working in jobs that provide care and housing support.
3. Answering questions related to systems, structures, processes and costs of care.
4. Evaluating the processes that enabled this large and complex “whole of community” response, and how it unfolds from here.

“I really believe in evidence-based decision making and having as much information as we can to go into program and policy design,” said Barnes. “It's so important to understand what parts of our homelessness response are working well and what can be improved. Research and evaluation are some of the best ways to do that.”

The importance of voices and stories

Research teams will collect quantitative data, including statistics on how many people get housed, how this housing affects the number of hospital and police contacts and the cost-benefit of these new activities. They’ll also collect qualitative data, which involves hearing the experiences of those without homes, those accessing care and support and those providing and leading services. 

This evaluation framework will be presented to city council, sitting as the Strategic Priorities and Policies Committee, on October 8, 2024. 

“It is really important to us that this not just be numbers,” said Barnes. “We know how important people’s voices and stories are. When we take the numbers and combine them with people’s descriptions of their experiences, and the discussion of their journey, that gives us really solid information to bring back to the policy-makers and program developers to show what’s working and what isn’t.”

This research and evaluation work will span the next two years, with results shared annually with city council starting in July 2025. In addition to annual reporting, research project teams will share data as it emerges. 

“The research and evaluation efforts led by the backbone team of this movement, including the System Foundations Table and our CHRESI research and evaluation managers, will be instrumental in guiding our present and future work, by illustrating the real impact our interventions are having on the health and well-being of those we’re aiming to support, as well as by responding to the questions and concerns voiced by all members of our community,” said Kunze.

Health & Homelessness Whole of Community System Response 

The Whole of Community Response is about developing wrap-around health care and housing supports for those who need them most, ensuring basic human needs are met and building trusting relationships with people so they’re set up to succeed. It includes three main pillars: establishing hubs to meet immediate needs for safe shelter, nutrition and hygiene, and allowing care providers to start the process of stabilizing people’s mental and physical health. Alongside establishing hubs, the broader plan includes bringing more highly supportive housing units to London and implementing a human rights-based approach to support people wherever they are on the housing spectrum. 

City council endorsed the Whole of Community Response approach in March 2023. Since then, two hubs have been established, as well as 93 highly supportive housing units, with 50 more units in development, toward a goal of 600 highly supportive housing units within three years. 

The Whole of Community Response is being facilitated through the City of London and implemented by lead agencies, with ongoing collaboration among several sectors, including police and emergency services, hospitals, front-line community service organizations, educational institutions and government.

The Health and Homelessness Fund for Change, fuelled by a transformative $25-million donation from a London, Ont. family who wishes to remain anonymous, primarily provides capital funding to help fast-track the creation of hubs and highly supportive housing units. The Fund for Change is administered by London Community Foundation in partnership with the donor family.