When we first started working with Chris, she had been discharged from her personal care home without alternate housing arrangements or a discharge plan. She was using hotels that consumed a month’s worth of rent funding in only a few days, and she refused to use shelters due to her age and physical health concerns. Due to her mental health, she was inconsistent about presenting to healthcare providers and difficult to reach any compromise with. Chris bounced around between hospitals, emergency rooms, hotels and shelters without a plan. Several service providers were connected to her, but there was no coordinated plan that she would agree to.
We connected Chris to a single point of contact for healthcare via Health Outreach and Community Services (HOCS), a program of the WRHA. We used a variety of psychosocial rehabilitation skills and interventions to help her learn to accept behaviour limits and see the benefit in cooperating with service providers. We continued to work on her housing search and found housing through advocacy and coaching while further assisting her by working with her bank to set withdrawal limits and curb her spending.
Upon gaining affordable accommodations, Chris struggled with the adjustment. We continued to gently, but firmly, enforce limits on her behaviour when dealing with us and HOCS. We mediated between her and her landlord when she voiced complaints, and consistently referred her to the appropriate routes of communication according to a crisis plan that we created together. We coached Chris on how to build healthy and supportive social contacts.
Chris has remained safely housed for about nine months and maintains regular connections with her DCSP support system.