New complex-care housing in BC includes proper mental health and addictions services

Jim Green Residence at 415 Alexander Street in Vancouver's Downtown Eastside. (Google Maps)

For individuals with mental health and opioid addictions, providing them with merely a roof over their heads is often insufficient for the fighting chance they need to get their lives back on track.

That is why the provincial government announced today it is initiating complex-care housing, which provides residents with 24/7 wrap-around supports. This is also a step in the direction of the community care type of model that was intended to replace institutionalized care, following the closure of Riverview Hospital.

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Unlike supportive housing, complex-care housing provides residents with treatment and specialized care, such as support from nurses, social workers, and other health professionals.

Specific clinical services and other supports include physical, mental health, and substance use care, and psychosocial rehabilitation, as well as proper food nutrition, social and community supports, and personal care and living supports.

“If somebody does escalate, if they go off medication or deepen into addiction or have PTSD manifest, the wrap-around supports can anticipate that. The care plan that is developed for the individual and partnership gets us ready to soften the fall or move to a higher level of care, and then have that housing secured and protected for them when they return from a higher level of care, whether that be primary care or mental health,” said Sheila Malcolmson, BC Minister of Mental Health and Addictions, during the press conference.

“The investments that our government has made into affordable housing, supportive housing, and mental health and addictions is unprecedented in BC, and yet there are people who continue to be alienated from those supports — people who have been left behind — partly because they have not been housed, or their housing is precarious.”

These individuals often have trauma, and as a result of their opioid addictions and the frequency of their overdoses, many have severe brain injuries.

The first four complex-care housing locations — accomplished by upgrading portions of existing or planned supportive housing spaces — will provide a combined total capacity for 103 individuals.

This includes elevating the services provided at the existing Jim Green Residence at 415 Alexander Street in the Downtown Eastside, where there will be 44 complex-care spaces.

The modular supportive housing building, named Naomi Place, at 3598 Copley Street in East Vancouver will see 12 of its single-occupancy units dedicated for complex care.

In Surrey, the brand new Foxglove supportive housing and shelter building at 9810 Foxglove Drive will have 39 complex-care spaces.

Another complex-care facility will be located in Abbotsford within Red Lion supportive housing, a former hotel, at 2509 Pauline Street. It will have eight spaces.

Foxglove, currently under construction, will be the first to open in March, and the other locations at existing housing buildings will follow later in the year.

Jim Green Residence and Red Lion are operated by Lookout Housing and Health Society, Naomi Place is operated by Community Builders Group, and Foxglove is operated by Raincity Housing and Support Society.

Such a housing model carries substantially higher operating costs. Through the local health authorities, the provincial government will distribute a total of $4.8 million in annual operating funding to these non-profit operators and service providers, equivalent to about $47,000 per space per year. These initial complex-care housing sites will be evaluated and monitored for future expansion.

Currently across the province, about 3,500 people are living in supportive housing, which offer comparatively limited on-site support services. Many of these supportive housing units were built during the pandemic.

It was previously estimated that about 2,000 people in BC are need of a complex-care housing environment.

However, Malcolmson has emphasized that complex-care housing is completely voluntary. Nobody will be involuntarily detained under complex-care housing.

“If someone is a risk to themselves or others, there are tools in the mental health act to detain them involuntarily. That is a tool that exists now with or without complex housing, and it has been identified that when people are admitted to hospitals, sometimes under the mental health act, that can be a trigger for them to lose the housing they have already. And when they are discharged, they are in a worse situation than when they started,” she said.

“This is something we want to avoid, and that’s one of the central designs of complex care housing — retaining housing no matter where people need to seek treatment, they will have a safe place to return to.”

Over the past two years, the significant rise in unsheltered homelessness is partially attributed to individuals being evicted from supportive housing due to their untreated aggression, substance use, and often with acquired brain injury.

Non-profit housing operators previously told Daily Hive Urbanized residents have also been evicted from their housing arrangements for repeatedly failing to abide with strict COVID-19 health safety protocols, especially throughout 2020. This contributed to street homelessness, and the size of encampments in parks.

Under complex-care housing, people will not be evicted because of their complex needs and vulnerabilities, she said.

“The bottom line, the easiest to measure, is to have people stabilized, retain housing, and not see the cycle of people for whom we might have offered or connected them with supportive housing, and then cycling back out into homelessness,” said Malcolmson.

“We’re also going to be looking particularly closely at making sure people do not continue to cycle, whether it be corrections, the justice system, foster care, primary care, or addictions treatment. We want to see people retain housing, and then accessing healthcare, and when they leave treatment, we want to make sure they have secure housing to go back to.”

Mayor Kennedy Stewart suggested the complex-care model will have a significant impact on Vancouver, given that the ongoing health challenges cannot be simply relied on the criminal justice system.

“Mayors across the province see what happens when neighbours with these complex care needs fall through the cracks: unnecessary suffering and even death of loved ones, something that has impacted so many across BC, including my own family, negative interactions between people on the street, businesses dealing with crime and vandalism, and unsafe encampments,” said Stewart.

“We know what is happening in our cities is driven by a lack of support and care for those with complex mental healthcare needs, substance abuse issues, traumatic injuries, and the poverty that goes along with these ailments.”

Individuals who “escalate” within a complex-care housing setting will be sent to facilities such as the newly-opened, 105-bed Red Fish Healing Centre for Mental Health and Addiction at the former Riverview Hospital lands in Coquitlam, and the recently-built, 75-bed Mental Health and Substance Use Wellness Centre at Royal Columbian Hospital in New Westminster.

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