Hope for the homeless with at-shelter mental health care

Key players in the implementation of the PRISM program, a collaboration between CIUSSS West-Central Montreal and the Welcome Hall Mission to help homeless men with mental health problems. From left: Tung Tran, CIUSSS Assistant Director, Mental Health and Addiction Programs; Samuel Watts, CEO and Executive Director of the Welcome Hall Mission; and Psychiatrist Vincent Laliberté, head of the PRISM program.
Key players in the implementation of the PRISM program, a collaboration between CIUSSS West-Central Montreal and the Welcome Hall Mission to help homeless men with mental health problems. From left: Tung Tran, CIUSSS Assistant Director, Mental Health and Addiction Programs; Samuel Watts, CEO and Executive Director of the Welcome Hall Mission; and Psychiatrist Vincent Laliberté, head of the PRISM program.

Marco is a man in his 50s. About 20 years ago, he came to Canada from the Caribbean with his wife and children.

Sometime after his arrival, Marco developed schizophrenia. Within a decade, he lost his job, got divorced, was separated from his children, and wound up on the streets of Montreal.

But that was not where Marco’s journey ended. He was one of the first men to participate in the Projet de ré-affiliation en itinérance et santé mentale (PRISM) program offered at the Welcome Hall Mission, a shelter in downtown Montreal. With the right treatment and care, within a few months he was able to move out of the shelter and into his own apartment.

This was one of the stories recounted during the public launch of PRISM in June by the head of the program, JGH Psychiatrist Dr. Vincent Laliberté. A collaboration between the Welcome Hall Mission and CIUSSS West-Central Montreal, PRISM brings together a team of healthcare professionals to work with homeless men with chronic mental illnesses directly at the shelter. By program’s end—between eight to 12 weeks—participants have the tools and guidance to reintegrate into an affordable apartment.

A bed in the Welcome Hall Mission for a client of the PRISM program.
A bed in the Welcome Hall Mission for a client of the PRISM program.

“When you’re homeless, you’re always taking care of your immediate needs,” says Dr. Laliberté. “With PRISM, we offer an environment that is peaceful, where these men have space to think about where they are headed in life and reflect on their future.”

The shelter has eight available beds, and a common salon area reserved for members of the program. Participants meet regularly with a coordinator from the Welcome Hall Mission, a social worker or psycho-educator, a psychiatrist and a nurse.

Community organizations, the Montreal police force or health and social service professionals can refer an individual to PRISM. In some cases, visitors of the Welcome Hall Mission may be referred, or individuals who have been hospitalized or have gone to an emergency room for help.

“One of the major challenges with the homeless is that they visit emergency rooms regularly, because they may not know where else to turn,” explains Tung Tran, Associate Director of the Mental Health and Addiction Program at the CIUSSS. “The idea of the program is to provide continuity of care—when you look after somebody effectively, they don’t need to come to the emergency room.”

Once the individual has completed the program and is living on their own, they are followed by an external healthcare team in their area as needed, to ensure they are stable.

“For a program like PRISM to work, this is essential,” says Mr. Laliberté. “There needs to be community support, as well as affordable housing.”

“I really believe that for mental health, and perhaps other services in our network, it’s crucial to make more services available close to the patient,” adds Mr. Tran.

Since the program launched at the Welcome Hall Mission in November 2017, it has seen about 10 individuals successfully move from the streets to their own apartment. The Welcome Hall Mission is the fourth site in Montreal to offer PRISM.

“It’s very rewarding as a psychiatrist to see people transform their lives with the right treatment,” says Dr. Laliberté. These men are pleasant to work with, and it is always inspiring and impressive to witness the hardship they overcome.”

Mr. Laliberté is assessing how PRISM’s participants have benefitted from the program several weeks following completion and again after one year of being housed.

“I think that in this short amount of time, we’ve shown this program can make a difference,” says Mr. Laliberté.”It’s possible to treat this population and put an end to homeless.”

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