New Possibilities

Allison had been diagnosed with schizophrenia and had been homeless for more than ten years. She had no identification, no health card and had no regular income.

The various shelters and drop-in centres in Toronto knew Allison very well. She had run into many problems at these facilities because she was a careless smoker and had been transferred throughout the women's shelter system because of this behaviour. Her hygiene was poor and she dressed inappropriately for the weather, wearing light summer clothing and sandals in winter. She seemed oblivious to her surroundings. She was very quiet and avoided contact with staff and residents at the shelters and drop-ins.

Fortunately, Allison had a case worker at the City of Toronto's Women's Residence, a facility in downtown Toronto that offers emergency shelter, case management, health care support, and day-to-day basic needs to homeless women until alternate housing is secured. The residence offers the services of counsellors, a housing worker and a health care worker. Women are provided with meals, recreational activities and help in obtaining financial assistance.

Women's Residence also operates Bellwoods House, a communal house that can accommodate ten women who have become entrenched in the hostel system. Bellwoods House offers room and board, as well as individualized case management.

"A turning point for Allison was when she was admitted to the Toronto General Hospital under the Mental Health Act on the grounds that she was a danger to herself and others," says Susan Harris of the Women's Residence. "This related to her careless smoking, poor self care and the fact that she was not taking her medication."

During her hospitalization, her caseworker from Women's Residence attended a number of case conferences with hospital staff and Bellwoods House staff and was in almost daily contact with Allison's nurses and social worker. Allison was eventually discharged from the hospital to Bellwoods House.

"She was on a waiting list for a program called IMPACT at the Toronto Western Hospital," says Susan. "Her caseworker visited her weekly at Bellwoods House and worked with the staff there to help her budget her money and control her smoking."

Initially, Allison had difficulty adjusting to life at Bellwoods House and, after nine months, had to be hospitalized again. During her hospitalization, her bed at Bellwoods House was reserved so she could return and continue with the progress she had made.

Prior to her hospital discharge, a meeting was held to set up a discharge plan. The meeting was attended by her relevant service providers, the Toronto General Hospital attending psychiatrist and social worker, Bellwoods House staff and the IMPACT team psychiatrist. It was agreed that IMPACT would provide clinical support and Bellwoods House staff would continue working with her on daily living activities such as taking her medication, smoking safely and dressing appropriately for the weather.

Allison continued her success as a resident of Bellwoods House. She developed a good relationship with staff and the other residents. She took her medication and began to dress appropriately. She was even cooperative and willing to try different strategies to encourage her to smoke safely.

The Women's Residence caseworker remained involved to ensure services were coordinated and that Allison was appropriately housed when she left Bellwoods House.

"With every little step forward we were able to demonstrate that Allison can be housed in the community," says Susan. "This will open up new possibilities for her away from the shelter system."

Today, Allison is successfully housed in the community, thanks to the efforts of the dedicated staff at Women's Residence.