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Journal of Military, Veteran and Family Health
▌( ▌) 2020 doi:10.3138/jmv fh-2019-0042
▌
Exploring harm reduction among Canadian Veterans experiencing
homelessness
Olivia Marsella
a , Cheryl Forchuk
a,b and Abe Oudshoorn
a
ABSTRACT
Introduction: In Canada, Veteran homelessness is an increasing concern. It is estimated that approximately 2,950
Veterans experienced homelessness in 2016. Some may also have substance use disorders, which has been linked to
loss of housing and homelessness many years a er exiting military service. A strategy that facilitates housing stability
and reduces the harms of substance use is harm reduction. is study explored how Veterans who have experienced
homelessness perceive and experience harm reduction. Methods: is study was a secondary analysis of data collected
from the Canadian Model for Housing and Support of Veterans Experiencing Homelessness study that evaluated a
Veteran-speci c housing model in four Canadian cities. In the primary study, 78 participants received housing and
related programming intervention. Focus groups with Veterans occurred at each of the four housing sites from 2012 to
2014. Across all sites, 24 Veterans attended both the 2012 and 2013 focus groups. A total of 39 Veterans attended the
nal focus groups in 2014. We conducted a thematic analysis of Veteran focus group data where data were extracted
from transcripts and organized into themes. Results: Various themes emerged from the data including (1) regimented
structure, (2) understanding both worlds, (3) congruent recovery journeys, (4) location close enough to services, far
enough from harm, and (5) harm reduction is housing stability and housing stability is harm reduction. ese themes
represent the interface between military culture and homeless culture. Overall, Veterans considered harm reduction as
an essential component of housing. Discussion: is study has shown that harm reduction may be part of the solution
to ending Veteran homelessness in Canada. e ndings of this study may inform how Veteran housing and substance
use needs are addressed. Additional research is needed to explore further how harm reduction can be e ectively incor-
porated into Housing First for Veterans.
Key words: addiction, harm reduction, homelessness, housing, Housing First, mental health, substance-related
disorders, Veterans
RÉSUMÉ
INTRODUCTION: L’itinérance des vétérans est une préoccupation croissante au Canada. On estime que
2,950vétérans vivent dans cette situation en 2016. Certains vétérans peuvent être aux prises avec des troubles de con-
sommation de substances psychoactives, qui entraînent la perte de leur logement et leur situation d’itinérance plusieurs
années après qu’ils ont quitté le service militaire. La réduction des méfaits est une stratégie qui favorise la stabilité du loge-
ment et réduit la consommation de substances psychoactives. La présente étude visait à explorer comment les vétérans
qui ont connu l’itinérance perçoivent et vivent la réduction des méfaits. MÉTHODOLOGIE: La présente étude est
une analyse secondaire des données colligées dans l’étude du Modèle canadien pour l’hébergement et le soutien des anciens
combattants en situation d’itinérance , qui évaluait le modèle de logement des vétérans dans quatre villes canadiennes.
Dans l’étude primaire, 78participants ont reçu un logement et une intervention liée au programme. Des groupes de tra-
vail composés de vétérans ont été organisés entre 2012 et 2014 à chacun des quatre emplacements des logements. Dans
tous les emplacements, 24vétérans ont participé à la fois aux groupes de travail de 2012 et de 2013. Au total, 39vétérans
ont participé aux groupes de travail naux de 2014. Les chercheurs ont procédé à une analyse thématique des données
tirées des groupes de travail de vétérans, c’est-à-dire que les données ont été extraites des transcriptions et classées par
thèmes. RÉSULTATS: Plusieurs thèmes ont émergé des données, soit a)la structure régimentée, b)la compréhension
des deux mondes, c)les parcours congruents vers le rétablissement, d)le lieu assez près des services, mais assez loindes
méfaits et e)la réduction des méfaits assure la stabilité du logement et la stabilité du logement assure la réduction des
méfaits. Ces thèmes constituent l’interface entre la culture militaire et la culture d’itinérance. Dans l’ensemble, les
RESEARCH
a Arthur Labatt Family School of Nursing, Western University, London, Ontario
b Lawson Health Research Institute, London, Ontario
Correspondence should be addressed to Olivia Marsella at oliviamarsella@hotmail.com
https://jmvfh.utpjournals.press/doi/pdf/10.3138/jmvfh-2019-0042 - Friday, May 01, 2020 7:00:14 AM - IP Address:198.2.82.178
This advance online version may differ slightly from the final published version.
Marsella, Forchuk and Oudshoorn
Journal of Military, Veteran and Family Health
doi:10.3138/jmv fh-2019-0042 2020 ▌( ▌)
▌
vétérans considéraient la réduction des méfaits comme un volet essentiel du logement. DISCUSSION: La présente
étude démontre que la réduction des méfaits peut faire partie de la solution à la situation d’itinérance des vétérans au
Canada. Les observations qui en sont tirées pourraient éclairer les façons de répondre aux besoins des vétérans en matière
de logement et de consommation de substances psychoactives. D’autres recherches s’imposent pour mieux explorer com-
ment intégrer la réduction des méfaits avec e cacité au programme Logement d’abord pour les vétérans.
Mots-clés: dépendance, logement, Logement d’abord, personnes itinérantes, réduction des méfaits, santé mentale,
troubles liés à la consommation de substances psychoactives, vétérans
INTRODUCTION
e rate of homelessness in Canada has been increasing
since the 1980s. Each year, approximately 235,000 Ca-
nadians will experience homelessness.
1 Despite their past
service in the Canadian Armed Forces (CAF), Veterans
have a risk of homelessness similar to other Canadians.
2
It is estimated approximately 2,950 CAF Veterans were
homeless in 2016.
1 Some Veterans experience substance
use disorders, particularly alcoholism, many years a er
exiting military service, which has been linked to loss
of housing and subsequent homelessness.
3 e nation-
al Life A er Service Survey also found that the rate of
heavy drinking among Regular Force Veterans was 25%,
similar to the general Canadian population.
4
Harm reduction is a recovery-oriented, evidence-
based approach that aims to reduce the harms of sub-
stance use without requiring individuals to abstain from
substances. 5 It was identi ed by Forchuk and Richard-
son 6 as a key principle in preventing Veteran homeless-
ness. Evidence has shown that harm reduction reduces
negative outcomes associated with substance use.
7 – 10
Housing First includes the principle of harm reduction
and facilitates access, as quickly as possible, to stable,
permanent, and a ordable housing of choice. is
strategy does not require individuals to abstain from
substance use to receive housing.
11 Harm reduction and
Housing First may be key to addressing homelessness
among CAF Veterans.
6 is study explored how home-
less Veterans experience and perceive harm reduction as
a component of stable housing. e following research
questions were addressed in this study:
1. What are the experiences with harm reduction for
Canadian Veterans who have experienced home-
lessness?
2. What does harm reduction mean for Canadian
Veterans who have experienced homelessness?
METHODS
Design
A qualitative secondary analysis was chosen to re-
analyze focus group data from the Canadian Model for
Housing and Support of Veterans Experiencing Home-
lessness 6 study. is 2-year study evaluated a housing
model and individualized programming for Veterans
experiencing, or at risk of experiencing, homelessness
in Toronto, London, Calgary, and Victoria.
6 e qual-
itative component of the study involved focus group
interviews with Veterans, housing sta , and other key
stakeholders, that occurred at three time-points at all
four sites. A qualitative secondary analysis examined
pre-existing data to investigate new research questions
or con rm existing research. is type of analysis also
investigated an issue or situation that was not consid-
ered, or fully examined, in the original research.
12 , 13
In the primary study, several ndings related to harm
reduction emerged from the focus groups. For the qual-
itative secondary analysis, this data was further exam-
ined to reveal what harm reduction meant for Veterans
who experienced homelessness.
Sample
In the Canadian Model for Housing and Support of
Veterans Experiencing Homelessness
6 s t u d y , V e t e r a n s
residing at each of the four housing sites were surveyed
and invited to join the focus groups. In total, 78 partici-
pants received the housing and related programming in-
tervention. Baseline questionnaires were completed by
63 Veterans. Table 1 outlines the demographic charac-
teristics of study participants at baseline, including de-
tails of military service and homelessness. All Veterans
were given a choice to participate in the focus groups.
Attendees of focus groups included those who were cur-
rently involved in the program, as well as former tenants
who received housing services from the four programs.
Across all sites, 24 Veterans attended both the 2012 and
2013 focus groups. A total of 39 Veterans attended the
nal focus groups in 2014.
6
Data collection
Data for the primary study was collected from Veterans,
service providers, and stakeholders from 2012 to 2014.
Quantitative demographic data was collected via struc-
tured interviews with Veterans at baseline, 3, 9, and 15
months. Qualitative data was collected through focus
https://jmvfh.utpjournals.press/doi/pdf/10.3138/jmvfh-2019-0042 - Friday, May 01, 2020 7:00:14 AM - IP Address:198.2.82.178
This advance online version may differ slightly from the final published version.
Harm reduction among Canadian Veterans experiencing homelessness
Journal of Military, Veteran and Family Health
▌( ▌) 2020 doi:10.3138/jmv fh-2019-0042
▌
groups and individual interviews, which occurred in
three cycles at each site. e purpose of the focus groups
was to collect information about the housing model,
including recommendations for future programs. ese
encounters were audio recorded and lasted approxi-
mately 20 minutes (the individual interview) to 2 hours.
Recordings were transcribed verbatim by research assis-
tants. In total, data from 12 focus groups and one indi-
vidual interview were analyzed.
Data analysis
In this supplementary analysis, the process of re-
coding 13 was used to analyze data from the focus
groups. Prior to analysis, audio recordings of the focus
groups were listened to in order to ensure the accura-
cy of the transcripts.
14 Transcripts were examined for
themes related to harm reduction. Speci c quotes from
the transcripts were coded and organized into respec-
tive themes. ese themes were continually re ned and
combined based on similarities and connections. e
transcripts were read, repeatedly, until no new themes
related to harm reduction were identi ed. To achieve
triangulation, the ndings were presented to an advi-
sory committee member and the principle investigator
of the primary study to con rm or modify the themes.
e purpose of this secondary analysis was to provide
further insight into how Veterans experiencing home-
lessness describe and experience harm reduction. By
re-coding the primary focus group data, themes relat-
ed to harm reduction could be identi ed and further
explored
Ethical approval
Western University’s research ethics board for Health
Sciences Involving Human Subjects granted approval
for the primary study with permission for secondary
analyses included.
RESULTS
Analysis revealed ve themes that captured how Vet-
erans experienced and understood harm reduction .
ese themes represent the interface between the mil-
itary culture and homeless culture, which was concep-
tualized into a diagram (see Figure 1 ). Overall, Veteran
perceptions of harm reduction were strongly in uenced
by both their experiences in the military, and with
homelessness. Understanding Veterans’ unique military
culture was integral to revealing what harm reduction
meant to them.
Theme 1. Regimented structure
Veterans spoke of the highly structured nature and
cultu
re of military service. ey described the clear
“chain of command,” hierarchy, organization of time,
and rules that were present in the military. When Vet-
erans exited the military and returned to civilian life,
this important sense of structure was o en lost. When
they transitioned into the housing programs, Veterans
Table 1. Participant demographics at baseline
Characteristic N (%)
Sex
Male 58 (92.1)
Female 5 (7.9)
Age (years), mean (SD)
30–39 7 (11.1)
40–49 16 (25.4)
50–59 30 (47.6)
60–69 6 (9.5)
70–79 4 (6.3)
Marital status
Single or never married 25 (39.7)
Married or common-law 1 (1.6)
Separated or divorced 33 (52.4)
Widowed 3 (4.8)
Other 1 (1.6)
Highest level of education
Community college or university 21 (33.9)
High school 29 (46.8)
Grade school 12 (19.4)
Ethnicity
White English 25 (40.3)
Canadian 24 (38.7)
Aboriginal/Métis 6 (9.7)
European 4 (6.5)
French Canadian 2 (3.2)
Semitic 1 (1.6)
Years in Canadian Forces, mean (SD) 8.1 (8.8)
Years since discharge from Canadian
Forces, mean (SD)
28.4 (13.6)
Years spent homeless, mean (SD) 5.8 (6.8)
Time lapse since fi rst episode of
homelessness, mean (SD)
9.8 (10.5)
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Marsella, Forchuk and Oudshoorn
Journal of Military, Veteran and Family Health
doi:10.3138/jmv fh-2019-0042 2020 ▌( ▌)
▌
also struggled to grasp and adjust to this sudden change
in their living environments. One Veteran spoke of his
experience of transitioning from the shelter system into
the housing strategy:
It was a big transition for me because I had been [liv-
ing] in the shelter for the last few years. en, all of
a sudden, you’re le to your own devices. You’re not
being forced to get up, go anywhere. It’s so easy to sit
in your apartment and just watch TV all day.
Most of the Veterans preferred a living environment
that mimicked and re-established the regimented struc-
ture of military service. However, Veterans frequent-
ly discussed the general lack of structure within some
housing programs. For example, it was o en unclear
who was managing housing programs, which was con-
tradictory to the clear chain of command within the
military. Furthermore, some reported sta and support
workers occasionally missed, or were late for, scheduled
appointments, which was frustrating for those who had
come from a military background where a structured
routine was followed:
You know how frustrating it is, especially for mili-
tary guys to have to get to an appointment at 10:00
and not get seen until 11:30?
Veterans strongly appreciated rules where they existed
within the housing programs. Most agreed the pres-
ence of rules was bene cial and helped to maintain sta-
bility. is signi cant desire for rules and regulations
o en stemmed from a highly disciplined military back-
ground. For some, the existence of rules also created a
sense of accountability for their substance use. Many
Veterans also recommended that individuals who vio-
lated housing rules be disciplined accordingly. ey be-
lieved breaching the rules, such as smoking or drinking
indoors, could negatively impact Veterans recovering
from drug or alcohol addictions:
ere has to be consequences. Um … drinking,
smoking inside the building. … ere just has to be
some boundaries that can’t be crossed. It’s detrimen-
tal to the other Veterans that are in there.
Theme 2. Understanding both worlds
Veterans spoke of the importance of interacting with
individuals who understood not only the experience of
being homeless, but also military culture. is prefer-
ence o en originated from the comradery they expe-
rienced with other military members during service.
Living in housing, or attending programs with other
Veterans, helped re-establish the commonality and
comradery associated with military service. Veterans
o en explained military culture is unique, so being
with people who shared similar experiences and under-
stood the distinctive language was essential. Two Vet-
erans explained:
You’re with people who understand at least 90% of
what you’re talking about.
You belong to something. When you’re on the
street you don’t belong to anything. … But in this
Figure 1. The interface between military and homeless culture
https://jmvfh.utpjournals.press/doi/pdf/10.3138/jmvfh-2019-0042 - Friday, May 01, 2020 7:00:14 AM - IP Address:198.2.82.178
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Harm reduction among Canadian Veterans experiencing homelessness
Journal of Military, Veteran and Family Health
▌( ▌) 2020 doi:10.3138/jmv fh-2019-0042
▌
building, at least everybody here has served in one
form or another.
Most of the Veterans also described the signi cance of
having sta members who understood military culture.
However, some of the support at the housing programs
was provided by sta or volunteers without a military
background. Consequently, it was di cult for them to
relate to sta members and develop e ective relation-
ships with those helping them:
We could use somebody that could understand
where we come from. Someone who has had a bit
of a military background themselves. We’re so used
to it that we talk a certain way. We use certain terms,
certain people like me who did 37-odd years in re-
serves. So, that they understand some of the vocab-
ulary we use.
During the focus groups, the value of peer support was
o en highlighted and discussed. e housing programs
o ered peer support services, which allowed Veterans to
associate with individuals who have experienced both
military service and a substance use disorder. A Veteran
described his experience with peer support:
If you’re not an alcoholic, you can’t tell an alcoholic
how to become sober and (name) is a Veteran and he
understands us. at is important, to know where
we are coming from. If you were never an addict or
an alcoholic, I don’t care what you say, you have no
clue. We gotta relate to who’s helping us.
Local police associations were a signi cant source of
peer support at some of the sites. For example, at one
of the programs, police o cers regularly escorted Veter-
ans to participate in recreational activities. O en, these
police o cers were also Veterans and could relate to the
Veterans at the housing programs. Unlike some other
homeless populations, these Veterans were comforted
by a uniform:
Oh, I would say the rst thing is go over to the po-
lice, because a lot of those guys are Veterans and are
so, so supportive! ey are incredible.
Theme 3. Congruent recovery journeys
While the principles of the program remained the same,
the housing models di ere d at e ac h of th e fou r sites . e
models included shared accommodations and indepen-
dent, private-sector apartments.
6 Veterans who lived in
shared accommodations were o en concerned about
living with individuals who were at varying stages of
recovery from substance use. Although some Veterans
enjoyed the comradery associated with shared units,
issues frequently occurred when roommates were at in-
compatible recovery stages. For instance, Veterans who
were attempting to remain sober were sometimes placed
with individuals who were actively engaging in sub-
stance use. A Veteran described his negative experience
with roommates:
I mean, I’ve lived in shared accommodation … 30
roommates later in 4 years and I’ve had all these
people with schizophrenia and they’re all poking
up [on] the streets. Another guy smoking crack at
like 9 a.m. or drinking like crazy, we have nothing
in common.
erefore, most of the Veterans preferred living inde-
pendently. ey strongly agreed that housing programs
should ensure individuals are compatible prior to pair-
ing them together if roommates are required. Matching
individuals who were at di erent stages of recovery cre-
ated tension, con ict, and instability.
Theme 4. Location: close enough to ser-
vices, far enough from harm
e location of the housing programs also varied, with
some located more centrally than others. e location
of the programs was integral to both the wellbeing and
recovery of Veterans. For those who lived in less central
areas, location was o en a major barrier to accessing
important resources, such as grocery stores and health
care providers. Without access to transportation, it was
di cult for these Veterans to travel to essential services:
I found that I was stuck in the middle of nowhere …
Like half the services that I access here are all down-
town. Having to nd those services in (city name)
and (city name) takes some time.
Although living in less central locations created a bar-
rier to accessing services, most of the Veterans agreed
that housing programs should not be in downtown city
cores. ey felt these areas should be avoided due to the
high availability of illicit drugs and alcohol. Living in
areas where substance use is widespread could be detri-
mental for those recovering from addiction. Some Vet-
erans referred to downtown as “the belly of the beast”
and “skid row.”
I think we’re in a great spot. It’s better to put the
men in a place like here instead of downtown. I used
to like downtown but not anymore. Downtown, it’s
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Marsella, Forchuk and Oudshoorn
Journal of Military, Veteran and Family Health
doi:10.3138/jmv fh-2019-0042 2020 ▌( ▌)
▌
a lot of pests and bugs. Here it’s very clean and less
temptations [to use].
erefore, most of Veterans recommended housing sites
be located centrally, but far enough away from down-
town. is proposed location would not only facilitate
access to essential resources, but also prevent exposure
to substance-related harms.
Theme 5. Harm reduction is housing
stability, and housing stability
is harm reduction
Many Veterans described the necessity of implementing
harm reduction and Housing First to facilitate perma-
nent housing. In their opinion, securing stable and per-
manent housing should be the rst step in the recovery
process, as it creates stability. Having a stable home pro-
vided access to the resources Veterans needed to address
personal issues. For example, a Veteran explained it can
be di cult for programs and services to contact them
without a permanent address:
It all starts with a stable home. If [programs] can’t
contact you, you have nothing. … And nobody can
get a hold of you if you don’t have a place to stay or
if you don’t have access to a phone.
Being homeless also limited employment opportunities
for Veterans. However, with a permanent address, they
were no longer overlooked by employers due to the stig-
ma of being labelled “homeless.” Harm reduction and
Housing First also gave Veterans the time to address
their substance use. When they were homeless, they had
little time available to address the issues they were expe-
riencing; they were in a constant state of survival. Secur-
ing stable housing, however, eliminated daily concerns
about meeting basic needs. Referring to stable housing,
a Veteran explained:
It takes [away] 90% of the worry that you have
about where you’re going to be every morning. So,
without that worry, you can concentrate on trying
to clean up and get your life back together. You’re
not concentrating on trying to survive out there [on
the streets] all the time.
In some cases, harm reduction programming changed
the types of substances Veterans used:
When I came here, I was o the street. I was drink-
ing all kinds of shit, I mean all kinds. But, through
the harm reduction thing I could cut down to just
regular alcohol.
Securing stable housing also reduced the safety risks and
issues Veterans experienced while homeless. ey o en
described unsafe, and sometimes violent, conditions of
the streets and shelters. However, the housing programs
protected them from the dangers associated with home-
lessness.
DISCUSSION
e purpose of this study was to explore how homeless
Veterans experience and perceive harm reduction as
a component of stable housing. e theme regimented
structure revealed Veterans prefer a highly structured
living environment that mimicked military service. is
theme is supported by literature
3 , 15 that has shown struc-
tured housing supports Veterans during their recovery
from homelessness.
16 However, Veterans’ desire to dis-
cipline those who use substances indoors is contradicto-
ry to the harm reduction philosophy. Harm reduction
does not require abstinence, nor does it involve disci-
plining those who continue to use substances.
5 , 17 ere-
fore, Veteran-speci c Housing First programs may need
to consider how to incorporate structure for Veterans in
a way that is still congruent with harm reduction.
Understanding both worlds showed that peer sup-
port was essential to the Veterans’ recovery from sub-
stance use. Research has commonly cited peer support
as both an e ective evidence-based recovery model and
housing stability model.
18 , 19 Peer mentorships for Vet-
erans has also resulted in more e ective relationships
with providers, increased levels of social support, greater
quality of life, and improved psychological health.
20 – 22
Supplementing this evidence, this study has further re-
vealed peer support can produce positive outcomes for
Veterans recovering from homelessness and substance
use. Veteran-speci c housing programs may need to fur-
ther explore how to integrate peer support into services,
especially in private accommodations where it is not as
readily available.
e theme congruent recovery journeys aligns with
previous research showing mental health consumers,
including Veterans, prefer independent living.
23 – 25 H o w-
ever, if shared accommodations are o ered, Housing
First programs should ensure roommates are compatible
and matched based on recovery stages. Location: close
enough to services, far enough om harm revealed the
barriers associated with less central housing locations.
It emphasized the location of housing needs to not only
facilitate access to essential resources, but also limit ex-
posure to substance-related harms. Harm reduction is
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Harm reduction among Canadian Veterans experiencing homelessness
Journal of Military, Veteran and Family Health
▌( ▌) 2020 doi:10.3138/jmv fh-2019-0042
▌
housing stability and housing stability is harm reduction
established harm reduction created housing stability and
supported Veterans in their recovery. Evidence frequent-
ly shows harm reduction e ectively reduces the harms
of substance use.
26 – 28 Housing First has also resulted in
similar outcomes for both Veterans and non-Veterans ex-
periencing homelessness, including greater social func-
tioning, improved quality of life, and increased housing
retention. 29 In addition, homeless Veterans experience
similar physical health conditions as non-Veterans,
30 a n d
it has been suggested that Housing First may provide a
more supportive environment for Veterans to address
these challenges.
29 is study has further shown that
harm reduction and Housing First may be bene cial
to Veterans, as with other homeless groups. is study
has added to the literature and revealed Housing First
may need to consider the unique needs of Veterans, such
as the desire for structure, to more e ectively address
homelessness within this population.
Implications
is study’s ndings have the potential to inform poli-
cies to address Veteran homelessness in Canada. Partic-
ularly, a housing strategy that acknowledges the unique
needs of Veterans may e ectively address homelessness
among this group, since there is no one-size- ts-all solu-
tion to homelessness.
1 Exploring Veteran perceptions of
harm reduction may reveal the policy solutions to home-
lessness and substance use among this group. Speci cal-
ly, housing policies that incorporate harm reduction in
a way that is congruent with Veterans’ unique needs and
culture may address Veteran homelessness. Housing
First programs can also utilize the study ndings to pro-
vide housing that is tailored to the preferences of Vet-
erans. For example, many Veterans reported they were
incompatible with some housing and support workers.
To address this issue, programs may provide sta with
Veteran-speci c training, or advertise in job postings
a preference for candidates who have prior experience
working with Veterans. e value of peer support and
police participation in Housing First for Veterans was
also highlighted in this study.
Limitations
e predominantly white, male, sample may limit the
transferability of the ndings, as it did not fully de-
scribe the unique experiences of female, Aboriginal,
and Métis Veterans. Analysis of focus group data also
omitted the experiences of Veterans who chose not to
attend these groups. Veterans’ limited understanding of
harm reduction was a further limitation of this study.
Despite the perceived bene ts of harm reduction, a gen-
eral misunderstanding of this approach existed among
this group.
Conclusions
is study con rmed homeless Veterans are a unique
population and harm reduction is an important part of
Housing First for Veterans. Analysis of focus group data
from e Canadian Model for Housing and Support
of Veterans Experiencing Homelessness
6 study revealed
various themes that captured Veterans’ understanding
of this approach. Overall, this study showed Veterans
require stable housing that, not only incorporates harm
reduction principles, but also takes into consideration
their unique military background and experiences.
Housing First programs, the government, and service
providers can utilize these ndings to ensure the unique
housing and addiction needs of Canadian Veterans are
adequately addressed.
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Available from: http://homelesshub.ca/sites/default/
les/SOHC16_ nal_20Oct2016.pdf .
2. Bourque J , VanTil L , LeBlance S , et al. Correlates of
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AUTHOR INFORMATION
Olivia Marsella, RN, MScN, recently completed her
Master of Science in Nursing degree at Western University.
She currently works as the Float Registered Nurse for the
seven Assertive Community Treatment teams at St. Joseph’s
Health Care London. She provides intensive support to
individuals living with severe and persistent mental illness
and assists them in regaining the skills to live meaningful
and ful lling lives in their community.
Cheryl Forchuk, RN, PhD is the Beryl and Richard Ivey
Research Chair in Aging, Mental Health, Rehabilitation
and Recovery; a Distinguished University Professor in
the Arthur Labatt Family School of Nursing at Western
University; and Scientist and Assistant Director at Lawson
Health Research Institute. She has published on many topics
including transitional discharge, technology in mental
health care, and poverty, housing, and homelessness. She
has been honoured with numerous awards throughout her
career, including the Order of Ontario.
Abe Oudshoorn, RN, PhD is an Assistant Professor in
the Arthur Labatt Family School of Nursing at Western
University. Having worked as a nurse with people
experiencing homelessness, Dr. Oudshoorn’s research
focuses on health equity through housing stability. Dr.
Oudshoorn is past chair of the London Homeless Coalition,
a Canada 150 medal recipient, and remains an advocate
for translating research knowledge into practice for those
experiencing housing loss.
COMPETING INTERESTS
None declared.
is article has been peer reviewed.
CONTRIBUTORS
Olivia Marsella conceived the study, selected the research
questions, analyzed the data, and dra ed the manuscript.
Cheryl Forchuk and Abe Oudshoorn edited and revised the
manuscript and approved the nal version submitted for
publication.
FUNDING
None declared.
https://jmvfh.utpjournals.press/doi/pdf/10.3138/jmvfh-2019-0042 - Friday, May 01, 2020 7:00:14 AM - IP Address:198.2.82.178
