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Item type:Item, Sites and Shapes of Transinstitutionalization(Canadian Disability Studies Association, 2020-09-26) Leblanc Haley, Tobin; Temple Jones, ChelseaThe study of transinstitutionalization necessarily varies by context. In this issue we guard against misconceptions that institutionalization is an action that took place in the past, whose loose ends we are now trying to tie together and where contemporary institutionalizing conditions are merely legacies that will, in time, fade away. To think of institutionalization as something of the past is to gently scratch its surface. And, given the wide breadth of transinstitutionalization and the many lives and stories it encompasses, we are aware of the limitations of covering this vast topic in one special issue. Yet, following a call to include disability in developing new approaches to understanding modernity (Van Trigt, 2019), our aim with this collection is to gather the latest research and reflections on transinstitutionalization as a topic that can take flight in our theoretical and cultural imaginations, a topic that can help us transcend the dangers of “theoretical complacency” that come with imagining the ongoing as a past, one-time thing (Bauman, 2000, p. 3).Item type:Item, Intimate constraints: a feminist political economy analysis of biological reproduction and parenting in high-support housing in Ontario(Nature, 2017-12-19) LeBlanc Haley, TobinTo date there has been little consideration of the role of housing programs in conditioning the intimate lives of people living with mental illness labels. This article employs a Feminist Political Economy lens with insights from Mad & Disability Studies to interrogate the intimate constraints experienced by some residents in high-support mental health housing in Ontario, Canada. It demonstrates that long-standing medicalized notions of mental illness and system-wide anxiety over the social and financial costs of the reproduction of disabled bodies give rise to these intimate constraints, specifically limitations and control over biological reproduction and parenting practices. In this way, the mechanisms of intimate constraint within high-support housing are not merely holdovers from a time gone by, but are rather part of a mental health care system guided by the principles of neoliberalism under which neo-eugenics is regularly enacted. This is a timely contribution, as the province of Ontario is currently planning to expand the supportive housing system within which high-support housing is situated and because high-support housing in Ontario is rarely studied in relation to feminist political economy and/or mental health care. This article draws on documentary review of governmental and third-sector materials and 38 semi-structured interviews with service providers and residents in the high-support housing system in Ontario. It situates intimate constraints within the long history of eugenics and neo-eugenics in Ontario and Canada, and the classed, raced, and gendered hierarchy of human bodies that is taking on new forms under neoliberalism.Item type:Item, Resident Work in High-Support Housing(Canadian Disability Studies Association, 2018) LeBlanc Haley, TobinWhile feminist political economists have identified social service provisioning as socially reproductive work and have examined its reorganization under neoliberalism, little attention has been paid to the mental health care sector. Furthermore, within feminist political economy scholarship on work in the social service sector, little attention has been paid to the contributions of service users. I address some of these gaps by developing a Mad feminist political economy framework to analyze the unpaid socially reproductive work completed by residents in high-support psychiatric housing in Ontario today. Drawing on data from interviews with 23 residents and 15 service providers in high-support psychiatric housing in Ontario, as well as a review of government and non-profit organization documents, I argue that the work done by residents alleviates demands on social service workers in a time of neoliberal restraint, intensified workplace demands, and a heightened focus on service user independence in all aspects of life. I then conclude with recommendations for change.Item type:Item, “Talk with me”: perspectives on services for men with problem gambling and housing instability(Springer Nature, 2016-08-02) Guilcher, Sara J. T.; Hamilton-Wright, Sarah; Skinner, Wayne; Woodhall-Melnik, Julia; Ferentzy, Peter; Wendaferew, Aklilu; Hwang, Stephen W.; Matheson, Flora I.Background Problem gambling and homelessness are recognized as important public health concerns that significantly impact individuals, their friends and families, communities and broader society. We aimed to explore the experiences with health and social services of men who had histories of problem gambling and housing instability in Toronto, Ontario. Methods We used a community-based participatory approach with a multi-service agency serving low-income individuals. We conducted qualitative interviews with men (n = 30) who had experienced problem gambling and housing instability. Our interviews employed open-ended questions to elicit men’s perceptions of services related to housing instability, problem gambling and other comorbid conditions (e.g., mental illness, substance use). We reviewed relevant themes related to experiences with services (e.g., Use of and feedback on: health and social services, housing services, justice/legal aid services, substance use services, gambling services; stigma; goals; triggers; physical health; coping strategies; finances; relationships; barriers to services and recommendations for services). Results The concept of person-centred engagement was identified as a main overarching theme, and seemed to be lacking in most of the men’s experiences of services. Person-centred engagement for these men entailed empowerment and autonomy; empathy, compassion and sincerity; respectful communication; and tailored and holistic life plans. While there was a strong emphasis placed on independence, the men identified the importance of positive therapeutic relationships as being critical aspects of the recovery process. Based on our analyses, several recommendations were identified: 1) Increasing general awareness of services for problem gambling; 2) Delivering integrated services in a one-stop-shop; 3) Addressing mental health with psychotherapy and pharmacotherapy; 4) Providing timely access to prevention and recovery services; and 5) Enhancing life skills with peer support. Conclusions Our study highlighted that most of the men we interviewed were not having their health and social needs met. Services need to address the intersection of problem gambling, housing instability, and other comorbidities. Ensuring services are grounded in person-centred engagement appears to be critical for optimal service delivery.Item type:Item, Testing the theory of change for Housing First: a secondary qualitative analysis of gender differences in the experiences of men and women in the AH/CS trial(BMJ Journals, 2025-07-28) Alfayumi- Zeadna, Samira; Perri, Melissa; Mejia- Lancheros, Cilia; Woodhall, Julia; Kirst, Maritt; Douglin, Margaret; Reiser, Chloe; O’Campo, PatriciaObjectives: Housing First (HF) is an evidence-based approach to ending homelessness, particularly for individuals with mental illness. Yet, limited research explores which aspects of HF programmes facilitate change over time, within the context of a programme theory of change (ToC). A particular research gap includes how mechanisms of change within HF programmes differ between men and women. This study examines gender-specific pathways of change in the HF model based on secondary qualitative data from Toronto’s original At Home/Chez Soi (AH/CS) trial, focusing on outcomes of housing stability, socio-economic status, health and overall well-being. Design: This was a secondary qualitative analysis of the AH/CS trial data. This analysis was guided using a gender-sensitive ToC framework. Settings: This multisector study was conducted in a large Canadian urban centre in Toronto, Canada. Participants: A total of 32 participants (23 men and nine women) who identified themselves as male or female, 18 months after their enrolment in the treatment arm of the Toronto site of the AH/CS randomised controlled trial. Data collection and analysis: Semistructured interviews were conducted as part of the trial’s qualitative study. Thematic analysis was guided by the ToC framework and conducted using NVivo software. We assessed differences between men and women across the following outcome domains: housing stability, financial status, physical and mental health, substance use recovery and inpatient care. Results: The findings largely confirmed the ToC with participants, particularly women, experiencing greater improvements across all mechanisms of change, especially in housing stability, financial status and health outcomes. Men faced ongoing challenges, including difficulty maintaining stable income, limited engagement with education/training and continued struggles with mental health and substance use. Despite these improvements, both men and women participants reported ongoing challenges in achieving consistent income and accessing education or training opportunities. Conclusions: This study provides insight into how mechanisms of change within HF programmes differ between men and women. It underscores the need for ongoing programme adaptation and gender-responsive evaluation to meet the diverse needs of individuals, particularly those with mental health illness and histories of chronic homelessness.
