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Homelessness was already a well-known risk factor contributing to premature death, morbidity, mental illness, and substance use disorder. The coronavirus disease for 2019 (COVID-19) pandemic has amplified disparities in Canada’s public health system, disproportionately impacting people experiencing homelessness. The present study aimed to investigate the impact of the COVID-19 pandemic on the homelessness situation in Canada from community stakeholders’ perceptions. The study used qualitative research approaches underlain by focused ethnography tenets. The sample includes 200 service providers from 28 communities across Canada (at least one site in each province and territory) to participate in virtual focus groups. Data analysis followed a four-step ethnographic approach for thematic analysis in qualitative research. Six main themes emerged: (a) system changes precipitated by the COVID-19 pandemic; (b) personal changes in life circumstances; (c) previous strategies no longer working; (e) opportunities; (d) some things getting better; (f) an overall increase in first time and recurrent homelessness in Canada. The study findings underscored mechanisms required to help ‘tip the scale’ in affording people experiencing homelessness the opportunity to avoid or exit homelessness.

The “No Fixed Address” version 2 (NFAv.2) project tested the efficacy of a potential best practice program that aimed to prevent discharge from hospital into homelessness. Forchuk and colleagues developed a system that streamlined housing and social supports using on-site access to help inpatients in a psychiatric unit who were homeless or at-risk of homelessness find safe, affordable housing. A total of 370 individuals accessed the NFAv.2 program between August 2017 and May 2020. Of these, 88 participants who accessed the intervention were enrolled in the evaluation of the project. Information on housing history and housing outcomes were collected during hospital admission and at 3-time points post-discharge. Focus groups were conducted for program participants, health care staff, and community partners to gather information regarding their experiences with the program. Of those who participated in the intervention, 80% were housed and remained housed at 12 months post-discharge. Results from focus groups also indicated that the majority of NFAv.2 clients, staff, and community partners were satisfied with the intervention. Since homelessness has a detrimental effect on recovery, client safety, and healthcare expenditures, locating safe housing has had a positive impact on treatment, rehabilitation, and the healthcare system as a whole. The findings of this project offer policy alternatives for the prevention of homelessness for at-risk individuals.