Dr. Carrie Marshall stands at the forefront of a critical mission: supporting the well-being of individuals experiencing homelessness. With a deeply rooted passion for social justice and human rights, Carrie’s journey into this field began during her studies in Occupational Therapy, where she encountered a glaring gap in the support systems for those transitioning out of homelessness. Motivated by a desire to make a tangible difference, she embarked on a mission to understand and address the multifaceted challenges faced by this group of people.

Reflecting on her journey, Carrie says, “I started in my PhD working on helping to identify how to support people to transition to housing following homelessness. What we know is that when people are housed following homelessness, their psychosocial well-being isn’t necessarily improved…I realized that when people get a home after being homeless, they still often feel lonely or like they don’t fit in.” This realization served as a catalyst for her research, driving her to explore innovative solutions to enhance the lives of people who have experienced homelessness.

Carrie’s groundbreaking work led to the development of the Peer-to-Community model, a holistic initiative that combines peer support and occupational therapy to facilitate the integration of individuals into their communities following homelessness. Rooted in the principles of empowerment and community building, this model has shown promising results in helping participants rebuild social networks and regain a sense of belonging.

“I believe that community integration is essential for individuals transitioning out of homelessness,” Carrie asserts. “The Peer-to-Community model provides a supportive framework for individuals to reconnect with their communities and rebuild their lives with dignity and respect.”

Beyond her research endeavors, Carrie is committed to countering the stigma surrounding homelessness—a pervasive issue that often exacerbates the challenges faced by those experiencing homelessness. Recognizing the power of education and awareness, she launched the “At Least Five Ways” initiative—an innovative campaign aimed at empowering youth and young adults to challenge stereotypes and foster empathy through creative expression.

Explaining the inspiration behind the campaign, she says, “One thing that holds people back from integrating into their communities following homelessness is the stigma associated with having experienced homelessness. By empowering young people to engage in dialogue and raise awareness, we hope to spark meaningful change in societal perceptions.”

The “At Least Five Ways” initiative invites participants to create animated videos highlighting innovative approaches to reducing stigma and promoting understanding. Through these videos, participants share personal experiences, challenge stereotypes, and offer practical solutions to address homelessness stigma. By fostering empathy and understanding, Dr. Marshall believes that we can create a more inclusive and supportive environment for people rebuilding their lives after experiencing homelessness.

As Carrie continues her research and advocacy efforts, her commitment remains steadfast. With every project, she strives to make a meaningful impact and advocate for the rights and dignity of individuals experiencing homelessness. Through collaboration, education, and empathy, she believes that we can create a more just and inclusive society for all. Dr. Carrie Marshall’s work serves as a beacon of hope, inspiring positive change and paving the way for a brighter future for generations to come.

Here are some papers directly related to this work:

Marshall, C.A., Holmes, J., Todd, E., Panter, G., *Plett, P., *Easton, C., *Perez, S., Landry, T., Collins, S., Jastak, M., Murray, R., *Goldszmidt, R., Rudman, D., Carlsson, A., Oudshoorn, A. & Forchuk, C. (2024). Co-designing the “Peer to Community (P2C) Model”: an intervention for promoting community integration following homelessness. International Journal on Homelessness. In press.

Marshall, C., *Cooke, A., *Bengall, J., Holmes, J., Aryobi, S., Phillips, B., Lysaght, R. & Gewurtz, R. (2024). “It’s like your days are empty and yet there’s life all around”: A mixed methods, multi-site study exploring boredom during and following homelessness. PLOS One. https://doi.org/10.1371/journal.pone.0302900

Marshall, C., Phillips, B., Holmes, J., Todd, E., Hill, R., Panter, G., *Easton, C., Landry, T., Collins, S., Greening, T., O’Brien, A., Jastak, M., Ridge, R., *Goldszmidt, R., *Shanoff, C., Laliberte Rudman, D., Carlsson, A., Aryobi, S., *Szlapinski, J., *Carrillo-Beck, R., *Pacheco, N., *Perez, S., Oudshoorn, A. (2023). “I can’t remember the last time I was comfortable about being home”: lived experience perspectives on thriving following homelessness. International Journal of Qualitative Studies on Health and Well-being, 18(1), 2176979. https://doi.org/10.1080/17482631.2023.2176979. [Contribution: 75%; IFR 2.179; Citations: 0]

Marshall, C., *Easton, C., Phillips, B., Boland, L., Isard, R., Holmes, J., *Shanoff, C., *Hawksley, K., Landry, T., *Goldszmidt, R., Aryobi, S., *Plett, P. & Oudshoorn, A. (2022). Experiences of transitioning from homelessness: A systematic review and meta-aggregation of qualitative studies conducted in middle to high income countries. Journal of Social Distress and Homelessness. Online ahead of print. 1-22. https://doi.org/10.1080/10530789.2022.2141868.

Marshall, C.A., Phillips, B., Holmes, J., Todd, E., Hill, R., Panter, G., *Easton, C., Landry, T., Collins, S., Greening, T., O’Brien, A., Jastak, M., Ridge, R., *Goldszmidt, R., *Shanoff, C., Laliberte Rudman, D., Carlsson, A., Aryobi, S., *Perez, S. & Oudshoorn, A. (2022). ‘We stick people in a house and say okay, you’re housed. The problem is solved’: A qualitative study of service provider and organisational leader perspectives on thriving following homelessness. Health & Social Care in the Community. Online ahead of print. https://doi.org/10.1111/hsc.14035

Marshall, C., Boland, L., Westover, L., Marcellus, B., Weil, S. & Wickett, S. (2020). Interventions to address community integration in homeless persons: A systematic review. Health and Social Care in the Community, 26(8), 1843-1862. https://doi.org/10.1111/hsc.13030

Applications now open for the 2024-25 EnAbling Change Program

The Ontario government is investing up to $1.5 million in the EnAbling Change Program this year to support not-for-profits, municipalities, and other organizations across the province that are developing and implementing innovative initiatives to make Ontario accessible to people of all abilities.

“By working together with businesses, organizations and communities, we can build a stronger and more accessible Ontario,” said Raymond Cho, Minister for Seniors and Accessibility. “The EnAbling Change Program allows organizations to develop tailored supports to ensure Ontario is open and inclusive to everyone.”

Applications for the 2024-25 EnAbling Change Program are open now until June 27, 2024. Eligible projects can include those that increase the accessibility of community programs and services, as well as online initiatives, educational tools, and public outreach programs that help communities and businesses understand the benefits of accessibility and inclusion.

Examples of projects currently funded through the 2023-24 program include:

• BioTalent Canada is receiving approximately $150,000 to promote equitable employment opportunities for people with disabilities.
• The Geneva Centre for Autism is receiving approximately $112,500 to create The Inclusive Education Resource Hub to support better outcomes and experiences for neurodiverse students in publicly funded education.
• The Canadian Apprenticeship Forum is receiving approximately $100,000 to develop a guide for employers on recruiting and retaining apprentices with disabilities in the skilled trades.
• Toronto Metropolitan University is receiving approximately $150,000 to develop, pilot and disseminate a curriculum called The Enabling Accessible Healthcare Delivery project, which aims to foster accessible and sensitive health care for disabled people.

The Ministry for Seniors and Accessibility’s Age-friendly and accessibility grants web page has information on how to apply for the 2024-25 EnAbling Change Program.

Quick Facts

• The EnAbling Change Program started in 1999 and has supported more than 230 projects across Ontario. It provides funding to municipalities, not-for-profit, industry and professional associations across a range of sectors.

Additional Resources

• 2023-24 EnAbling Change Program Recipients
• Learn about ways that inclusion improves business.
• Find out how you can make your organization more accessible and inclusive.

Are you ready to make a difference in combating the stigma of homelessness? Ontario’s Ministry of Colleges and Universities, in collaboration with Dr. Carrie Anne Marshall from Western University, is launching an exciting initiative called the “At Least Five Ways” campaign. This campaign aims to engage youth and young adults across Ontario in generating ideas to reduce the stigma associated with homelessness.

What’s the Campaign About?

Funded by the Ministry of Ontario Colleges and Universities, this initiative focuses on raising awareness and fostering discussions about homelessness in Canada. Dr. Carrie Anne Marshall’s research project at Western University, called the “Peer to Community (P2C)” model, is at the heart of this campaign. The P2C model aims to help individuals integrate into their communities after experiencing homelessness.

The “At Least Five Ways” Campaign: How Does It Work?

Every May, youth and young adults aged 16-30 in Ontario are invited to submit videos of 2-5 minutes in length. These videos should propose “At Least Five Ways” to reduce the stigma of homelessness in Canadian communities. Submissions can be made by individuals or teams.

Participating in the Campaign: What You Need to Know

• Eligibility: Youth and young adults aged 16-30 residing in Ontario are eligible to submit videos. Both individuals and teams can participate.
• Video Content: To protect privacy, only animated videos are accepted. Videos should not contain personal information that could compromise individuals’ safety.
• Submission Deadline: Videos must be submitted by May 31st, 2024.
• Video Creation Tools: Several free programs are available for creating animated videos, including Canva, Adobe Express, Powtoon, Moovly, and Renderforest.

Recognition and Awards

The winning video will be featured on the P2C website and social media pages. The individual or team behind the winning video will receive a $200 award and a certificate recognizing their contribution to reducing homelessness stigma in our communities.

How to Submit Your Video

When your video is ready, use the following link to submit: Submit Your Video Here

Campaign Timeline

The submitted videos will be circulated on social media and the P2C website throughout June 2024.

Join the Movement!

Let’s work together to break the stigma of homelessness. Your creative ideas can make a real difference. Get your videos ready, submit them by May 31st, and let’s spread awareness and compassion throughout our communities!

Learn More

Visit the campaign website to learn more: At Least Five Ways Campaign

For any questions, feel free to contact at: AtLeastFiveWays@peer2community.ca

Let’s make change happen!

 High Level Summary of Key Discussions & Next Steps

 On February 16th, 2024 CRHESI hosted an event on the importance of generating and mobilizing research and evaluation knowledge in ways informed by trauma-and violence informed care (TVIC) and equity principles. Panel discussions and small groups centered on the creation and implementation of rigourous and impactful evaluation methods, while also exploring strategic, respectful and effective approaches to knowledge sharing and use. 

This synthesis highlights the importance of building relationships, managing expectations, and effectively communicating narratives surrounding health and homelessness. It emphasizes the need for community involvement, TVIC approaches, and equitable representation in research and storytelling. Through respectful engagement, diverse perspectives, and transparent communication, efforts can be made to counter stigma, shift negative perceptions, and promote positive change in addressing health and homelessness in London. 

Trauma and Violence-Informed Care 

Trauma-informed care establishes a safe environment for service users by recognizing the effects of trauma and its close association with health and behaviour, focusing on understanding rather than eliciting or treating individual trauma. Expanding on this approach, trauma- and violence-informed care (TVIC) acknowledges the intersecting impacts of systemic and interpersonal violence, as well as structural inequities, on a person’s life. It emphasizes both historical and ongoing violence and their traumatic effects, shifting the focus to encompass a person’s experiences of past and present violence, including marginalized social circumstances. 

Embedding TVIC Principles in Producing & Sharing Evaluation Knowledge: Overarching Considerations

• Collaborate to design questions, and collect and use data efficiently, effectively and safely. 
• Evaluation questions and designs should focus on addressing structural and systemic violence and be analysed and interpreted to show the impact of these factors on individuals and groups. 
• Shift from identifying problems to understanding ongoing issues and traumatic impacts. 
• Acknowledge trauma’s complexity influenced by genetic, biological, and social factors and how it can look in research interactions – prepare all staff accordingly. 
• Recognize substance use as a continuum and address stigma as it often causes the most harm. 

What to Evaluate about London’s New Housing Support Interventions: 

(Hubs, Highly Supportive Housing, Encampment Strategy, etc.) 

• Emphasis on critical role of these supports in connecting with and meeting people where they’re at and moving them to the kind of housing they need:
  • describe and evaluate these pathways and outcomes across intervention types;
    • importance of individual and intersectional experiences, and collective action;
    • use data purposefully and transparently;
  • demonstrate (cost-)effectiveness of interventions to influence public policy and to highlight barriers.
• Examine the impact of new approaches and spaces on staff transitions, wellbeing and job satisfaction.
• Initial Hubs (youth, women, Indigenous) aim to fill most pressing needs exacerbated by the COVID-19 pandemic – include this framing in interpretation of findings.

Managing Expectations, Hopes and Fears: 

• Manage expectations about what can and might be found by maintaining communication.
• Collaboration between academia and the community to address biases in data interpretation.
• Concerns about political manipulation of data and importance of honesty in evaluation.
• Significance of telling accurate stories to reflect realities of marginalized communities.

Specific Strategies for Safe & Inclusive Participation: 

• Use existing relationships to help recruit; ensure fair payment, though people should not feel they can’t afford to decline to get money or service (i.e., recruitment arms’ length from staff but using their advice).
• Address concerns about privacy and confidentiality during recruitment; build data protection into all practices and strategies.
• Let participants tell their stories but ensure support is available during data collection, interpretation (e.g., member checking) and when data are made public (anticipatory guidance to avoid surprises).
• Train all research staff in TVIC, cultural safety & humility, and inclusive and respectful communication with all participants; emphasize (e.g., role play) strategies to build trust and comfort.

Sharing and Mobilizing Knowledge: 

• Emphasize inclusivity, respect, timeliness and collaboration in communication and engagement efforts.
• Use clear, concise and destigmatizing language and point to systems and structures that need to change (i.e., don’t use data to blame staff or service users for their individual circumstances or behaviours).
• Use data enhanced with narrative and share in multiple formats (including photos, art, poetry, videos, song, etc.) to tell the story of the work in ways accessible and safe for all involved.
• Proactively understand public concerns and expectations and develop a communications plan to prepare the public (and politicians) for various types of findings.
• Continuously evolve and iterate knowledge-sharing strategies.
• Actively create and “field test” de-stigmatizing, equity-promoting messages for the London community, particularly regarding health and homelessness, regardless of study findings.

Engaging Indigenous & Racialized People and Groups Across Activities: 

• Listen, build relationships, and support people and groups (as they’re willing) in decision-making.
• Include diverse perspectives, decolonizing approaches, and ensure benefit for those facing most harm.

Next Steps for CRHESI’s H&H Facilitators

1. Convene first 4 research/evaluation teams and outline key evaluation questions with input from Tables:
   • Experiences and Outcomes of Defined Groups
   • Experiences and Outcomes of Direct Service Workers
   • Systems, Structures, Processes, and Cost of Care
   • Overall WCR Process Review
2. Support each team in developing research/evaluation plans, ethics protocols, funding applications, etc.
3. Support London CARES and LHSC to document their outcomes in the new Dundas St. highly supportive housing site.
4. Develop templates, guides and trainings for researchers/evaluators to ensure safety, consent, privacy, confidentiality, and community engagement in research, evaluation and knowledge sharing processes.
5. Continued efforts towards inclusive and respectful communication and engagement, especially with local Indigenous partners and the new Indigenous Reference Table