In this episode, Dr. Cheryl Forchuk — a leading Canadian researcher and mental health nurse — traces how hospitals shifted from rarely discharging patients into homelessness to doing so with alarming frequency.

In the 1980s, a discharge to “no fixed address” was so unusual it set off hospital-wide concern. By the 2000s, it had become routine. Forchuk led landmark studies showing that simple changes at discharge, such as connecting patients to housing advocates and fast-tracking income supports, could prevent homelessness altogether. These interventions not only stabilized lives, but also reduced strain and costs across the healthcare system.

We explore how hospitals can play a huge role in preventing homelessness and why homeless prevention is both cheaper and more effective than relying on emergency responses.

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Guest: Dr. Cheryl Forchuk is Distinguished University Professor at Western University and Assistant Director at the Lawson Health Research Institute. A registered nurse and researcher, she has spent decades leading collaborative studies on the intersections of homelessness, housing, and mental health. Her work has shaped discharge planning practices, Housing First models, and national policy conversations on treating housing as healthcare. This summer she was appointed to the Order of Canada.

Topics Covered:

• How discharges from hospitals became a pathway into homelessness
• Landmark studies on preventing “No Fixed Address” at discharge
• Why homelessness increases healthcare costs and hospital stays
• How health data suggests homeless numbers could be 3x higher than we thought
• Practical models to overcome agency silos and scale homeless prevention nationally

Studies referenced:

• Developing and Testing an Intervention to Prevent Homelessness among Individuals Discharged from Psychiatric Wards to Shelters and ‘No Fixed Address’ (2008)
• Preventing Psychiatric Discharge to Homelessness (2013)
• Hospital discharge planning for Canadians experiencing homelessness (2018)
• Validation study of health administrative data algorithms to identify individuals experiencing homelessness and estimate population prevalence of homelessness in Ontario, Canada (2019)
• Preventing Discharge to No Fixed Address – Version 2: Evaluation of a Best Practice Program to Prevent Discharge from Hospital into Homelessness (2023)
• Collaboration to Address Homelessness: Health, Housing, and Income (H2I) (2023)
• Opioid-related overdose deaths among people experiencing homelessness, 2017 to 2021: A population-based analysis using coroner and health administrative data from Ontario, Canada (2023)
• Community Stakeholders’ Perceptions of the Impact of the Coronavirus Pandemic on Homelessness in Canada (2023)
• Pathways of displacement: A pan-Canadian perspective on the nature and dynamics of rural and remote homelessness (2024)

Production:

• Producers: Tristan Markle, Lina Moskaleva, and CJ Tremblay
• Sound and original music: Matthew Hayter, matthewhaytermusic.com
• This podcast is a project of The Publication Cooperative
• If you have thoughts, feedback, or ideas, email us at policycrimes@thepublication.ca