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Bringing politics and evidence together: Policy entrepreneurship and the conception of the At Home/Chez Soi Housing First Initiative for addressing homelessness and mental illness in Canada

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  • Macnaughton, Eric
  • Nelson, Geoffrey
  • Goering, Paula

Abstract

An interesting question concerns how large-scale (mental) health services policy initiatives come into being, and the role of evidence within the decision-making process behind their origins. This paper illustrates the process by which motivation to address homelessness, in the context of the upcoming 2010 Vancouver Olympics, was leveraged into a pan-Canadian project including sites in Vancouver, Winnipeg, Toronto, Montreal and Moncton, New Brunswick. The aim of the initiative was to implement and evaluate an intervention, Housing First, to provide housing and support to previously homeless people with mental illness. This qualitative case study was conducted between December 2009 and December 2010, employing grounded theory, and drawing on archival documents and interviews with 19 key informants involved in the conception of the project. Overall, the findings affirm that policy-making does not follow a rational, linear process of knowledge translation/exchange (KTE) and implementation, whereby evidence-based “products” are brought forward to address objectively determined needs and then “placed into decision-making events” (Lomas, 2007, p. 130). Instead, evidence-based policy making should be understood within the much more complex context of “policy entrepreneurship” (Kingdon, 2003; Mintrom & Norman, 2009) which entails taking advantage of windows of opportunity, and helping to bring together the “streams” of problems, politics, and policy ideas (Kingdon, 2003).

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  • Macnaughton, Eric & Nelson, Geoffrey & Goering, Paula, 2013. "Bringing politics and evidence together: Policy entrepreneurship and the conception of the At Home/Chez Soi Housing First Initiative for addressing homelessness and mental illness in Canada," Social Science & Medicine, Elsevier, vol. 82(C), pages 100-107.
    • Handle: RePEc:eee:socmed:v:82:y:2013:i:c:p:100-107
    DOI: 10.1016/j.socscimed.2013.01.033
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    References listed on IDEAS

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    1. Waddell, Charlotte & Lavis, John N. & Abelson, Julia & Lomas, Jonathan & Shepherd, Cody A. & Bird-Gayson, Twylla & Giacomini, Mita & (Dan) Offord, David R., 2005. "Research use in children's mental health policy in Canada: Maintaining vigilance amid ambiguity," Social Science & Medicine, Elsevier, vol. 61(8), pages 1649-1657, October.
    2. Ward, Vicky & Smith, Simon & House, Allan & Hamer, Susan, 2012. "Exploring knowledge exchange: A useful framework for practice and policy," Social Science & Medicine, Elsevier, vol. 74(3), pages 297-304.
    3. Tsemberis, S. & Gulcur, L. & Nakae, M., 2004. "Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals with a Dual Diagnosis," American Journal of Public Health, American Public Health Association, vol. 94(4), pages 651-656.
    4. Barbara Wake Carroll & Ruth J. E. Jones, 2000. "The Road to Innovation, Convergence or Inertia: Devolution in Housing Policy in Canada," Canadian Public Policy, University of Toronto Press, vol. 26(3), pages 277-293, September.
    5. Battams, Samantha & Baum, Fran, 2010. "What policies and policy processes are needed to ensure that people with psychiatric disabilities have access to appropriate housing?," Social Science & Medicine, Elsevier, vol. 70(7), pages 1026-1034, April.
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    Cited by:

    1. Guta, Adrian & Strike, Carol & Flicker, Sarah & J. Murray, Stuart & Upshur, Ross & Myers, Ted, 2014. "Governing through community-based research: Lessons from the Canadian HIV research sector," Social Science & Medicine, Elsevier, vol. 123(C), pages 250-261.
    2. Evans, Joshua & Collins, Damian & Anderson, Jalene, 2016. "Homelessness, bedspace and the case for Housing First in Canada," Social Science & Medicine, Elsevier, vol. 168(C), pages 249-256.
    3. Nelson, Geoffrey & Stefancic, Ana & Rae, Jennifer & Townley, Greg & Tsemberis, Sam & Macnaughton, Eric & Aubry, Tim & Distasio, Jino & Hurtubise, Roch & Patterson, Michelle & Stergiopoulos, Vicky & Pi, 2014. "Early implementation evaluation of a multi-site housing first intervention for homeless people with mental illness: A mixed methods approach," Evaluation and Program Planning, Elsevier, vol. 43(C), pages 16-26.
    4. Clifford, Brendan & Wilson, Andrew & Harris, Patrick, 2019. "Homelessness, health and the policy process: A literature review," Health Policy, Elsevier, vol. 123(11), pages 1125-1132.

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